AJNR. American journal of neuroradiology最新文献

{"title":"MRI interpretation errors in adult patients with Medically Refractory Epilepsy.","authors":"Aoife M Haughey, Nadav Gasner, Timo Krings","doi":"10.3174/ajnr.A8681","DOIUrl":"https://doi.org/10.3174/ajnr.A8681","url":null,"abstract":"<p><strong>Background/purpose: </strong>Determine the most common MRI interpretation errors in patients with MRE according to our experience in a tertiary academic center with a large volume epilepsy program, in order to raise awareness of the 'blind spots' in imaging patients with MRE and to highlight the importance of combining clinical and electroencephalographic information to obtain the most accurate diagnosis.</p><p><strong>Materials and methods: </strong>This is a retrospective observational study. All MRE-patients who underwent MRI brain (on 3 Tesla, with dedicated epilepsy protocol), and who were discussed at the weekly interdisciplinary epilepsy conference in our center between January 2008 and July 2023 were included. The initial MRI interpretation and final MRI interpretation results were reviewed.</p><p><strong>Results: </strong>886 patients with MRE were included. 300 patients were MRI-negative (33.86%), diagnoses were missed in 95 patients (10.7%), a second diagnosis was missed in patients with dual pathologies in 42 patients (4.74%), findings were misinterpreted in 4 patients (0.45%), an overcall was made in 2 patients (0.2%), and in 5 patients the correct diagnosis was discussed but erroneously deemed absent on initial interpretation (0.56%), resulting in a total of 148 discrepant MRI reports.MTS comprised the most common pathology encountered overall, followed by encephalomalacia related to prior insult, enlarged amygdala, malformations of cortical development, cavernoma and ulegyria.The relative proportion of missed focal cortical dysplasia, encephalocele and enlarged amygdala accounted for the commonest misses/misdiagnoses.</p><p><strong>Conclusion: </strong>Evaluation of patients with MRE requires excellent inter-disciplinary care. Input from all members of the interdisciplinary team is essential for accurate interpretation of MRI in MRE patients for the neuroradiologist.We hope to inform radiologists of commonly overlooked pathologies in MRI brain interpretation for patients with epilepsy. In doing so, we want to maximize the yield of initial MRI interpretation in these patients.</p><p><strong>Abbreviations: </strong>EA, enlarged amygdala; EEG, electroencephalogram; EMR, electronic medical record, FCD, focal cortical dysplasia; MCD, Malformations of Cortical Development; MEG, Magnetoencephalography; MRE, medically refractory epilepsy; MTS, mesial temporal sclerosis; TLE, temporal lobe epilepsy; Positron emission tomrgrpahy (PET), Subtraction Ictal SPECT Co-registered to MRI (SISCOM) SCNH, subcortical nodular heterotopia.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Susceptibility changes on preoperative acetazolamideloaded 7T MR quantitative susceptibility mapping predict post-carotid endarterectomy cerebral hyperperfusion.","authors":"Kazuto Kimura, Yosuke Akamatsu, Kentaro Fujimoto, Ikuko Uwano, Makoto Sasaki, Shunrou Fujiwara, Masakazu Kobayashi, Takahiro Koji, Kenji Yoshida, Kazunori Terasaki, Kuniaki Ogasawara","doi":"10.3174/ajnr.A8692","DOIUrl":"https://doi.org/10.3174/ajnr.A8692","url":null,"abstract":"<p><strong>Background and purpose: </strong>Post-carotid endarterectomy (CEA) cerebral hyperperfusion (CH) can cause intracerebral hemorrhage and cognitive decline. Alterations in susceptibility in response to acetazolamide (ACZ) on 7T MRI quantitative susceptibility mapping (QSM) detects elevated CBV occurring due to impaired cerebrovascular autoregulation. We explored preoperative relative susceptibility changes on 7T MRI QSM in response to ACZ and their ability to predict CH following CEA.</p><p><strong>Materials and methods: </strong>Sixty-three patients with uni-or bilateral cervical ICA stenosis ≥70% underwent 7T MRI at baseline and at 5, 10, 15, and 20 min after ACZ administration before surgery. The difference between the susceptibility of venous structures and surrounding brain parenchyma at each time point after ACZ administration relative to the difference at baseline (relative susceptibility difference; RSD) on QSM images was calculated in the cerebral hemisphere ipsilateral to surgery. Brain perfusion SPECT was conducted preoperatively and immediately following CEA to detect postoperative CH (≥ 100% rise in CBF postoperatively).</p><p><strong>Results: </strong>In nine patients with postoperative CH, RSD was significantly increased at 5 or 10 min following ACZ administration (p < 0.05) but reduced at 15 and 20 min (p < 0.05). In 54 patients without postoperative CH, RSD at all four time points after ACZ administration was significantly lower than the baseline value (p < 0.05). The area under the receiver operating characteristic curve to predict postoperative CH was significantly greater in RSD₅ (0.981; 95% CI, 0.910-0.999) than in RSD₁₅ (0.872; 95% CI, 0.764-0.943) (p < 0.05) or RSD₂₀ (0.780; 95% CI, 0.658-0.874) (p < 0.01). Sensitivity, specificity, and positive and negative predictive values for RSD₅ at a cutoff near the left upper corner of the curve were 100%, 89%, 60%, and 100%, respectively. Logistic regression analysis revealed that only RSD₅ significantly predicted postoperative CH (95% CI, 455.9-4043.6; p < 0.05).</p><p><strong>Conclusions: </strong>Changes in susceptibility on preoperative 7T MRI QSM following ACZ administration predict CH following CEA. Patients with increased RSD₅ on pre-CEA 7T MRI QSM following ACZ administration should undergo brain perfusion imaging immediately after surgery. Detection of CH on postoperative brain perfusion imaging warrants intensive blood pressure control.</p><p><strong>Abbreviations: </strong>CEA= carotid endarterectomy; CH= cerebral hyperperfusion; OEF= oxygen extraction fraction; ACZ= acetazolamide; QSM =quantitative susceptibility mapping; 3D =three-dimensional; RSD=relative susceptibility difference; SD= standard deviation; ROC =receiver operating characteristic.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Radiologist Recommendations for Temporal Bone CT to Assess Superior Semicircular Canal Dehiscence on Temporal Bone MRI.","authors":"Pejman Rabiei, Jisoo Kim, Amir A Satani, C Eduardo Corrales, Ronilda Lacson, Ramin Khorasani, Jeffrey P Guenette","doi":"10.3174/ajnr.A8691","DOIUrl":"https://doi.org/10.3174/ajnr.A8691","url":null,"abstract":"<p><strong>Background and purpose: </strong>Superior semicircular canal dehiscence can be detected on temporal bone MR images. Radiologists often recommend confirmation with temporal bone CT due to reported lower MRI positive predictive value. The value of these recommendations is unclear given that CT overestimates dehiscence due to volume averaging and that only a small proportion of patients with dehiscence on CT suffer from dehiscence syndrome. We thus evaluated final diagnoses and outcomes in patients who adhered to the recommended additional CT.</p><p><strong>Materials and methods: </strong>This retrospective cohort observational study, performed at a multi-institution healthcare system, included consecutive temporal bone MRI reports 6/1/2021-5/31/2022 with a recommendation for additional temporal bone CT. We recorded: whether CT was performed, dehiscence present on CT, symptoms, final diagnosis, treatment decisions, and outcomes. Actionability elements (complete containing imaging modality, time frame, and rationale; unambiguous; unconditional; without multiplicity; and without alternate language) of the recommendations were extracted from a prior data set. Descriptive statistics were performed. A binomial generalized linear model was used to test the correlation of ambiguous recommendation language with recommendation adherence.</p><p><strong>Results: </strong>Summarize actual data. 5109 temporal bone MRI examinations were performed and interpreted by 34 radiologists. 187/5109 reports (3.7%) included a recommendation for additional temporal bone CT including 101/5109 (2.0%) specifically for suspected superior semicircular canal dehiscence. While 22% (22/101) of these recommended examinations were performed, only 32% of these (7/22) confirmed dehiscence. Ultimately, only 1 patient was diagnosed with dehiscence syndrome and was managed conservatively. No recommendations for additional imaging (0/101) met actionable criteria and 76.2% (77/101) were ambiguous. Ambiguous recommendations had 0.54 lower, but not statistically significant, odds of being performed (95% CI: 0.19-1.6, p=0.25).</p><p><strong>Conclusions: </strong>Radiologist recommendations for temporal bone CT in the setting of questionable superior semicircular canal dehiscence findings on MRI appear to have negligible clinical value and thus it is likely most appropriate to report possible SSCD in the MRI report impression without recommending further imaging.</p><p><strong>Abbreviations: </strong>SSCD= superior semicircular canal dehiscence.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-specific association between anatomical variants of the circle of Willis and intracranial aneurysms in individuals with a familial predisposition.","authors":"Marloes H A Nanninga, Denise A M van Strien, Birgitta K Velthuis, Mireille R E Velthuis, Iris N Vos, Phebe J Groenheide, Ynte M Ruigrok, Irene C van der Schaaf","doi":"10.3174/ajnr.A8690","DOIUrl":"https://doi.org/10.3174/ajnr.A8690","url":null,"abstract":"<p><strong>Background and purpose: </strong>First-degree relatives of aneurysmal subarachnoid hemorrhage patients face elevated risks for intracranial aneurysm development and aneurysmal subarachnoid hemorrhage, which both occur more often in women. Anatomical variants of the circle of Willis affect its hemodynamics and are associated with unruptured intracranial aneurysms. It is unknown if these findings apply to patients with a familial predisposition for these conditions, and if they are sex-specific. We therefore assessed if anatomical circle of Willis variants are associated with intracranial aneurysms identified at screening in individuals with a familial predisposition, and if these associations are sex-specific.</p><p><strong>Materials and methods: </strong>Individuals with and without intracranial aneurysms, identified at MRA-TOF screening, were compared. Circle of Willis arterial diameters were measured to identify anatomical variants, categorized into six types for both the anterior and posterior parts. Logistic regression was used for comparison, adjusted for age, hypertension, and the cohorts the individuals were part of, and stratified for sex-specific subgroups.</p><p><strong>Results: </strong>Of all 1,291 included individuals, 94 (7.3%) had aneurysms. A normal anterior variant was less common among individuals with aneurysms (OR 0.59, 95% CI 0.37-0.93). This effect was only observed in women (OR 0.45, 95% CI 0.25-0.80), and not in men (OR 1.39, 95% CI 0.57-3.35). The variant with anterior communicating artery hypoplasia or absence was more common in individuals with aneurysms (OR 1.61, 95% CI 1.03-2.54). This effect was observed in both women (OR 1.62, 95% CI 0.95-2.75) and men (OR 1.37, 95% CI 0.55-3.41). No differences were found for variants of the posterior part of the circle of Willis.</p><p><strong>Conclusions: </strong>Women with intracranial aneurysms identified at screening less frequently had a normal anterior part of the circle of Willis compared to those without aneurysms. Additionally, individuals with aneurysms more often had anterior communicating artery hypoplasia or absence, which association was not sex-specific. These anatomical variations may enhance the effectiveness of screening for intracranial aneurysms.</p><p><strong>Abbreviations: </strong>ACA = anterior cerebral artery; Acom = anterior communicating artery; ADPKD = autosomal dominant polycystic kidney disease; aSAH = aneurysmal subarachnoid hemorrhage; CoW = circle of Willis; PCA = posterior cerebral artery; Pcom = posterior communicating artery; UIA = unruptured intracranial aneurysm; UMCU = University Medical Center Utrecht.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Post-Operative Side Effects in VIM MRgFUS Based on THalamus Optimized Multi Atlas Segmentation (THOMAS) on White-Matter-Nulled MRI: A Retrospective Study.","authors":"Sonoko Oshima, Asher Kim, Xiaonan R Sun, Ziad Rifi, Katy A Cross, Katherine A Fu, Noriko Salamon, Benjamin M Ellingson, Ausaf A Bari, Jingwen Yao","doi":"10.3174/ajnr.A8448","DOIUrl":"10.3174/ajnr.A8448","url":null,"abstract":"<p><strong>Background and purpose: </strong>Precise and individualized targeting of the ventral intermediate thalamic nucleus for the MR-guided focused ultrasound is crucial for enhancing treatment efficacy and avoiding undesirable side effects. In this study, we tested the hypothesis that the spatial relationships between Thalamus Optimized Multi Atlas Segmentation derived segmentations and the post-focused ultrasound lesion can predict post-operative side effects in patients treated with MR-guided focused ultrasound.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 30 patients (essential tremor, n = 26; tremor-dominant Parkinson's disease, n = 4) who underwent unilateral ventral intermediate thalamic nucleus focused ultrasound treatment. We created ROIs of coordinate-based indirect treatment target, focused ultrasound-induced lesion, and thalamus and ventral intermediate thalamic nucleus segmentations. We extracted imaging features including 1) focused ultrasound-induced lesion volumes, 2) overlap between lesions and thalamus and ventral intermediate thalamic nucleus segmentations, 3) distance between lesions and ventral intermediate thalamic nucleus segmentation and 4) distance between lesions and the indirect standard target. These imaging features were compared between patients with and without post-operative gait/balance side effects using Wilcoxon rank-sum test. Multivariate prediction models of side effects based on the imaging features were evaluated using the receiver operating characteristic analyses.</p><p><strong>Results: </strong>Patients with self-reported gait/balance side effects had a significantly larger extent of focused ultrasound-induced edema, a smaller fraction of the lesion within the ventral intermediate thalamic nucleus segmentation, a larger fraction of the off-target lesion outside the thalamus segmentation, a more inferior centroid of the lesion from the ventral intermediate thalamic nucleus segmentation, and a larger distance between the centroid of the lesion and ventral intermediate thalamic nucleus segmentation (<i>p</i> < 0.05). Similar results were found for exam-based side effects. Multivariate regression models based on the imaging features achieved areas under the curve of 0.99 (95% CI: 0.88 to 1.00) and 0.96 (95% CI: 0.73 to 1.00) for predicting self-reported and exam-based side effects, respectively.</p><p><strong>Conclusions: </strong>Thalamus Optimized Multi Atlas Segmentation-based patient-specific segmentation of the ventral intermediate thalamic nucleus can predict post-operative side effects, which has implications for aiding the direct targeting of MR-guided focused ultrasound and reducing side effects.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"330-340"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-Guided C2 Diagnostic Related Group Injection and Radiofrequency Ablation for Cervicogenic Headache.","authors":"J Levi Chazen","doi":"10.3174/ajnr.A8651","DOIUrl":"10.3174/ajnr.A8651","url":null,"abstract":"<p><p>CT-guided injection and radiofrequency ablation (RFA) of the C2 dorsal root ganglion (DRG) is a safe and effective treatment for cervicogenic headache arising from C1-C2 joint arthritis. The C2 nerve root is unique in that it lacks a motor component; RFA can be performed with pain relief in exchange for occipital numbness. This video article outlines the imaging anatomy and technical considerations of this procedure.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"434"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Distance-Resolved Evaluation of the Perienhancing Tumor Areas with FLAIR Hyperintensity Indicates Different ADC Profiles by <i>MGMT</i> Promoter Methylation Status in Glioblastoma.","authors":"Gergely Bertalan, Nicolin Hainc, Fabian Dominik Von Dehn, Tibor Hortobágyi, Andrea Bink, Emilie Le Rhun, Michael Weller, Zsolt Kulcsar","doi":"10.3174/ajnr.A8493","DOIUrl":"10.3174/ajnr.A8493","url":null,"abstract":"<p><strong>Background and purpose: </strong>Whether differences in the O⁶-methylguanine-DNA methyltransferase (<i>MGMT</i>) promoter methylation status of glioblastoma (GBM) are reflected in MRI markers remains largely unknown. In this work, we analyze the ADC in the perienhancing infiltration zone of GBM according to the corresponding <i>MGMT</i> status by using a novel distance-resolved 3D evaluation.</p><p><strong>Materials and methods: </strong>One hundred one patients with <i>IDH</i> wild-type GBM were retrospectively analyzed. GBM was segmented in 3D with deep learning. Tissue with FLAIR hyperintensity around the contrast-enhanced tumor was divided into concentric distance-resolved subvolumes. Mean ADC was calculated for the 3D tumor core and for the distance-resolved volumes around the core. Differences in group mean ADC between patients with <i>MGMT</i> promoter methylated (mMGMT, <i>n</i> = 43) and <i>MGMT</i> promoter unmethylated (uMGMT, <i>n</i> = 58) GBM was analyzed with Wilcoxon signed rank test.</p><p><strong>Results: </strong>For both mMGMT and uMGMT GBM, mean ADC values around the tumor core significantly increased as a function of distance from the core toward the periphery of the perienhancing FLAIR hyperintensity (approximately 10% increase within 5 voxels with <i>P</i> < 001). While group mean ADC in the tumor core was not significantly different, the distance-resolved ADC profile around the core was approximately 10% higher in mMGMT than in uMGMT GBM (<i>P</i> < 10^-8 at 5 voxel distance from the tumor core).</p><p><strong>Conclusions: </strong>Distance-resolved volumetric ADC analysis around the tumor core reveals tissue signatures of GBM imperceptible to the human eye on conventional MRI. The different ADC profiles around the core suggest epigenetically influenced differences in perienhancing tissue characteristics between mMGMT and uMGMT GBM.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"302-310"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre- and Postoperative Imaging of Cochlear Implantation in Cadaveric Specimens Using Low-Dose Photon-Counting Detector CT.","authors":"Bjoern Spahn, Franz-Tassilo Müller-Graff, Kristen Rak, Jonas Engert, Johannes Voelker, Stephan Hackenberg, Rudolf Hagen, Tilmann Neun, Bernhard Petritsch, Thorsten Alexander Bley, Jan-Peter Grunz, Henner Huflage","doi":"10.3174/ajnr.A8533","DOIUrl":"https://doi.org/10.3174/ajnr.A8533","url":null,"abstract":"<p><strong>Background and purpose: </strong>Anatomically adapted cochlear implantation and efficient postoperative cochlear implant-fitting strategies benefit from reliable and highly detailed imaging techniques. Since image quality in CT is related to the applied radiation dose, this study aimed to evaluate low-dose cochlear imaging with a photon-counting detector by investigating the accuracy of pre- and postoperative cochlear analysis.</p><p><strong>Materials and methods: </strong>Photon-counting CT images of 10 temporal bone specimens were acquired with 3 different radiation dose levels (regular dose: 27.1 mGy, low dose: 4.81 mGy, and ultra-low dose: 3.43 mGy) before and after cochlear implant electrode carrier insertion. A clinical scan protocol was used with a tube potential of 120 kV in ultra-high-resolution scan mode (detector collimation 120 × 0.2 mm). The accuracy of cochlear duct length measurements for the organ of Corti and electrode contact determination was investigated for all applied settings by 2 independent otosurgeons.</p><p><strong>Results: </strong>No substantial differences were ascertained between photon-counting CT scans performed with standard dose and dedicated low-dose imaging regarding the accuracy of neither pre- and postoperative cochlear analysis nor postoperative cochlear implant electrode analysis. Radiation dose reduction of 82.3% (low dose) and 87.3% (ultra-low dose) could be realized compared with the clinical standard protocol.</p><p><strong>Conclusions: </strong>Ultra-high-resolution cochlear imaging is feasible with very low radiation exposure when using a first-generation photon-counting CT in combination with dedicated low-dose protocols. The accuracy of pre- and postoperative cochlear analysis with the applied dose reduction settings was comparable with a clinical regular-dose protocol.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":"46 2","pages":"362-371"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Susceptibility Mapping in Adults with Persistent Postconcussion Symptoms after Mild Traumatic Brain Injury: An Exploratory Study.","authors":"Tiffany K Bell, Muhammad Ansari, Julie M Joyce, Leah J Mercier, David G Gobbi, Richard Frayne, Chantel Debert, Ashley D Harris","doi":"10.3174/ajnr.A8454","DOIUrl":"10.3174/ajnr.A8454","url":null,"abstract":"<p><strong>Background and purpose: </strong>It is estimated that 18%-30% of patients with concussion experience symptoms lasting more than 1 month, known as persistent post-concussion symptoms (PPCS). Symptoms can be debilitating, and include headache, dizziness, nausea, problems with memory and concentration, sleep and mood disruption, and exercise intolerance. Previous studies have used quantitative susceptibility mapping (QSM) to show altered tissue susceptibility levels in adults acutely following concussion, however this finding has yet to be investigated in participants with PPCS.</p><p><strong>Materials and methods: </strong>In this exploratory case-controlled study, we measured tissue susceptibility using QSM in 24 participants with PPCS after mild traumatic brain injury (mTBI) and 23 healthy controls with no history of concussion. We compute tissue susceptibility for 7 white matter tracts and 3 deep gray matter regions and compare tissue susceptibility between groups using ANCOVA models controlling for age and sex. We also assess the relationship between regional tissue susceptibility and symptoms.</p><p><strong>Results: </strong>There were no significant differences between tissue susceptibility in participants with PPCS compared with control subjects in any of the evaluated regions. However, we show lower tissue susceptibility across 4 white matter tracts was generally associated with worse symptoms in the PPCS group. Specifically, we saw relationships between white matter susceptibility and headache (<i>p</i> = .006), time since injury (<i>p</i> = .03), depressive symptoms (<i>p</i> = .021), and daytime fatigue (<i>p</i> = .01) in participants with PPCS.</p><p><strong>Conclusions: </strong>These results provide evidence in support of persistent changes in the brain months to years after injury and highlight the need to further understand the pathophysiology of PPCS, to determine effective prevention and treatment options.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"435-442"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging and Anesthesia Protocol Optimization in Sedated Clinical Resting-State fMRI.","authors":"Elmira Hassanzadeh, Alyssa Ailion, Masoud Hassanzadeh, Alena Hornak, Noam Peled, Dana Martino, Simon K Warfield, Zhou Lan, Taha Gholipour, Steven M Stufflebeam","doi":"10.3174/ajnr.A8438","DOIUrl":"10.3174/ajnr.A8438","url":null,"abstract":"<p><strong>Background and purpose: </strong>The quality of resting-state fMRI (rs-fMRI) under anesthesia is variable and there are no guidelines on optimal image acquisition or anesthesia protocol. We aim to identify the factors that may lead to compromised clinical rs-fMRI under anesthesia.</p><p><strong>Materials and methods: </strong>In this cross-sectional study, we analyzed clinical rs-fMRI data acquired under anesthesia from 2009-2023 at Massachusetts General Hospital. Independent component analysis-driven resting-state networks (RSNs) of each patient were evaluated qualitatively and quantitatively and grouped as robust or weak. Overall networks were evaluated by using the qualitative method, and motor and language networks were evaluated by using the quantitative method. RSN robustness was analyzed in 4 outcome categories: overall, combined motor-language, individual motor, and language networks. Predictor variables included rs-fMRI acquisition parameters, anesthesia medications, underlying brain structural abnormalities, age, and sex. Logistic regression was used to examine the effect of the study variables on RSN robustness.</p><p><strong>Results: </strong>Sixty-nine patients were identified. With qualitative assessment, 40 had robust and 29 had weak overall RSN. Quantitatively, 45 patients had robust, while 24 had weak motor-language networks. Among all the predictor variables, only sevoflurane significantly contributed to the outcomes, with sevoflurane administration reducing the odds of having robust RSN in overall (OR = 0.2, 95% CI = 0.05-0.79, <i>P</i> = .02), motor-language (OR = 0.18, 95% CI = 0.04-0.80, <i>P</i> = .02), and individual motor (OR = 0.1, 95% CI = 0.02-0.64, <i>P</i> = .02) categories. Individual language network robustness was not associated with the tested predictor variables.</p><p><strong>Conclusions: </strong>Sevoflurane anesthesia may compromise the visibility of fMRI RSN, particularly impacting motor networks. This finding suggests that the type of anesthesia is a critical factor in rs-fMRI quality. We did not observe the association of the MR acquisition technique or underlying structural abnormality with the RSN robustness.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"293-301"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}