Clinical Neuroradiology最新文献

{"title":"Correction to: Long-Term Follow-up of the Woven EndoBridge (WEB) Device for the Treatment of Broad Based Intracranial Aneurysms: A Single-Center Retrospective Observational Analysis.","authors":"Humberto Abraham Cortés Magdaleno, Ansgar Berlis, Guilherme Quint, Mahmoud Zaki, Christoph Maurer","doi":"10.1007/s00062-026-01647-3","DOIUrl":"10.1007/s00062-026-01647-3","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"471"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147575873","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":"Ultra-Fast Sub-Minute Brain MRI with Deep-Learning-reconstruction for Anesthesia-Free Emergency Imaging in Children.","authors":"Sebastian Altmann, Nils F Grauhan, Mario A A Mercado, Haidara Almansour, Roman H Paul, Vannessa Ines Schöffling, Malte Ottenhausen, Marc A Brockmann, Ahmed E Othman","doi":"10.1007/s00062-026-01627-7","DOIUrl":"10.1007/s00062-026-01627-7","url":null,"abstract":"<p><strong>Purpose: </strong>As MRI frequently requires general anesthesia in pediatric patients, there is an undersupply in clinical routine. This may result in delayed examinations or use of CT, especially in emergency settings. To enable ad-hoc MRI scans and rule out increased intracranial pressure or intracranial mass lesions, we combined various acceleration techniques with Deep-Learning reconstruction, generating ultra-fast diagnostic images sufficient to exclude critical pathologies.</p><p><strong>Methods: </strong>Thirty-six MRI datasets of infants with a median age of 35.2 months (SD ± 23.2) and anesthesia-free imaging were retrospectively evaluated. Imaging was performed using ultra-fast T2-weighted sequences in three planes (slice thickness 5 mm; total acquisition time 47s). Four readers evaluated subjective image quality using a 5-point Likert-scale. Readers were asked to indicate how safe they felt about assessing possible midline displacement or mass lesion. For semi-quantitative analysis, readers reported diameters of lateral and third ventricles. Gwet's AC2 and intraclass correlation (ICC) were used for interrater agreement.</p><p><strong>Results: </strong>94.4% of datasets showed at least acceptable diagnostic confidence. Readers felt confident excluding acute intracranial pathology. 52.1% of ultra-fast sequences demonstrated good to excellent image quality. 72.6% were rated with good or excellent diagnostic confidence. Interrater reliability demonstrated almost excellent agreement of diagnostic confidence (Gwet's AC2 ≥ 0.886) and image quality (Gwet's AC2 ≥ 0.942). Excellent agreement regarding ventricular width (ICC values ≥ 0.966) was shown for all measurements.</p><p><strong>Conclusion: </strong>The use of deep-learning reconstruction algorithms in pediatric brain MRI is feasible, allowing anesthesia-free emergency imaging. This will reduce periprocedural risk, number of necessary CT scans, and lower healthcare costs.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"681-690"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146229381","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":"White Matter Microstructural Alterations Are Linked to Cognitive Impairment in Patients with Fabry Disease: an Automated Fiber Quantification Study.","authors":"Zhongru Sun, Yan Chen, Tianchi Liu, Zhaoting Li, Ning Wang, Ji Zhang, Jingyuan Cao, Jianguo Xia, Weizhong Tian","doi":"10.1007/s00062-025-01593-6","DOIUrl":"10.1007/s00062-025-01593-6","url":null,"abstract":"<p><strong>Purpose: </strong>Fabry disease (FD), an X‑linked lysosomal disorder caused by deficient α‑galactosidase A (α-Gal A), leads to glycosphingolipid accumulation and multi-organ damage. The specific characteristics and clinical relevance of white matter microstructural damage in FD remain insufficiently explored. This study therefore aimed to explore these specific changes using automated fiber quantification (AFQ), as well as to analyze their correlations with neuropsychological scales and clinical indicators.</p><p><strong>Methods: </strong>19 FD patients and 22 healthy controls (HC) underwent neuropsychological assessments and diffusion tensor imaging (DTI). The AFQ technique was used to extract fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) values at 100 equidistant nodes along 18 major white matter tracts. Partial correlation analysis explored relationships between DTI indicators and neuropsychological as well as clinical indicators. ROC analysis was performed to evaluate the diagnostic efficacy of the FA and MD values in differentiating FD patients from HC.</p><p><strong>Results: </strong>FD patients showed decreased FA values and increased MD, AD, and RD values in several fiber tracts, particularly in the corticospinal tract (CST) and the cingulum cingulate (CC). Diffusion metrics in the left CC (CC_L) showed significant correlations with neuropsychological scores: the FA values were positively correlated with the MMSE score, while the MD and RD values were negatively correlated with the MMSE score. Additionally, the MD and RD values were positively correlated with the HAMD and HAMA scores, respectively. The AD values of the left CST (CST_L), as well as the MD and AD values of the left arcuate fasciculus (AF_L), were negatively correlated with α‑galactosidase A (α-Gal A) activity in FD patients. Furthermore, ROC analysis demonstrated that the MD values of the right CST (CST_R) achieved superior diagnostic performance (AUC = 0.933).</p><p><strong>Conclusions: </strong>FD patients demonstrated segment-specific white matter damage. The abnormalities in these specific fiber segments were associated with symptoms such as cognitive impairment and depression, especially in the CC and CST. These findings may provide novel insights into the clinical symptoms associated with FD and offer new neuroimaging support for disease monitoring in this condition.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"411-422"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606817","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":"Radiological Patterns and Clinical Features in Adult-onset Subacute Sclerosing Panencephalitis: a Cross-sectional Study.","authors":"Divyani Garg, Ayush Agarwal, Ashish Upadhyay, Ajay Garg, Achal Srivastava","doi":"10.1007/s00062-025-01589-2","DOIUrl":"10.1007/s00062-025-01589-2","url":null,"abstract":"<p><strong>Purpose: </strong>Subacute sclerosing panencephalitis (SSPE) is a progressive neurological disorder caused by persistent measles virus infection in the brain. Traditionally a pediatric disorder, adult-onset cases are increasingly reported. Imaging characteristics in adult-onset SSPE remain underexplored. We aimed to characterize radiological abnormalities in adult-onset SSPE and explore clinico-radiological associations.</p><p><strong>Methods: </strong>A cross-sectional study was conducted. Patients with SSPE with symptom onset at age 18 years and above were included. Clinical, demographic, laboratory and MRI brain features were recorded and analyzed.</p><p><strong>Results: </strong>Fifty-three patients (male: female = 43:10) were included. The median age at presentation was 19 (19-21.5) years and median symptom duration was 10 (10-19) months. The median Jabbour stage was 2 (2-3). Forty-three (81.1%) had MRI abnormalities. Subcortical and periventricular white matter signal change was noted in 28 (65.1%) and 33 (76.7%) patients respectively. The most frequently involved lobes were parietal (39, 90.7%) and frontal (35, 81.4%). Diffusion restriction occurred in 10 (23.3%). Tremor (p = 0.018) and elevated CSF protein (P < 0.001) correlated with overall MRI abnormality. Myoclonus correlated with occipital signal change (p = 0.036). Tremor (p = 0.034) and visual abnormality (p = 0.024) correlated with subcortical involvement. Dysphagia was associated with cortical involvement (p = 0.018), basal ganglia abnormality (p = 0.041), and diffusion restriction (p = 0.008). Symptom duration correlated with periventricular white matter involvement (p = 0.0034), supratentorial atrophy (p < 0.001), and symmetrical involvement (p = 0.027).</p><p><strong>Conclusion: </strong>MRI abnormalities are frequent in adult-onset SSPE, with diffusion restriction being more prevalent than previously recognized. Our findings highlight the role of neuroimaging in adult-onset SSPE cases, to guide diagnosis and prognostication.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"349-358"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145453299","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":"Mid- and Long-Term Outcomes Following Flow Diversion for Carotid-Ophthalmic Aneurysms: a Single-Centre Experience.","authors":"Gian Marco Frigerio, Sara Sciacca, Jeremy Lynch, Sahan Guruge, Matthew Benger, Parthiban Balasundaram, Thomas Booth, Naga Kandasamy","doi":"10.1007/s00062-026-01625-9","DOIUrl":"10.1007/s00062-026-01625-9","url":null,"abstract":"<p><strong>Background and purpose: </strong>Flow diverter stents (FDS) have shown promise in treating carotid-ophthalmic aneurysms (COAs), but mid- to long-term data remain limited. This study reports our institutional experience using FDS for unruptured COAs.</p><p><strong>Methods: </strong>Between August 2010 and September 2023, 105 unruptured COAs in 99 patients (87 females, mean age 54 ± 14 years) were retrospectively analyzed. The anatomical relationship between the ophthalmic artery (OphA) and the aneurysm was classified as Type 1 (separate), Type 2 (neck), or Type 3 (dome). Patients were treated with FDS alone or with adjunctive coiling. Clinical and angiographic outcomes, including visual complications, were assessed.</p><p><strong>Results: </strong>Technical success was 98.1%. At a mean follow-up of 38.5 months, complete occlusion was achieved in 89.1% and adequate occlusion in 98.0%. Occlusion rates were comparable across types, with a trend toward lower rates in Type 2. Retreatment was required in 1.0%. Major adverse events occurred in 1.0%, neurological complications in 3.0%, and in-stent stenosis in 2.0%. New visual deficits occurred in 6.1% (4.0% transient, 2.0% permanent). Aneurysm size > 12 mm was significantly associated with persistent symptoms (p = 0.003). Preoperative visual symptoms were the only independent predictor of poor visual outcome. Outcomes were comparable between FDS-only and FDS+coiling groups.</p><p><strong>Conclusion: </strong>FDS, with or without coiling, is a safe and effective treatment for COAs, achieving durable occlusion and generally favorable visual outcomes. The OphA-aneurysm relationship may influence occlusion, although residual filling may also reflect physiological flow preservation. Early treatment is essential in patients with large aneurysms and visual symptoms.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"743-755"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357229","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":"Leveraging Task FMRI Data to Extract Resting-State Metrics in Brain Tumor and Healthy Populations.","authors":"Shiori Amemiya, Jun Kanzawa, Hidemasa Takao, Osamu Abe","doi":"10.1007/s00062-026-01617-9","DOIUrl":"10.1007/s00062-026-01617-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study examined whether task-based functional MRI (fMRI) can provide metrics of local brain activity and hemodynamics typically derived from resting-state fMRI (rsfMRI).</p><p><strong>Methods: </strong>Two publicly open datasets from healthy individuals and brain tumor patients were retrospectively used to compare amplitude of low-frequency fluctuations (ALFF) and global signal metrics, namely, global signal correlation (GSC), global signal cross-correlation (GSXC), and global signal time delay (GSTD) derived from motor and language fMRI with those from a reference rsfMRI scan (rest-1). Factors influencing the correlations between each measurement were examined using a mixed-effects model with post-hoc pairwise comparisons.</p><p><strong>Results: </strong>Our study included 50 healthy subjects (mean age: 29 ± 3 years; 32 women) and 38 patients (45 ± 14 years; 24 men). Significant correlations (p < 0.001) were found for all metrics between those derived from motor, language, or a second rest scan (rest-2) against rest-1 scans for both healthy subjects and patients. Both fMRI type and motion magnitude affected the measurements of healthy subjects' GSC (fMRI type: F [2, 69.1] = 15.4, p < 0.001; motion: F [1, 123.1] = 8.5, p = 0.004), GSXC (fMRI type: F [2, 69.5] = 18.9, p < 0.001; motion: F [1, 123.2] = 9.89, p = 0.002), and GSTD (fMRI type: F [2, 58.7] = 9.89, p < 0.001; motion: F [1, 123.2] = 15.26, p < 0.001). FMRI type by motion interaction was significant for ALFF (F [2, 65.9] = 6.13, p = 0.004). The effects were less pronounced and observed only for GSC (F [2, 40.4] = 6.1, p = 0.005) and GSXC (F [2, 41.2] = 6.4, p = 0.004) in the clinical dataset.</p><p><strong>Conclusion: </strong>Repurposing existing task-based functional MRI data for evaluating local brain activities and hemodynamics is feasible in the entire brain in healthy and brain tumor subjects.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"563-576"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013034","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":"Time-intensity Profiles and T1-corrected Arterial Transit Time from Multi-delay Pseudo-continuous ASL with a Variable-TR Scheme for the Characterization of Adult-type Diffuse Glioma.","authors":"Koji Yamashita, Makoto Obara, Kazufumi Kikuchi, Ryoji Mikayama, Daichi Momosaka, Masaoki Kusunoki, Daisuke Kuga, Ryusuke Hatae, Yutaka Fujioka, Ryosuke Otsuji, Tatsuhiro Wada, Chiaki Tokunaga, Marc Van Cauteren, Osamu Togao, Koji Yoshimoto, Kousei Ishigami","doi":"10.1007/s00062-026-01616-w","DOIUrl":"10.1007/s00062-026-01616-w","url":null,"abstract":"<p><strong>Purpose: </strong>The cerebral blood flow (CBF) measured by multi-delay ASL (4D-ASL) offers superior diagnostic performance compared to single-delay ASL-CBF for glioma grading. Dynamic changes in signal intensity (SI) and arterial transit time (ATT) obtained from 4D-ASL may also be key factors in differentiating adult-type diffuse glioma. Furthermore, the longitudinal relaxation time (T1) of brain tumor may influence on CBF and ATT when using ASL techniques. Our purpose was to determine if time-intensity profiles from 4D-ASL using a variable-TR scheme and T1-corrected ATT (ATT_T1corr) could distinguish among adult-type diffuse gliomas.</p><p><strong>Materials and methods: </strong>The 4D-ASL with a variable-TR scheme data were collected by changing the labeling duration (LD) and post-labeling delay (PLD). Data acquisition at each phase consisted of pre-saturation and control or labeling modules followed by data acquisition. A total of 14 LD and PLD combinations were used. In addition, T1 measurement was conducted using pseudo-continuous ASL with a variable-TR scheme, without label and background suppression pulses. The SI peak time was obtained based on the time-intensity curve. The SI peak time, ATT, and ATT_T1corr were compared among adult-type diffuse gliomas.</p><p><strong>Results: </strong>Thirty patients were included in the study. ATT and the SI peak time in diffuse glioma with IDH-wildtype (IDHw) were significantly shorter than astrocytoma, IDH-mutant (p < 0.01, each). Moreover, ATT_T1corr in astrocytoma, IDH-mutant was longer than the other types of diffuse glioma (p < 0.0001).</p><p><strong>Conclusion: </strong>The 4D-ASL with a variable-TR scheme includes ATT_T1corr and the SI peak time could potentially improve the differential diagnosis of adult-type diffuse gliomas.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"553-562"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146013083","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":"Effect of Stenosis Severity on Outcomes After Rescue Stenting for Acute Middle Cerebral Artery Occlusions: a Real-world Multicenter Analysis.","authors":"Andrea Maria Alexandre, Luca Scarcia, Valerio Brunetti, Arturo Consoli, Wen Sun, Yingjie Xu, Xianjun Huang, Charlotte Chung, Alessandro Sgreccia, Mohamad Abdalkader, Nicola Limbucci, Francesco Arba, Alessandro Pedicelli, Maria Maddalena Viola, Luigi Cirillo, Mariangela Piano, Vittorio Semeraro, Emilio Lozupone, Chiara Gaudino, Riccardo Russo, Julien Burel, Julien Allard, Nicolas Chausson, Roberta Partesano, Nicola Cavasin, Nicolò Mandruzzato, Joseph Domenico Gabrieli, Pietro Trombatore, Antonio Armando Caragliano, Federico Mazzacane, Giancarlo Salsano, Antioco Sanna, Pietro Panni, Andrea Zini, Frédéric Clarençon, Eytan Raz, Thanh Nguyen, Aldobrando Broccolini","doi":"10.1007/s00062-026-01635-7","DOIUrl":"10.1007/s00062-026-01635-7","url":null,"abstract":"<p><strong>Purpose: </strong>Rescue stenting (RS) can achieve durable recanalization in cases of acute large vessel occlusion due to underlying intracranial artery stenosis (ICAS), but its clinical effects may be influenced by procedural factors. This study aimed to evaluate whether the severity of stenosis affects the outcomes after RS.</p><p><strong>Methods: </strong>In this multicenter retrospective study, patients with acute middle cerebral artery occlusion and underlying ICAS were divided into two groups based on the treatment they received: mechanical thrombectomy (MT) + RS (n = 172) or MT-only (n = 131). Inverse probability of treatment weighting was used to balance baseline characteristics. We systematically evaluated stenosis thresholds from 40% to 90% to identify the optimal cutoff that best differentiated treatment effects on the 90-day modified Rankin Scale (mRS) score and safety outcomes, including symptomatic intracranial hemorrhage (sICH).</p><p><strong>Results: </strong>A stenosis severity of 75% was identified as the optimal cutoff for effect modification. While RS improved recanalization rates overall, its effect on the 90-day mRS score was beneficial only in patients with > 75% stenosis compared to MT-only (Average Treatment Effect (ATE) -0.98, 95% CI -1.73 to -0.22; p = 0.01). In contrast, it showed a detrimental effect in those with < 75% stenosis (ATE 1.08, 95% CI 0.32 to 1.83; p = 0.005). Furthermore, RS increased the rate of sICH regardless of ICAS severity.</p><p><strong>Conclusions: </strong>The clinical benefit of RS is contingent on the underlying stenosis severity, providing favorable outcomes in patients with high-grade stenoses only. ICAS severity should also be considered for treatment decisions, though these findings require validation in prospective controlled studies.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"711-720"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318804","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":"Shape Modification of the New ARTISSE Intrasaccular Device Following Aneurysm Embolization.","authors":"Baptiste Donnard, Richard Bibi, Johannes Kaesmacher, Kevin Janot","doi":"10.1007/s00062-025-01609-1","DOIUrl":"10.1007/s00062-025-01609-1","url":null,"abstract":"","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"781-784"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146004827","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":"Prediction of Major Stroke (NIHSS > 5) Based on MR Perfusion Imaging Using a 3D ResNet.","authors":"Christoph C Kurmann, Adnan Mujanovic, Morin Beyeler, Leander Clénin, Philipp Becker, Roman Rohner, Richard McKinley, Shaokai Zheng, Marta Olive Gadea, Eike Immo Piechowiak, Tomas Dobrocky, Sara Pilgram-Pastor, Valerian Altersberger, Bruce Campbell, Thomas Raphael Meinel, David Seiffge, Urs Fischer, Jan Gralla, Johannes Kaesmacher","doi":"10.1007/s00062-026-01623-x","DOIUrl":"10.1007/s00062-026-01623-x","url":null,"abstract":"<p><strong>Purpose: </strong>Prediction of stroke symptoms from perfusion patterns in ischemic stroke imaging would be desirable for decision making in relevant clinical scenarios as for example after incomplete mechanical thrombectomy or in perioperative strokes. Aim was to train a model to detect a major stroke defined as NIHSS > 5.</p><p><strong>Methods: </strong>Retrospective study of patients from the prospectively collected local Stroke Registry with large-/medium-vessel anterior circulation or without occlusion from 01/2015-12/2021 (N = 982, median age 74.5 (IQR 64.3-82), 47.5% female). Splits into training-set (80%), validation-set (10%) and temporally separated internal test-set (10%). Admission MR-perfusion Tmax-maps from 6 different MR-scanners were used as input for an 18-layer 3D-ResNet to predict major stroke (NIHSS > 5). Association of reported and predicted NIHSS > 5 with 90-days modified Rankin Scale (mRS) > 2 was tested using multivariate logistic regression.</p><p><strong>Results: </strong>Vessel occlusion was observed in 80% and NIHSS > 5 in 50% of all patients. On the internal test-set, Receiver Operating Characteristic area under the curve (ROC-AUC) was 0.87 (95%-CI ± 0.04) and Precision-Recall-AUC (PR-AUC) 0.85 (95%-CI ± 0.05). Accuracy was 78%, weighted F1-score 0.78. Including only vessel occlusions in the internal test-set, ROC-AUC was 0.81 (95%-CI ± 0.05) and PR-AUC 0.87 (95%-CI ± 0.05), accuracy was 73%, weighted F1-score 0.73. Reported NIHSS > 5 (aOR 2.03, 95%-CI 0.94-4.38, p = 0.07) and predicted NIHSS > 5 (aOR 3.61, 95%-CI 0.88-14.88, p = 0.08) both predicted 90-days mRS > 2, with similar model performance (BIC: 310.6 vs. 310.7; AIC: 252.4 vs. 252.5).</p><p><strong>Conclusion: </strong>Prediction of a major stroke (NIHSS > 5) from MR-perfusion Tmax-maps was feasible and performed well on our internal test set.</p>","PeriodicalId":49298,"journal":{"name":"Clinical Neuroradiology","volume":" ","pages":"661-671"},"PeriodicalIF":3.2,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13687120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146214666","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}