AJNR. American journal of neuroradiology最新文献

{"title":"CSF-venous Fistulas Occurring in First Degree Relatives: A Multi-Center Case Series.","authors":"Ajay A Madhavan, Michelle L Kodet, Timothy J Amrhein, William P Dillon, Maggie Waung, Matthew Amans, Ian T Mark, Jeremy K Cutsforth-Gregory, Marcel M Maya, Wouter I Schievink","doi":"10.3174/ajnr.A9039","DOIUrl":"https://doi.org/10.3174/ajnr.A9039","url":null,"abstract":"<p><p>CSF-venous fistulas are a common cause of spontaneous intracranial hypotension. Although these fistulas are increasingly recognized and diagnosed, their risk factors and pathogenesis remain incompletely understood. Previous studies have elucidated many nonheritable risk factors associated with CSF-venous fistulas, including elevated body mass index, presence of spinal degenerative changes, and advanced age. Furthermore, these fistulas are associated with the presence of spinal meningeal diverticula, although many asymptomatic patients also possess these diverticula. There are likely additional predisposing factors for this disease that are yet to be discovered. The existence of CSF-venous fistulas among closely related relatives has not been previously studied, even though such cases may imply a heritable basis for this disease. In this clinical report, we performed a retrospective, multi-center case series describing four pairs of first-degree relatives (eight patients) who developed CSF-venous fistulas. We evaluated the clinical and imaging features of these patients, finding that the majority had an elevated body mass index and spinal meningeal diverticula. No patients had evidence of a connective tissue disorder. Overall, our study supports previous literature regarding nonheritable risk factors for CSF-venous fistulas but also suggests the presence of undiscovered genetic predispositions.ABBREVIATIONS: CVF = CSF-venous fistula; FTD = frontotemporal dementia; SIH = spontaneous intracranial hypotension.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276765","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":"Spine MRI Diverticular Patterns Predict CSF-Venous Fistula Location: A 100-Patient Study.","authors":"Mark D Mamlouk, James F R Latoff, Adriana Gutierrez, Mark F Sedrak","doi":"10.3174/ajnr.A9042","DOIUrl":"https://doi.org/10.3174/ajnr.A9042","url":null,"abstract":"<p><strong>Background and purpose: </strong>CSF-venous fistulas (CVFs) are an increasingly recognized cause of spontaneous intracranial hypotension and require invasive myelography for localization. Whether spine MRI can noninvasively predict CVF origin remains unclear. The purpose of our study was to determine if spine MRI features, particularly the size and location of spinal meningeal diverticula, are predictive of the CVF location identified on myelography.</p><p><strong>Materials and methods: </strong>Retrospective review of 100 patients with a CVF confirmed on decubitus CT myelography who underwent preprocedural spine MRI. The primary outcome was whether the CVF arose at or adjacent to the largest diverticulum. Secondary outcomes included distribution patterns of largest adjacent-level diverticula and their spatial relationship to the CVF (cranial, caudal, ipsilateral, contralateral). Chi-square tests, one-sided binomial tests, and t-tests were used to assess statistical significance.</p><p><strong>Results: </strong>CVFs originated at or adjacent to the largest diverticulum in 77% of patients, significantly more than expected by chance (<i>P</i> < .001). 71.7% of CVFs were within one level of the adjacent largest diverticulum on spine MRI. Among adjacent-level cases of the largest diverticula, there was a significant directional preference for the adjacent largest diverticulum to occur caudal to the CVF compared to a uniform distribution (<i>P</i> = .001). There were three specific diverticular patterns that were statistically significant: caudal and ipsilateral 1 level below the CVF (<i>P</i> < .001), contralateral same level (<i>P</i> < .001), and caudal and contralateral 1 level (<i>P</i>= 0.002). There was no significant correlation between the laterality of the largest diverticulum size nor the laterality of the majority of the diverticula compared to the laterality of the CVF.</p><p><strong>Conclusions: </strong>Spinal CVFs most commonly arise at or adjacent to the largest meningeal diverticulum. The adjacent largest diverticulum was commonly within one level to the CVF and most commonly caudal one level to the CVF or at the same level contralateral side to the CVF. These MRI-based predictors may help guide myelography.</p><p><strong>Abbreviations: </strong>CVF ＝ CSF-venous fistula; CTM ＝ CT myelogram.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276781","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":"Circumferential Epidural Patch for Postdural Puncture Headache: A Technical Report.","authors":"Soren Christensen, Peter G Kranz, Michael D Malinzak, Linda Gray, Jay Willhite, Daphne Zhu, Timothy J Amrhein","doi":"10.3174/ajnr.A9038","DOIUrl":"https://doi.org/10.3174/ajnr.A9038","url":null,"abstract":"<p><p>A subset of postdural puncture headaches (PDPH) persist despite conventional epidural blood patches, leading to chronic symptoms and substantial disability. Dural punctures may involve not only the dorsal dural surface, which is covered by a standard interlaminar epidural blood patch (EBP), but also in some instances the ventral dural surface, which may not be covered by standard EBPs. This report describes the CT fluoroscopy-guided circumferential EBP, a technique that achieves 360° coverage of patching material around the thecal sac using combined ventral transforaminal and dorsal interlaminar injections. The procedural details for this technique are described, and the technical success and clinical results are reported for six patients with PDPH, four of whom had failed prior dorsal-only EBPs. Intraprocedural imaging confirmed complete circumferential patch coverage in all cases, and all six patients reported substantial or complete symptomatic resolution. These results establish the feasibility of CT fluoroscopy-guided circumferential EBP for PDPH.ABBREVIATIONS: EBP = epidural blood patch; PDPH = postdural puncture headache.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276705","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":"Temporal Characteristics of Type 2 Lateral Spinal CSF Leaks on Digital Subtraction Myelography: Fast, Medium or Slow Leaks?","authors":"Niklas Lützen, Horst Urbach, Florian Volz, Amir El Rahal, Katharina Wolf, Laura Krismer, Jürgen Beck, Charlotte Zander","doi":"10.3174/ajnr.A9040","DOIUrl":"https://doi.org/10.3174/ajnr.A9040","url":null,"abstract":"<p><strong>Background and purpose: </strong>Type 2 leaks occur in up to 20% of spontaneous intracranial hypotension (SIH) due to a spinal lateral dural tear, typically accompanied by arachnoid hernia. Their CSF-outflow dynamics are unclear, but could have implications on performing myelography for best possible detection. This cross-sectional study analyzed temporal characteristics of type 2 leaks using digital subtraction myelography (DSM).</p><p><strong>Materials and methods: </strong>Between February 2020 and April 2025, 63 consecutive patients with type 2 leaks were retrospectively identified. Patients undergoing sufficient decubitus DSM (comprising additional fluoroscopy and X-ray images) were included. We assessed the time for the contrast agent to first appear in the epidural space after reaching the level of the leak intrathecally at 1-2 frames-per-second (fps), and categorized them as fast (0-9 sec), medium (10-90 sec), and slow (>90 sec) leaks. Furthermore, effects of intrathecal pressurization, arachnoid hernia size, opening pressure and symptom-duration on CSF-outflow were studied.</p><p><strong>Results: </strong>Forty-five patients (36 women) were included. Mean age was 39.0 years (SD ± 11.4 years), mean BMI 23.2 (SD ± 3.9) and median Bern score 6 (IQR 5). Type 2 leaks most commonly occurred at the T10/11 level (12/45; 26.7%) ranging between T7/8 -L1/2. During DSM, contrast appeared in the epidural space within 0-9 sec in 3/45 (6.7%), 10-90 sec in 24/45 (53.3%) and >90 sec in 5/45 (11,1%) of cases (range: 4 to 473 sec). If DSM (or fluoroscopy/X-ray) missed the leak, subsequent cone-beam or CT myelography detected it (13/45; 28.9%); total slow leaks were 18/45 (40%). All patients undergoing surgery (40/45) had the leak confirmed intraoperatively. In a subgroup of patients undergoing pressurization during DSM (12/45), there were significantly more leaks detected within 90s (p=0.02), while arachnoid hernia size, opening pressure and symptom duration did not affect CSF-outflow significantly.</p><p><strong>Conclusions: </strong>Type 2 leaks show a wide range of CSF-outflow characteristics, with most being medium and slow. For DSM, we propose using a 90-second run with intrathecal pressurization and cone-beam CT standby for effective leak detection, whereas less than 1 fps (e.g., 0.5 fps) seems feasible to minimize radiation. Alternatively, dynamic CT myelography can be considered -although timing of CT scans has yet to be evaluated.</p><p><strong>Abbreviations: </strong>SIH=spontaneous intracranial hypotension; DSM (digital subtraction myelography); CB-CTM (Cone-beam CT myelography); EID-CTM (energy-integrating detector CT myelography).</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276730","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":"Microcatheter Intrathecal Selective Myelography for Intraprocedural CSF-Venous Fistula Evaluation Pre-and Post-Embolization.","authors":"Troy A Hutchins, Anton Peled, Miriam Peckham, Lubdha M Shah, Forrest Hamrick, Lidia Guzhva, Ramesh Grandhi","doi":"10.3174/ajnr.A9041","DOIUrl":"https://doi.org/10.3174/ajnr.A9041","url":null,"abstract":"<p><p>Recognition of cerebrospinal fluid-venous fistulas as a cause of spontaneous intracranial hypotension is increasing. Currently, lateral decubitus digital subtraction myelography and lateral decubitus CT myelography are the mainstays for diagnosing cerebrospinal fluid- venous fistulas. Although various methods exist for diagnostic assessment of spinal cerebrospinal fluid-venous fistulas, real-time intraprocedural evaluation during endovascular treatment has yet to be described. We report our experience with real-time intraprocedural evaluation of a cerebrospinal fluid-venous fistula before and after transvenous embolization using the technique of microcatheter intrathecal selective myelography.ABBREVIATIONS: CVF = cerebrospinal fluid-venous fistula; CTM = computed tomography myelography; DSM = digital subtraction myelography; mISM = microcatheter intrathecal selective myelography.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276751","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 Radiomic Features are Associated with DNA Copy Number Alterations of Head and Neck Squamous Cell Carcinomas.","authors":"Stefan P Haider, Andrea Schreier, Tal Zeevi, Moritz Gross, Benedikt Paul, Jasmin Krenn, Martin Canis, Philipp Baumeister, Christoph A Reichel, Seyedmehdi Payabvash, Kariem Sharaf","doi":"10.3174/ajnr.A9029","DOIUrl":"https://doi.org/10.3174/ajnr.A9029","url":null,"abstract":"<p><strong>Background and purpose: </strong>While a larger fraction of head and neck squamous cell carcinoma (HNSCC) genomes is characterized by a high prevalence of copy number alterations (CNA-positive), a smaller subset with more favorable oncologic outcome is instead driven by somatic mutations (CNA-negative). We aimed to investigate the radiomic phenotypes of CNA-positive and -negative HNSCCs in contrast CT images.</p><p><strong>Materials and methods: </strong>Single nucleotide polymorphism (SNP)-array copy number data were utilized and CNA-based hierarchical clustering of patients was performed to define CNA subclasses. Radiomic features (n=1037) quantifying shape, first-order intensity, and texture were extracted from HNSCC primary tumors in pretherapeutic neck CTs. We performed univariate association analyses and trained, optimized and validated radiomics-based CNA prediction models by combining feature selection algorithms with machine learning classifiers.</p><p><strong>Results: </strong>A total of 522 and 114 patients were included in the copy number and radiomic analyses, respectively. Univariate analysis revealed 190 features from all feature subtypes (shape, first-order, texture) were significantly associated with the CNA status; after multiple testing correction, 29 texture or first-order features remained significant. The best-performing CNA status prediction model utilized a support vector machine classifier, achieving an AUC of 0.71 (95% confidence interval: 0.60-0.83).</p><p><strong>Conclusions: </strong>CNA subgroups exhibit distinct radiomic phenotypes, primarily reflected in texture and intensity characteristics. These findings enhance our understanding of the biological significance of radiomic information in HNSCC. In the clinical setting, as CNA-positive and -negative HNSCCs may emerge as distinct subclasses with unique staging schemes and treatment implications, improved CT radiomics-based prediction models could offer a noninvasive, cost-effective method for CNA subtyping.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260225","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":"Artificial Intelligence-Driven Detection of Large Vessel Occlusions on NCCT: A Multi-Institutional Study.","authors":"Ansaar T Rai, Abdulrahman Al Halak, Mohamad Abdalkader, Artem Kaliaev, Thanh N Nguyen, David F Kallmes, Waleed Brinjikji, Thien Huynh, Dhairya Lakhani, Alistair Perry, Olivier Joly, Pau Bellot, James H Briggs, Zoe V J Woodhead, George Harston, Davide Carone","doi":"10.3174/ajnr.A8923","DOIUrl":"https://doi.org/10.3174/ajnr.A8923","url":null,"abstract":"<p><strong>Background and purpose: </strong>Imaging triage of stroke patients is primarily based on perfusion imaging. Simplified triage based on non-contrast CT are limited (NCCT). To evaluate the predictive capability of a deep learning algorithm, \"Triage Stroke\" (Brainomix 360) in identifying anterior circulation large vessel occlusions (LVO) on NCCT in patients with suspected acute ischemic stroke (AIS).</p><p><strong>Materials and methods: </strong>This multi-institutional study analyzed 612 patients with suspected AIS at 3 US comprehensive stroke centers. A balanced cohort of consecutive patients with and without anterior circulation LVO was analyzed. Ground truth was based on concurrent CTA evaluated by site neuroradiologists. The primary outcome was predictive performance for LVO detection. The secondary outcomes were 1) prospective comparison of NCCT LVO detection against general radiologists and subspecialty neuroradiologists, and 2) the influence of NIHSS on the model.</p><p><strong>Results: </strong>Triage Stroke software detected an LVO on NCCT with a 67% sensitivity and 93% specificity. The positive and negative predictive values were 59% and 95%, respectively, with an area under the curve (AUC) of 0.8. The software's sensitivity for LVO detection was significantly higher than the group average of all radiologists (difference = 20.5%; CI, 8.26-32.78; <i>P</i> = .001) and was also higher when separated into general and neuroradiology subgroups. The AUC for NCCT LVO was significantly higher than the group of all readers (difference = 11%; CI, 4%-17%; <i>P</i> < .001), and the nonexpert readers (difference = 13%, CI, 7%-20%; <i>P</i> < .001). The addition of NIHSS to the model yielded a high specificity (99%) and similar sensitivity (65%), resulting in the optimum positive predictive value of all models tested (91%).</p><p><strong>Conclusions: </strong>Triage Stroke software demonstrated strong predictive capabilities for NCCT detection of anterior circulation LVOs outperforming radiologists. Coupled with NIHSS it may simplify identification of endovascular candidates especially in resource-constrained environments worldwide.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260228","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":"Baseline Gadolinium Enhancement of the Intracranial Aneurysm Wall and 3D Morphologic Change during Long-Term Follow-Up.","authors":"Maarten J Kamphuis, Laura T van der Kamp, Jari T van Vliet, Ruben P A van Eijk, Jeroen Hendrikse, Gabriel J E Rinkel, Mervyn D I Vergouwen, Irene C van der Schaaf","doi":"10.3174/ajnr.A8825","DOIUrl":"10.3174/ajnr.A8825","url":null,"abstract":"<p><strong>Background and purpose: </strong>Previous studies have shown that intracranial aneurysm wall enhancement (AWE) is associated with aneurysm growth or rupture. These studies assessed growth with manual 2D measurements or eyeballing, both of which are prone to interobserver variability. To minimize this variability, we assessed the association between AWE and semiautomatically quantified 3D morphologic changes in aneurysms during long-term follow-up.</p><p><strong>Materials and methods: </strong>We included patients with an unruptured intracranial aneurysm who had baseline MR aneurysm wall imaging and were followed with MR or CT angiography for ≥1 year. We used in-house-developed software to measure six 3D morphologic parameters on paired baseline and follow-up scans and determined changes with time. We compared the proportion of aneurysms showing morphologic change (modified <i>z</i> score, ≤3.5 or ≥3.5) between aneurysms with and without AWE. The risk difference was calculated with 95% CI for each morphologic parameter. For parameters with a statistically significant change difference between aneurysms with and without AWE, we calculated ORs with 95% CI in a univariable logistic regression model and adjusted for aneurysm size in a bivariable model.</p><p><strong>Results: </strong>Sixty-two patients with 72 unruptured intracranial aneurysms met the inclusion criteria. Twenty aneurysms (28%) in 18 patients showed AWE at baseline. The median follow-up was 5.8 years (interquartile range, 4.6-6.6 years). For the parameter curvedness, the proportion of aneurysms showing an increase was higher in aneurysms with AWE (6 of 20, 30%) than in aneurysms without AWE (2 of 52, 4%), with a risk difference of 26%; 95% CI, 9-49. For the other 5 morphologic parameters, the proportion of aneurysms with morphologic change was comparable between aneurysms with and without AWE. In logistic regression analysis, AWE was associated with a curvedness increase (crude OR, 10.7; 95% CI, 2.2-78.9, adjusted OR, 6.1; 95% CI, 1.01-50.3).</p><p><strong>Conclusions: </strong>AWE was associated with aneurysm shape change during long-term follow-up, with an increase in 3D quantified curvedness that was independent of aneurysm size. This result reinforces previous findings that AWE is associated with aneurysm instability, in particular curvedness increase, and suggests that curvedness could be a suitable parameter to capture aneurysm instability. Future studies need to investigate whether an increase in this parameter predicts aneurysmal rupture.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993972","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":"Study of Cerebellar Network Dynamics in Post-Stroke Aphasia Patients Based on Resting-State Functional Magnetic Resonance Imaging.","authors":"Liting Chen, Yanhong Dai, Wenfeng Mai, Zhenye Luo, Yongqiang Shu, Xiaoyun Chen, Qun Fang, Lv Chen, Zhuoming Chen, Lifeng Li, Shuixing Zhang","doi":"10.3174/ajnr.A9030","DOIUrl":"https://doi.org/10.3174/ajnr.A9030","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and purpose: &lt;/strong&gt;This study investigated dynamic cerebellar networks in post-stroke aphasia patients using resting-state fMRI. We examined intra-cerebellar and cerebellar-cortical dynamic functional connectivity quantified their temporal properties and graph-theoretical topology.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Seventy-seven right-handed patients with post-stroke aphasia and 79 healthy controls underwent underwent 3T resting-state functional MRI. Dynamic cerebellar functional networks were constructed using the Seitzman-27 cerebellar atlas. A sliding-window approach (30 TR window, 1 TR step) was applied, followed by k-means clustering to identify distinct connectivity states. Graph-theoretical analyses were performed to quantify state-specific network topology. Variability of dynamic functional connectivity between cerebellar and cortical regions was calculated. Partial correlation analyses were conducted to examine relationships between dynamic network measures, lesion volume, and language and cognitive function.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Two cerebellar dynamic functional connectivity states were identified in post-stroke aphasia: a predominant segregated state (78.93%) with widespread reductions in connectivity and decreased clustering coefficient (d = -1.29), characteristic path length (d = -0.62), and Local Efficiency (d = -1.11), but higher Global Efficiency (d = 1.06); and a less frequent integrated state (21.07%) with enhanced connectivity and higher Clustering Coefficient (d = 0.57) and Characteristic Path Length (d = 0.70), but diminished Global Efficiency (d = -1.25) and small-worldness (d = -0.92), small-world index (d = -0.89). Post-stroke aphasia showed reduced variability of dynamic functional connectivity between cerebellar and cortical regions involved in language and cognition (Gaussian random field correction, voxel-level p &lt; 0.001, cluster-level p &lt; 0.05). Lesion volume negatively correlated with Aphasia Quotient, Repetition, Memory, Executive Function, and Attention (p &lt; 0.05). State-specific network metrics and variability measures were associated with language and cognitive performance independently of lesion volume.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Post-stroke aphasia patients exhibited a segregated cerebellar state with reduced intra-cerebellar connectivity and efficiency, and an integrated state with enhanced connectivity and small-world properties, together with reduced variability in cerebellar-cortical connections to language-and cognition-related regions. These state-specific network alterations were linked to distinct behavioral domains independently of lesion volume, highlighting a dissociation between structural constraints and dynamic, lesion-independent plasticity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Abbreviations: &lt;/strong&gt;PSA = Post-Stroke Aphasia; DFC = Dynamic Functional Connectivity; FPN = Frontoparietal Network; DMN = Default Mode Network; SMN = Somatomotor Network; Eloc = Local ","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145260270","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":"The Role of Ferumoxytol-Enhanced MR Venography in Transvenous Embolization of CSF-Venous Fistulas.","authors":"Javier L Galvan, Theodore W Hagens, Rola Saouaf, Wouter I Schievink, Marcel M Maya","doi":"10.3174/ajnr.A8837","DOIUrl":"10.3174/ajnr.A8837","url":null,"abstract":"<p><strong>Background and purpose: </strong>Spontaneous intracranial hypotension (SIH) often results from CSF-venous fistulas (CVFs), and transvenous embolization is an effective treatment. Precise preprocedural venous mapping is crucial to optimize outcomes and mitigate risks. The purpose of this study was to evaluate the utility of ferumoxytol-enhanced MRV in delineating venous anatomy for preprocedural planning in CVF treatment.</p><p><strong>Materials and methods: </strong>This retrospective study included 57 participants referred for paraspinal venous embolization between July 2021 and February 2024. Participants were categorized into 3 groups: SIH with confirmed CVFs, SIH without identified CVFs, and behavioral variant frontotemporal dementia without CVFs. All participants underwent ferumoxytol-enhanced MRV to assess venous anatomy.</p><p><strong>Results: </strong>The cohort had mean age of 56.4 years (range, 18-86 years) and included 31 women and 26 men. Identified findings included a high prevalence of lumbar segmental veins draining directly into the inferior vena cava (93%), lumbar segmental veins draining into the left renal vein (54%), and incomplete ascending lumbar veins (63%). Other findings included a duplicated inferior vena cava (1.8%) and the pathologic condition azygos vein stenosis (7%). Preprocedural MRV effectively identified venous variations, guiding tailored intervention strategies, and minimizing procedural risks.</p><p><strong>Conclusions: </strong>Ferumoxytol-enhanced MRV provides comprehensive venous mapping, facilitating safer and more efficient planning for CVF treatment.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086792","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}