American Journal of Neuroradiology最新文献

{"title":"Comprehensive Update and Review of Clinical and Imaging Features of SMART Syndrome.","authors":"Y Ota, E Liao, G Shah, A Srinivasan, A A Capizzano","doi":"10.3174/ajnr.A7859","DOIUrl":"10.3174/ajnr.A7859","url":null,"abstract":"<p><p>Stroke-like migraine attacks after radiation therapy (SMART) syndrome is a delayed complication of cranial irradiation, with subacute onset of stroke-like symptoms including seizures, visual disturbance, speech impairment, unilateral hemianopsia, facial droop, and aphasia, often associated with migraine-type headache. The diagnostic criteria were initially proposed in 2006. However, the diagnosis of SMART syndrome is challenging because clinical symptoms and imaging features of SMART syndrome are indeterminate and overlap with tumor recurrence and other neurologic diseases, which may result in inappropriate clinical management and unnecessary invasive diagnostic procedures. Recently, various imaging features and treatment recommendations for SMART syndrome have been reported. Radiologists and clinicians should be familiar with updates on clinical and imaging features of this delayed radiation complication because recognition of this entity can facilitate proper clinical work-up and management. This review provides current updates and a comprehensive overview of the clinical and imaging features of SMART syndrome.</p>","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"44 6","pages":"626-633"},"PeriodicalIF":3.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9609776","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":"Erratum.","authors":"","doi":"10.3174/ajnr.A7893","DOIUrl":"https://doi.org/10.3174/ajnr.A7893","url":null,"abstract":"In the article “Surgical or Endovascular Treatment of MCA Aneurysms: An Agreement Study” (Boisseau W, Darsaut TE, Fahed R, et al. AJNR Am J Neuroradiol 2022;43:1437–44. 10.3174/ajnr.A7648), Roland Jabre, MD, was accidentally omitted from the author list. His affiliation is the Department of Surgery, Division of Neurosurgery, Center Hospitalier de l’Université de Montréal, Montreal, Québec, Canada. The authors regret the error.","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"44 6","pages":"E31"},"PeriodicalIF":3.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249692/pdf/zj4E31.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9962328","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":"Femoral Access-Site Complications with Tenecteplase versus Alteplase before Mechanical Thrombectomy for Large-Vessel-Occlusion Stroke.","authors":"P Hendrix, M K Collins, O Goren, G M Weiner, S S Dalal, I Melamed, M J Kole, C J Griessenauer, A Noto, C M Schirmer","doi":"10.3174/ajnr.A7862","DOIUrl":"10.3174/ajnr.A7862","url":null,"abstract":"<p><strong>Background and purpose: </strong>IV thrombolysis with alteplase before mechanical thrombectomy for emergent large-vessel-occlusion stroke is associated with access-site bleeding complications. However, the incidence of femoral access-site complications with tenecteplase before mechanical thrombectomy requires exploration. Here, femoral access-site complications with tenecteplase versus alteplase before mechanical thrombectomy for large-vessel-occlusion stroke were compared.</p><p><strong>Materials and methods: </strong>All patients receiving IV thrombolytics before mechanical thrombectomy for large-vessel-occlusion stroke who presented from January 2020 to August 2022 were reviewed. In May 2021, our health care system switched from alteplase to tenecteplase as the primary thrombolytic for all patients with stroke, facilitating the comparison of alteplase-versus-tenecteplase femoral access-site complication rates. Major (requiring surgery) and minor (managed conservatively) access-site complications were assessed.</p><p><strong>Results: </strong>One hundred thirty-nine patients underwent transfemoral mechanical thrombectomy for large-vessel-occlusion stroke, of whom 46/139 (33.1%) received tenecteplase and 93/139 (66.9%) received alteplase. In all cases (<i>n</i> = 139), an 8F sheath was inserted without sonographic guidance, and vascular closure was obtained with an Angio-Seal. Baseline demographics, concomitant antithrombotic medications, and periprocedural coagulation lab findings were similar between groups. The incidence of conservatively managed groin hematomas (2.2% versus 4.3%), delayed access-site oozing requiring manual compression (6.5% versus 2.2%), and arterial occlusion requiring surgery (2.2% versus 1.1%) was similar between the tenecteplase and alteplase groups, respectively (<i>P</i> = not significant). No dissection, arteriovenous fistula, or retroperitoneal hematoma was observed.</p><p><strong>Conclusions: </strong>Tenecteplase compared with alteplase before mechanical thrombectomy for large-vessel-occlusion stroke is not associated with an alteration in femoral access-site complication rates.</p>","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"44 6","pages":"681-686"},"PeriodicalIF":3.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9978599","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":"Doppler Ultrasound Flow Reversal in the Superior Sagittal Sinus to Detect Cerebral Venous Congestion in Vein of Galen Malformation.","authors":"S Schwarz, F Brevis Nuñez, N R Dürr, F Brassel, M Schlunz-Hendann, A Feldkamp, T Rosenbaum, U Felderhoff-Müser, K Schulz, C Dohna-Schwake, N Bruns","doi":"10.3174/ajnr.A7891","DOIUrl":"10.3174/ajnr.A7891","url":null,"abstract":"<p><strong>Background and purpose: </strong>Vein of Galen malformation is a rare congenital cerebrovascular malformation. In affected patients, increased cerebral venous pressure constitutes an important etiologic factor for the development of brain parenchymal damage. The aim of this study was to investigate the potential of serial cerebral venous Doppler measurements to detect and monitor increased cerebral venous pressure.</p><p><strong>Materials and methods: </strong>This was a retrospective monocentric analysis of ultrasound examinations within the first 9 months of life in patients with vein of Galen malformation admitted at <28 days of life. Categorization of perfusion waveforms in the superficial cerebral sinus and veins into 6 patterns was based on antero- and retrograde flow components. We performed an analysis of flow profiles across time and correlation with disease severity, clinical interventions, and congestion damage on cerebral MR imaging.</p><p><strong>Results: </strong>The study included 44 Doppler ultrasound examinations of the superior sagittal sinus and 36 examinations of the cortical veins from 7 patients. Doppler flow profiles before interventional therapy correlated with disease severity determined by the Bicêtre Neonatal Evaluation Score (Spearman ρ = -0.97, <i>P</i> = < .001). At this time, 4 of 7 patients (57.1%) showed a retrograde flow component in the superior sagittal sinus, whereas after embolization, none of the 6 treated patients presented with a retrograde flow component. Only patients with a high retrograde flow component (equal or more than one-third retrograde flow, <i>n</i> = 2) showed severe venous congestion damage on cerebral MR imaging.</p><p><strong>Conclusions: </strong>Flow profiles in the superficial cerebral sinus and veins appear to be a useful tool to noninvasively detect and monitor cerebral venous congestion in vein of Galen malformation.</p>","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"44 6","pages":"707-715"},"PeriodicalIF":3.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9979701","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":"Perspectives.","authors":"Jeffrey S Ross","doi":"10.3174/ajnr.P0135","DOIUrl":"10.3174/ajnr.P0135","url":null,"abstract":"","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"44 6","pages":"625"},"PeriodicalIF":3.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9963985","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":"Improved Myelination following Camp Leg Power, a Selective Motor Control Intervention for Children with Spastic Bilateral Cerebral Palsy: A Diffusion Tensor MRI Study.","authors":"A Vuong, S H Joshi, L A Staudt, J H Matsumoto, E G Fowler","doi":"10.3174/ajnr.A7860","DOIUrl":"10.3174/ajnr.A7860","url":null,"abstract":"<p><strong>Background and purpose: </strong>Children with spastic cerebral palsy have motor deficits associated with periventricular leukomalacia indicating WM damage to the corticospinal tracts. We investigated whether practice of skilled lower extremity selective motor control movements would elicit neuroplasticity.</p><p><strong>Materials and methods: </strong>Twelve children with spastic bilateral cerebral palsy and periventricular leukomalacia born preterm (mean age, 11.5 years; age range, 7.3-16.6 years) participated in a lower extremity selective motor control intervention, Camp Leg Power. Activities promoted isolated joint movement including isokinetic knee exercises, ankle-controlled gaming, gait training, and sensorimotor activities (3 hours/day, 15 sessions, 1 month). DWI scans were collected pre- and postintervention. Tract-Based Spatial Statistics was used to analyze changes in fractional anisotropy, radial diffusivity, axial diffusivity, and mean diffusivity.</p><p><strong>Results: </strong>Significantly reduced radial diffusivity (<i>P</i> < . 05) was found within corticospinal tract ROIs, including 28.4% of the left and 3.6% of the right posterior limb of the internal capsule and 14.1% of the left superior corona radiata. Reduced mean diffusivity was found within the same ROIs (13.3%, 11.6%, and 6.6%, respectively). Additionally, decreased radial diffusivity was observed in the left primary motor cortex. Additional WM tracts had decreased radial diffusivity and mean diffusivity, including the anterior limb of the internal capsule, external capsule, anterior corona radiata, and corpus callosum body and genu.</p><p><strong>Conclusions: </strong>Myelination of the corticospinal tracts improved following Camp Leg Power. Neighboring WM changes suggest recruitment of additional tracts involved in regulating neuroplasticity of the motor regions. Intensive practice of skilled lower extremity selective motor control movements promotes neuroplasticity in children with spastic bilateral cerebral palsy.</p>","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"44 6","pages":"700-706"},"PeriodicalIF":3.5,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10249693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9609781","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":"3D Capsule Networks for Brain Image Segmentation.","authors":"A Avesta, Y Hui, M Aboian, J Duncan, H M Krumholz, S Aneja","doi":"10.3174/ajnr.A7845","DOIUrl":"10.3174/ajnr.A7845","url":null,"abstract":"<p><strong>Background and purpose: </strong>Current autosegmentation models such as UNets and nnUNets have limitations, including the inability to segment images that are not represented during training and lack of computational efficiency. 3D capsule networks have the potential to address these limitations.</p><p><strong>Materials and methods: </strong>We used 3430 brain MRIs, acquired in a multi-institutional study, to train and validate our models. We compared our capsule network with standard alternatives, UNets and nnUNets, on the basis of segmentation efficacy (Dice scores), segmentation performance when the image is not well-represented in the training data, performance when the training data are limited, and computational efficiency including required memory and computational speed.</p><p><strong>Results: </strong>The capsule network segmented the third ventricle, thalamus, and hippocampus with Dice scores of 95%, 94%, and 92%, respectively, which were within 1% of the Dice scores of UNets and nnUNets. The capsule network significantly outperformed UNets in segmenting images that were not well-represented in the training data, with Dice scores 30% higher. The computational memory required for the capsule network is less than one-tenth of the memory required for UNets or nnUNets. The capsule network is also >25% faster to train compared with UNet and nnUNet.</p><p><strong>Conclusions: </strong>We developed and validated a capsule network that is effective in segmenting brain images, can segment images that are not well-represented in the training data, and is computationally efficient compared with alternatives.</p>","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"44 5","pages":"562-568"},"PeriodicalIF":3.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442958","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":"Fluoroscopy- and CT-Guided Gold Fiducial Marker Placement for Intraoperative Localization during Spinal Surgery: Review of 179 Cases at a Single Institution-Technique and Safety Profile.","authors":"C P Siminski, C M Carr, D F Kallmes, M P Oien, J L D Atkinson, J C Benson, F E Diehn, D K Kim, G B Liebo, V T Lehman, A A Madhavan, I T Mark, P P Morris, D P Shlapak, J T Verdoorn, J M Morris","doi":"10.3174/ajnr.A7854","DOIUrl":"10.3174/ajnr.A7854","url":null,"abstract":"<p><strong>Background and purpose: </strong>Wrong-level spinal surgery, especially in the thoracic spine, remains a challenge for a variety of reasons related to visualization, such as osteopenia, large body habitus, severe kyphosis, radiographic misinterpretation, or anatomic variation. Preoperative fiducial marker placement performed in a dedicated imaging suite has been proposed to facilitate identification of thoracic spine vertebral levels. In this current study, we report our experience using image-guided percutaneous gold fiducial marker placement to enhance the accuracy and safety of thoracic spinal surgical procedures.</p><p><strong>Materials and methods: </strong>A retrospective review was performed of all fluoroscopy- or CT-guided gold fiducial markers placed at our institution between January 3, 2019, and March 16, 2022. A chart review of 179 patients was performed detailing the procedural approach and clinical information. In addition, the method of gold fiducial marker placement (fluoroscopy/CT), procedure duration, spinal level of the gold fiducial marker, radiation dose, fluoroscopy time, surgery date, and complications (including whether wrong-level surgery occurred) were recorded.</p><p><strong>Results: </strong>A total of 179 patients (104 female) underwent gold fiducial marker placement. The mean age was 57 years (range, 12-96 years). Fiducial marker placement was performed by 13 different neuroradiologists. All placements were technically successful without complications. All 179 (100%) operations were performed at the correct level. Most fiducial markers (143) were placed with fluoroscopy with the most common location at T6-T8. The most common location for placement in CT was at T3 and T4.</p><p><strong>Conclusions: </strong>All operations guided with gold fiducial markers were performed at the correct level. There were no complications of fiducial marker placement.</p>","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"44 5","pages":"618-622"},"PeriodicalIF":3.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442962","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":"Deep Learning of Time-Signal Intensity Curves from Dynamic Susceptibility Contrast Imaging Enables Tissue Labeling and Prediction of Survival in Glioblastoma.","authors":"J Yun, S Yun, J E Park, E-N Cheong, S Y Park, N Kim, H S Kim","doi":"10.3174/ajnr.A7853","DOIUrl":"10.3174/ajnr.A7853","url":null,"abstract":"<p><strong>Background and purpose: </strong>An autoencoder can learn representative time-signal intensity patterns to provide tissue heterogeneity measures using dynamic susceptibility contrast MR imaging. The aim of this study was to investigate whether such an autoencoder-based pattern analysis could provide interpretable tissue labeling and prognostic value in isocitrate dehydrogenase (<i>IDH</i>) wild-type glioblastoma.</p><p><strong>Materials and methods: </strong>Preoperative dynamic susceptibility contrast MR images were obtained from 272 patients with <i>IDH</i> wild-type glioblastoma (training and validation, 183 and 89 patients, respectively). The autoencoder was applied to the dynamic susceptibility contrast MR imaging time-signal intensity curves of tumor and peritumoral areas. Representative perfusion patterns were defined by voxelwise K-means clustering using autoencoder latent features. Perfusion patterns were labeled by comparing parameters with anatomic reference tissues for baseline, signal drop, and percentage recovery. In the validation set (<i>n</i> = 89), a survival model was created from representative patterns and clinical predictors using Cox proportional hazard regression analysis, and its performance was calculated using the Harrell C-index.</p><p><strong>Results: </strong>Eighty-nine patients were enrolled. Five representative perfusion patterns were used to characterize tissues as high angiogenic tumor, low angiogenic/cellular tumor, perinecrotic lesion, infiltrated edema, and vasogenic edema. Of these, the low angiogenic/cellular tumor (hazard ratio, 2.18; <i>P</i> = .047) and infiltrated edema patterns (hazard ratio, 1.88; <i>P</i> = .009) in peritumoral areas showed significant prognostic value. The combined perfusion patterns and clinical predictors (C-index, 0.72) improved prognostication when added to clinical predictors (C-index, 0.55).</p><p><strong>Conclusions: </strong>The autoencoder perfusion pattern analysis enabled tissue characterization of peritumoral areas, providing heterogeneity and dynamic information that may provide useful prognostic information in <i>IDH</i> wild-type glioblastoma.</p>","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"44 5","pages":"543-552"},"PeriodicalIF":3.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9442980","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":"Intensive Blood Pressure Management Preserves Functional Connectivity in Patients with Hypertension from the Systolic Blood Pressure Intervention Randomized Trial.","authors":"C Shah, D Srinivasan, G Erus, M Kurella Tamura, M Habes, J A Detre, W E Haley, A J Lerner, C B Wright, J T Wright, S Oparil, S B Kritchevsky, H A Punzi, A Rastogi, R Malhotra, C H Still, J D Williamson, R N Bryan, Y Fan, I M Nasrallah","doi":"10.3174/ajnr.A7852","DOIUrl":"10.3174/ajnr.A7852","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Systolic Blood Pressure Intervention (SPRINT) randomized trial demonstrated that intensive blood pressure management resulted in slower progression of cerebral white matter hyperintensities, compared with standard therapy. We assessed longitudinal changes in brain functional connectivity to determine whether intensive treatment results in less decline in functional connectivity and how changes in brain functional connectivity relate to changes in brain structure.</p><p><strong>Materials and methods: </strong>Five hundred forty-eight participants completed longitudinal brain MR imaging, including resting-state fMRI, during a median follow-up of 3.84 years. Functional brain networks were identified using independent component analysis, and a mean connectivity score was calculated for each network. Longitudinal changes in mean connectivity score were compared between treatment groups using a 2-sample <i>t</i> test, followed by a voxelwise <i>t</i> test. In the full cohort, adjusted linear regression analysis was performed between changes in the mean connectivity score and changes in structural MR imaging metrics.</p><p><strong>Results: </strong>Four hundred six participants had longitudinal imaging that passed quality control. The auditory-salience-language network demonstrated a significantly larger decline in the mean connectivity score in the standard treatment group relative to the intensive treatment group (<i>P</i> = .014), with regions of significant difference between treatment groups in the cingulate and right temporal/insular regions. There was no treatment group difference in other networks. Longitudinal changes in mean connectivity score of the default mode network but not the auditory-salience-language network demonstrated a significant correlation with longitudinal changes in white matter hyperintensities (<i>P</i> = .013).</p><p><strong>Conclusions: </strong>Intensive treatment was associated with preservation of functional connectivity of the auditory-salience-language network, while mean network connectivity in other networks was not significantly different between intensive and standard therapy. A longitudinal increase in the white matter hyperintensity burden is associated with a decline in mean connectivity of the default mode network.</p>","PeriodicalId":7875,"journal":{"name":"American Journal of Neuroradiology","volume":"44 5","pages":"582-588"},"PeriodicalIF":3.5,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10171386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9449795","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}