Clinical Neuroradiology最新文献

{"title":"How Topographic Diffusion-Weighted Imaging Patterns can Predict the Potential Embolic Source.","authors":"Y Yamamoto, Y Nagakane, E Tanaka, T Yamada, J Fujinami, T Ohara","doi":"10.1007/s00062-023-01366-z","DOIUrl":"10.1007/s00062-023-01366-z","url":null,"abstract":"<p><strong>Purpose: </strong>To develop an imaging prediction model for patients with embolic stroke of undetermined source (ESUS), we investigated the association of topographic diffusion-weighted imaging (DWI) patterns with potential embolic sources (PES) identified by transesophageal echocardiography.</p><p><strong>Methods: </strong>From a total of 992 consecutive patients with embolic stroke, 366 patients with the ESUS group were selected. ESUS was defined as no atrial fibrillation (Af) within 24h from admission and no PES after general examination. Clinical variables include age (> 80years, 70-80 years), sex, vascular risk factors and left atrial diameter > 4 cm. Age, sex and vascular risk factors adjusted odds ratio of each DWI for the different PESs were calculated. DWI was determined based on the arterial territories. Middle cerebral arteries were divided into 4 segments, i.e., M1-M4. Moreover, M2 segments were subdivided into superior and inferior branches.</p><p><strong>Results: </strong>The 366 patients consisted of 168 with paroxysmal Af (pAf), 77 with paradoxical embolism, 71 with aortic embolism and 50 with undetermined embolism after transesophageal echocardiography. The variables adjusted odds ratio (OR) of internal carotid artery (OR: 12.1, p = 0.037), M1 (4.2, p = 0.001), inferior M2 (7.5, p = 0.0041) and multiple cortical branches (12.6, p < 0.0001) were significantly higher in patients with pAf. Striatocapsular infarction (12.5, p < 0.0001) and posterior inferior cerebellar artery infarcts (3.6, p = 0.018) were significantly associated with paradoxical embolism. Clinical variables adjusted OR of multiple small scattered infarcts (8.3, p < 0.0001) were significantly higher in patients with aortic embolism.</p><p><strong>Conclusion: </strong>The associations of DWI with different PES have their distinctive characteristics and DWI along with clinical variables may help predict PES in patients with ESUS.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"363-371"},"PeriodicalIF":2.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089099","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":"Severe Complications After Ozone Therapy-related Stroke : A Case Report.","authors":"Daniel S Marín-Medina, Jimmy Hadid Anzueta, Adriana P Ortega-Quintero, Jorge Carrizosa","doi":"10.1007/s00062-023-01379-8","DOIUrl":"10.1007/s00062-023-01379-8","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"511-514"},"PeriodicalIF":2.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565163","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":"Mechanical Thrombectomy for Aseptic, Atraumatic, Medically Refractory Cerebral Venous Sinus Thrombosis: a Systematic Review.","authors":"John B Quealy","doi":"10.1007/s00062-023-01373-0","DOIUrl":"10.1007/s00062-023-01373-0","url":null,"abstract":"<p><strong>Background: </strong>Cerebral venous sinus thrombosis (CVST) follows a severe clinical course in 13.5% of cases. Practice guidelines recommend endovascular therapy (EVT); no randomised control trials (RCTs) exist comparing EVTs.</p><p><strong>Purpose: </strong>To determine whether specific EVTs are superior to alternatives.</p><p><strong>Data sources: </strong>CENTRAL, Medline, Embase, five other databases and four clinical trials registers. Grey literature searches, reference checking, citation searching, and author contact.</p><p><strong>Study selection: </strong>All CVST cases treated with mechanical thrombectomy (MT) were includible. Paediatric, and trauma-related or infection-related thromboses were excluded.</p><p><strong>Data analysis: </strong>Standard Cochrane review procedures. Primary outcome measures; clinical efficacy (modified Rankin Score, mRS), technical efficacy (recanalisation), and clinical safety (procedure-related complications and death). Subgroup analyses were performed, comparing outcome measures between demographic groups, clinico-radiological severity, interventional strategies, and degrees of recanalisation.</p><p><strong>Data synthesis: </strong>In this study 124 papers were included (n = 486). All patients underwent MT, with 69.5% of patients receiving concomitant chemolysis. New/expanding intracerebral haemorrhage (ICH) occurred in 5.1%; non-haemorrhagic complications in 1.4%; 10.7% died. Predictors of poor efficacy included age ≥ 55 years, altered mental status (AMS), Glasgow Coma Scale (GCS) < 8. Predictive of poor safety outcomes included pre-existing ICH, deep system thrombosis, and AMS. Complete recanalisation was associated with improved clinical efficacy and safety outcomes.</p><p><strong>Limitations: </strong>The review is based on case reports/series, increasing bias-risk. Myriad of potentially includible studies were necessarily excluded due to lack of requisite details.</p><p><strong>Conclusion: </strong>Predictors of poor outcomes with medical therapy predict poor outcomes with MT; these measures should not dictate candidacy. Complete recanalisation predicts favorable clinical and safety outcomes. Local chemolysis is safe, improves recanalisation, and should be recommended, provided there is no contraindication. Clot maceration strategies and stent-retriever thrombectomy are associated with superior clinical efficacy and safety endpoints, as compared with balloon angioplasty and rheolysis.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"451-463"},"PeriodicalIF":2.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703813","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":"Signal Abnormalities in Noonan Syndrome are Probably Consistent with Focal Areas of Signal Intensity (FASI).","authors":"Arne Vermeulen, Felice D'Arco, Liesbeth De Groote, Laurens J L De Cocker","doi":"10.1007/s00062-023-01356-1","DOIUrl":"10.1007/s00062-023-01356-1","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"495-497"},"PeriodicalIF":2.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240271","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":"Toxic Leukoencephalopathy due to Suspected Levamisole-adulterated Cocaine.","authors":"Rafael Willems, Se-Jong You, Friederike Vollmer, Elke Hattingen, Stefan Weidauer","doi":"10.1007/s00062-023-01358-z","DOIUrl":"10.1007/s00062-023-01358-z","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"503-506"},"PeriodicalIF":2.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11130053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92157117","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":"Detection of Spinal Cord Multiple Sclerosis Lesions Using a 3D-PSIR Sequence at 1.5 T.","authors":"Sönke Peters, Fernando Bueno Neves, Monika Huhndorf, Friederike Gärtner, Klarissa Stürner, Olav Jansen, Mona Salehi Ravesh","doi":"10.1007/s00062-023-01376-x","DOIUrl":"10.1007/s00062-023-01376-x","url":null,"abstract":"<p><strong>Purpose: </strong>Multiple sclerosis (MS) is a prevalent autoimmune inflammatory disease. Besides cerebral manifestations, an affection of the spinal cord is typical; however, imaging of the spinal cord is difficult due to its anatomy. The aim of this study was to assess the diagnostic value of a 3D PSIR pulse sequencing at a 1.5 T magnetic field strength for both the cervical and thoracic spinal cord.</p><p><strong>Methods: </strong>Phase sensitive inversion recovery (PSIR), short tau inversion recovery (STIR) and T₂-weighted (T₂-w) images of the spinal cord of 50 patients were separately evaluated by three radiologists concerning the number and location of MS lesions. Furthermore, lesion to cord contrast ratios were determined for the cervical and thoracic spinal cord.</p><p><strong>Results: </strong>Of the lesions 54.81% were located in the cervical spinal cord, 42.26% in the thoracic spinal cord and 2.93% in the conus medullaris. The PSIR images showed a higher sensitivity for lesion detection in the cervical and thoracic spinal cord (77.10% and 72.61%, respectively) compared to the STIR images (58.63% and 59.10%, respectively) and the T₂-w images (59.95% and 59.52%, respectively). The average lesion to cord contrast ratio was significantly higher in the PSIR images compared to the STIR images (p < 0.001) and the T₂-w images (p < 0.001).</p><p><strong>Conclusion: </strong>Evaluation of the spinal cord with a 3D PSIR sequence at a magnetic field strength of 1.5 T is feasible with a high sensitivity for the detection of spinal MS lesions for the cervical as well as the thoracic segments. In combination with other pulse sequences it might become a valuable addition in an advanced imaging protocol.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"403-410"},"PeriodicalIF":2.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11130041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576180","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":"Quantitative Magnetic Resonance Imaging for Neurodevelopmental Outcome Prediction in Neonates Born Extremely Premature-An Exploratory Study.","authors":"Victor U Schmidbauer, Mehmet S Yildirim, Gregor O Dovjak, Katharina Goeral, Julia Buchmayer, Michael Weber, Patric Kienast, Mariana C Diogo, Florian Prayer, Marlene Stuempflen, Jakob Kittinger, Jakob Malik, Nikolaus M Nowak, Katrin Klebermass-Schrehof, Renate Fuiko, Angelika Berger, Daniela Prayer, Gregor Kasprian, Vito Giordano","doi":"10.1007/s00062-023-01378-9","DOIUrl":"10.1007/s00062-023-01378-9","url":null,"abstract":"<p><strong>Purpose: </strong>Neonates born at < 28 weeks of gestation are at risk for neurodevelopmental delay. The aim of this study was to identify quantitative MR-based metrics for the prediction of neurodevelopmental outcomes in extremely preterm neonates.</p><p><strong>Methods: </strong>T1-/T2-relaxation times (T1R/T2R), ADC, and fractional anisotropy (FA) of the left/right posterior limb of the internal capsule (PLIC) and the brainstem were determined at term-equivalent ages in a sample of extremely preterm infants (n = 33). Scores for cognitive, language, and motor outcomes were collected at one year corrected-age. Pearson's correlation analyses detected relationships between quantitative measures and outcome data. Stepwise regression procedures identified imaging metrics to estimate neurodevelopmental outcomes.</p><p><strong>Results: </strong>Cognitive outcomes correlated significantly with T2R (r = 0.412; p = 0.017) and ADC (r = -0.401; p = 0.021) (medulla oblongata). Furthermore, there were significant correlations between motor outcomes and T1R (pontine tegmentum (r = 0.346; p = 0.049), midbrain (r = 0.415; p = 0.016), right PLIC (r = 0.513; p = 0.002), and left PLIC (r = 0.504; p = 0.003)); T2R (right PLIC (r = 0.405; p = 0.019)); ADC (medulla oblongata (r = -0.408; p = 0.018) and pontine tegmentum (r = -0.414; p = 0.017)); and FA (pontine tegmentum (r = -0.352; p = 0.045)). T2R/ADC (medulla oblongata) (cognitive outcomes (R² = 0.296; p = 0.037)) and T1R (right PLIC)/ADC (medulla oblongata) (motor outcomes (R² = 0.405; p = 0.009)) revealed predictive potential for neurodevelopmental outcomes.</p><p><strong>Conclusion: </strong>There are relationships between relaxometry‑/DTI-based metrics determined by neuroimaging near term and neurodevelopmental outcomes collected at one year of age. Both modalities bear prognostic potential for the prediction of cognitive and motor outcomes. Thus, quantitative MRI at term-equivalent ages represents a promising approach with which to estimate neurologic development in extremely preterm infants.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"421-429"},"PeriodicalIF":2.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11129968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576224","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":"Pretreatment CTP Collateral Parameters Predict Good Outcomes in Successfully Recanalized Middle Cerebral Artery Distal Medium Vessel Occlusions.","authors":"Vivek Yedavalli, Manisha Koneru, Omar Hamam, Meisam Hoseinyazdi, Elisabeth Breese Marsh, Raf Llinas, Victor Urrutia, Richard Leigh, Fernando Gonzalez, Risheng Xu, Justin Caplan, Judy Huang, Hanzhang Lu, Max Wintermark, Jeremy Heit, Adrien Guenego, Greg Albers, Kambiz Nael, Argye Hillis","doi":"10.1007/s00062-023-01371-2","DOIUrl":"10.1007/s00062-023-01371-2","url":null,"abstract":"<p><strong>Background/purpose: </strong>Distal medium vessel occlusions (DMVOs) account for a large percentage of vessel occlusions resulting in acute ischemic stroke (AIS) with disabling symptoms. We aim to assess whether pretreatment quantitative CTP collateral status (CS) parameters can serve as imaging biomarkers for good clinical outcomes prediction in successfully recanalized middle cerebral artery (MCA) DMVOs.</p><p><strong>Methods: </strong>We performed a retrospective analysis of consecutive patients with AIS secondary to primary MCA-DMVOs who were successfully recanalized by mechanical thrombectomy (MT) defined as modified thrombolysis in cerebral infarction (mTICI) 2b, 2c, or 3. We evaluated the association between the CBV index and HIR independently with good clinical outcomes (modified Rankin score 0-2) using Spearman rank correlation, logistic regression, and ROC analyses.</p><p><strong>Results: </strong>From 22 August 2018 to 18 October 2022 8/22/2018 to 10/18/2022, 60 consecutive patients met our inclusion criteria (mean age 71.2 ± 13.9 years old [mean ± SD], 35 female). The CBV index (r = -0.693, p < 0.001) and HIR (0.687, p < 0.001) strongly correlated with 90-day mRS. A CBV index ≥ 0.7 (odds ratio, OR, 2.27, range 6.94-21.23 [OR] 2.27 [6.94-21.23], p = 0.001)) and lower likelihood of prior stroke (0.13 [0.33-0.86]), p = 0.024)) were independently associated with good outcomes. The ROC analysis demonstrated good performance of the CBV index in predicting good 90-day mRS (AUC 0.73, p = 0.003) with a threshold of 0.7 for optimal sensitivity (71% [52.0-85.8%]) and specificity (76% [54.9-90.6%]). The HIR also demonstrated adequate performance in predicting good 90-day mRS (AUC 0.77, p = 0.001) with a threshold of 0.3 for optimal sensitivity (64.5% [45.4-80.8%]) and specificity (76.0% [54.9-90.6%]).</p><p><strong>Conclusion: </strong>A CBV index ≥ 0.7 may be independently associated with good clinical outcomes in our cohort of AIS caused by MCA-DMVOs that were successfully treated with MT. Furthermore, a HIR < 0.3 is also associated with good clinical outcomes. This is the first study of which we are aware to identify a CBV index threshold for MCA-DMVOs.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"341-349"},"PeriodicalIF":2.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058908","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":"Efficacy and Safety Outcomes for Acute Ischemic Stroke Patients Treated with Intravenous Infusion of Tirofiban After Emergent Carotid Artery Stenting.","authors":"Rana Garayzade, Ansgar Berlis, Stefan Schiele, Michael Ertl, Hauke Schneider, Gernot Müller, Christoph J Maurer","doi":"10.1007/s00062-023-01350-7","DOIUrl":"10.1007/s00062-023-01350-7","url":null,"abstract":"<p><strong>Introduction: </strong>Emergent stenting of the extracranial internal carotid artery (ICA) in stroke patients requires antiplatelet therapy to prevent in-stent thrombosis with a higher risk of intracranial haemorrhage.</p><p><strong>Aim of the study: </strong>Assess the efficacy and safety of emergent carotid stenting with intravenous tirofiban in acute ischemic stroke patients.</p><p><strong>Methods: </strong>Primary endpoint: symptomatic hemorrhage. Secondary endpoints: 90-day functional outcome and mortality.</p><p><strong>Results: </strong>Of the 62 patients, 21 (34%) received tirofiban as a single antiplatelet, and 41 (66%) received combined therapy. Premedication with anticoagulants and antiplatelets was significantly more frequent in the tirofiban-only group. The rate of symptomatic haemorrhage was significantly lower in the tirofiban-only group than in the combined group (4.8% vs. 27%, p = 0.046). The patients with tirofiban alone had a significantly better functional outcome at day 90 than the combined group (52% vs. 24%, p = 0.028). Mortality was equal (24%) in both groups. Pre-interventional NIHSS score (p = 0.003), significant blood pressure fluctuations (p = 0.012), tandem occlusion (p = 0.023), and thrombolysis (p = 0.044) showed relevant influence on the rate of symptomatic hemorrhage in the entire patient cohort.</p><p><strong>Conclusions: </strong>A single antiplatelet therapy with tirofiban regardless of the premedication may improve the functional outcome in patients with stroke due to acute extracranial carotid lesion and emergent carotid stenting with lower rates of serious intracranial haemorrhage. For patients with high pre-interventional NIHSS score, tandem occlusion and after pre-interventional thrombolysis, caution is advised. Additionally, strict blood pressure monitoring should be conducted during the first 72 h after intervention.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"163-172"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10881598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156347","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":"Artificial Intelligence Imaging for Predicting High-risk Molecular Markers of Gliomas.","authors":"Qian Liang, Hui Jing, Yingbo Shao, Yinhua Wang, Hui Zhang","doi":"10.1007/s00062-023-01375-y","DOIUrl":"10.1007/s00062-023-01375-y","url":null,"abstract":"<p><p>Gliomas, the most prevalent primary malignant tumors of the central nervous system, present significant challenges in diagnosis and prognosis. The fifth edition of the World Health Organization Classification of Tumors of the Central Nervous System (WHO CNS5) published in 2021, has emphasized the role of high-risk molecular markers in gliomas. These markers are crucial for enhancing glioma grading and influencing survival and prognosis. Noninvasive prediction of these high-risk molecular markers is vital. Genetic testing after biopsy, the current standard for determining molecular type, is invasive and time-consuming. Magnetic resonance imaging (MRI) offers a non-invasive alternative, providing structural and functional insights into gliomas. Advanced MRI methods can potentially reflect the pathological characteristics associated with glioma molecular markers; however, they struggle to fully represent gliomas' high heterogeneity. Artificial intelligence (AI) imaging, capable of processing vast medical image datasets, can extract critical molecular information. AI imaging thus emerges as a noninvasive and efficient method for identifying high-risk molecular markers in gliomas, a recent focus of research. This review presents a comprehensive analysis of AI imaging's role in predicting glioma high-risk molecular markers, highlighting challenges and future directions.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"33-43"},"PeriodicalIF":2.8,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565151","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}