AJNR. American journal of neuroradiology最新文献

{"title":"Pituitary gland duplication syndrome - An international imaging analysis.","authors":"Ulrike Löbel, Martin Catala, Felice D'Arco, Maarten H Lequin, Rossella Pasquariello, Pilvi Ilves, Dagmar Loorits, Annika Tähepõld, Giulio Pezzetti, Ian Craven, Mariasavina Severino, Andrea Rossi","doi":"10.3174/ajnr.A8534","DOIUrl":"https://doi.org/10.3174/ajnr.A8534","url":null,"abstract":"<p><strong>Background and purpose: </strong>Duplication of the pituitary gland is a rare developmental anomaly. Multiple associated craniofacial malformations have previously been reported with the largest series to date consisting of five patients. In this multi-institutional series of ten patients, we present a detailed review of the imaging features and discuss a possible overarching pathogenesis that would explain most of the detected malformations.</p><p><strong>Materials and methods: </strong>Inclusion criteria for this retrospective imaging review were the presence of a pituitary stalk and gland duplication and the characteristic appearance of the hypothalamic ventral midline. In addition to the clinical presentation, we recorded the imaging findings of ten patients (9 female) through onsite and online reviews. Genetic analysis was available for six patients.</p><p><strong>Results: </strong>The duplicated pituitary stalk and gland showed normal imaging appearances in all patients. Mammillary bodies were clearly identified lateral to the characteristic prominence of the hypothalamic ventral midline. Strands of tissue extending to the anterior dura (\"limited ventral myeloschisis\") were noted at the medulla oblongata in 10, and at the cervical spinal cord in 7 patients. The medulla oblongata showed a \"butterfly\" appearance on axial images in 9 patients. Ten patients had cervical segmentation anomalies (\"zipper\"-like), 9 anterior-posterior brainstem patterning defects (small pons, elongated medulla), and corpus callosum measurements were abnormal in all patients. Three patients each presented with diencephalic-mesencephalic junction abnormalities and 4 with an anterior mesencephalic \"cap\". An oropharyngeal teratoma was present in four patients. Genetics was normal in three of the six patients studied; the remainder were found to have mutations in <i>EFNB1</i> and a gene variant of <i>GIT1</i>, two copies of 7. And 8. exon of <i>SMN1</i> gene, and 2.126 megabase duplication at bands q11.1 and q11.2 of one chromosome 15, respectively.</p><p><strong>Conclusions: </strong>Duplication of the pituitary gland presents as well-defined craniofacial and cervical spine malformation phenotype. Axial mesoderm duplication generating an excess of Sonic Hedgehog may be the primary embryological driver leading to this condition.</p><p><strong>Abbreviations: </strong>CFNS＝ Craniofrontonasal Syndrome; DPG＝ Duplication of the Pituitary Gland; SHH＝ Sonic Hedgehog.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407335","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":"Multi-Site Benchmark Study for Standardized Relative Cerebral Blood Volume in Untreated Brain Metastases Using the DSC-MRI Consensus Acquisition Protocol.","authors":"Sarah Kohn Loizzo, Melissa A Prah, Min J Kong, Daniel Phung, Javier C Urcuyo, Jason Ye, Frank J Attenello, Jesse Mendoza, Yuxiang Zhou, Mark S Shiroishi, Leland S Hu, Kathleen M Schmainda","doi":"10.3174/ajnr.A8531","DOIUrl":"https://doi.org/10.3174/ajnr.A8531","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and purpose: &lt;/strong&gt;A national consensus recommendation for the collection of DSC (dynamic susceptibility contrast) MRI perfusion data, used to create maps of relative cerebral blood volume (rCBV), has been recently established for primary and metastatic brain tumors. The goal was to reduce inter-site variability and improve ease of comparison across time and sites, fostering widespread use of this informative measure. To translate this goal into practice the prospective collection of consensus DSC-MRI data and characterization of derived rCBV maps in brain metastases is needed. The purpose of this multi-site study was to determine rCBV in untreated brain metastases in comparison to glioblastoma and normal appearing brain using the national consensus protocol.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;Subjects from three sites with untreated enhancing brain metastases underwent DSC-MRI according to a recommended option that uses a mid-range flip angle, GRE-EPI acquisition and the administration of both a pre-load and 2&lt;sup&gt;nd&lt;/sup&gt; DSC-MRI dose of 0.1 mmol/kg GBCA. Quantitative maps of standardized rCBV (sRCBV) were generated and enhancing lesion ROIs determined from post-contrast T1-weighted images alone or calibrated difference maps, termed delta T1 (dT1) maps. Mean sRCBV for metastases were compared to normal appearing white matter (NAWM) and glioblastoma (GBM) from a previous study. Comparisons were performed using either the Wilcoxon signed-rank test for paired comparisons or the Mann-Whitney nonparametric test for unpaired comparisons.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;49 patients with a primary histology of lung (n=25), breast (n=6), squamous cell carcinoma (SCC) (n=1), melanoma (n=5), gastrointestinal (GI) (n=3) and genitourinary (GU) (n=9) were included in comparison to GBM (n=31). The mean sRCBV of all metastases (1.83+/-1.05) were significantly lower (p=0.0009) than mean sRCBV for GBM (2.67±1.34) with both statistically greater (p&lt;0.0001) than NAWM (0.68 +/- 0.18). Histologically distinct metastases are each statistically greater than NAWM (p&lt;0.0001) with lung (p=0.0002) and GU (p=.02) sRCBV being significantly different than GBM sRCBV.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;49 patients with a primary histology of lung (n=25), breast (n=6), squamous cell carcinoma (SCC) (n=1), melanoma (n=5), gastrointestinal (GI) (n=3) and genitourinary (GU) (n=9) were included in comparison to GBM (n=31). The mean sRCBV of all metastases (1.83+/-1.05) were significantly lower (p=0.0009) than mean sRCBV for GBM (2.67+1.34) with both statistically greater (p&lt;0.0001) than NAWM (0.68 +/- 0.18). Histologically distinct metastases are each statistically greater than NAWM (p&lt;0.0001) with lung (p=0.0002) and GU (p=.02) sRCBV being significantly different than GBM sRCBV.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Abbreviations: &lt;/strong&gt;dT1=delta T1; GBCA=gadolinium-based contrast agent; NAWM=normal appearing white matter; normalized relative cerebral blood volume=","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402239","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":"Macro- and Microstructural White Matter Differences in Neurologic Postacute Sequelae of SARS-CoV-2 Infection.","authors":"Erin E O'Connor, Rosangela Salerno-Goncalves, Nikita Rednam, Rory O'Brien, Peter Rock, Andrea R Levine, Thomas A Zeffiro","doi":"10.3174/ajnr.A8481","DOIUrl":"https://doi.org/10.3174/ajnr.A8481","url":null,"abstract":"<p><strong>Background and purpose: </strong>Neuropsychiatric complications of SARS-CoV-2 infection, also known as neurologic postacute sequelae of SARS-CoV-2 infection (NeuroPASC), affect 10%-60% of infected individuals. There is growing evidence that NeuroPASC is a multi system immune dysregulation disease affecting the brain. The behavioral manifestations of NeuroPASC, such as impaired processing speed, executive function, memory retrieval, and sustained attention, suggest widespread WM involvement. Although previous work has documented WM damage following acute SARS-CoV-2 infection, its involvement in NeuroPASC is less clear. We hypothesized that macrostructural and microstructural WM differences in NeuroPASC participants would accompany cognitive and immune system differences.</p><p><strong>Materials and methods: </strong>In a cross-sectional study, we screened a total of 159 potential participants and enrolled 72 participants, with 41 asymptomatic controls (NoCOVID) and 31 NeuroPASC participants matched for age, sex, and education. Exclusion criteria included neurologic disorders unrelated to SARS-CoV-2 infection. Assessments included clinical symptom questionnaires, psychometric tests, brain MRI measures, and peripheral cytokine levels. Statistical modeling included separate multivariable regression analyses of GM/WM/CSF volume, WM microstructure, cognitive, and cytokine concentration between-group differences.</p><p><strong>Results: </strong>NeuroPASC participants had larger cerebral WM volume than NoCOVID controls (β = 0.229; 95% CI: 0.017-0.441; <i>t</i> = 2.16; <i>P</i> = .035). The most pronounced effects were in the prefrontal and anterior temporal WM. NeuroPASC participants also exhibited higher WM mean kurtosis, consistent with ongoing neuroinflammation. NeuroPASC participants had more self-reported symptoms, including headache, and lower performance on measures of attention, concentration, verbal learning, and processing speed. A multivariate profile analysis of the cytokine panel showed different group cytokine profiles (Wald-type-statistic = 44.6, <i>P</i> = .046), with interferon (IFN)-λ1 and IFN-λ2/3 levels higher in the NeuroPASC group.</p><p><strong>Conclusions: </strong>NeuroPASC participants reported symptoms of lower concentration, higher fatigue, and impaired cognition compatible with WM syndrome. Psychometric testing confirmed these findings. NeuroPASC participants exhibited larger cerebral WM volume and higher WM mean kurtosis than NoCOVID controls. These findings suggest that immune dysregulation could influence WM properties to produce WM volume increases and consequent cognitive effects and headaches. Further work will be needed to establish mechanistic links among these variables.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402225","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":"Evidence for a Link of COVID-19-Associated Long-Term Neurologic Symptoms and Altered Brain Integrity?","authors":"Alexander Rau, Horst Urbach, Jonas A Hosp","doi":"10.3174/ajnr.A8433","DOIUrl":"10.3174/ajnr.A8433","url":null,"abstract":"","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142402224","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":"Black hole sign under anticoagulant therapy: A retrospective comparison of warfarin and direct oral anticoagulants.","authors":"Hirotaka Sato, Manabu Kinoshita, Takuma Takano, Takahiro Sanada, Seiya Fujikawa, Masahiro Toda, Kiyoshi Choji, Teruo Kimura","doi":"10.3174/ajnr.A8528","DOIUrl":"https://doi.org/10.3174/ajnr.A8528","url":null,"abstract":"<p><strong>Background and purpose: </strong>Direct oral anticoagulants (DOAC) have rapidly replaced warfarin. Intracerebral hemorrhage (ICH) is known to be one of the most severe side effects of anticoagulant drugs. The black hole (BH) sign is reportedly a valid radiological sign for predicting hematoma expansion in acute ICH. Here, we hypothesized that the frequency of BH signs might differ between warfarin and DOAC treatment, and critically evaluated the clinical value of the BH sign in acute ICH under warfarin versus DOAC therapy.</p><p><strong>Materials and methods: </strong>Patients with acute ICH under anticoagulant therapy were enrolled. Hematoma volumes were measured by ABC/2. Radiologists blinded to the clinical information determined the presence or absence of the BH sign on CT images. This study defined a more than 12.5 ml increase in hematoma volume as cases with \"expanded hematoma\".</p><p><strong>Results: </strong>We analyzed 111 acute ICH patients under anticoagulant therapy. Among them, 21 patients were treated with antagonists in this cohort. Multivariate logistic regression analysis revealed that the presence of ventricular perforation (<i>p</i>=0.02; adjusted odds ratio (OR): 3.51, 95% confidence interval (CI): 1.32 - 10.2) and the BH sign (<i>p</i><0.01; adjusted OR: 4.86, 95% CI: 1.73 - 14.3) were significantly different between expanded and non-expanded hematoma cases. Comparison of hematoma volume and the presence of the BH sign between warfarin and DOAC cases indicated significant differences in maximum hematoma volume (<i>p</i>=0.03) and presence of the BH sign (<i>p</i><0.01). The increase in hematoma volume was significantly greater when the BH sign was present under warfarin therapy (<i>p</i>=0.05). In contrast, the increase in hematoma volume did not differ between cases with and without the BH sign in patients under DOAC therapy (<i>p</i>=0.14) CONCLUSIONS: The BH sign is a useful radiological signature to predict the expansion of acute ICH under anticoagulant therapy. ICH under warfarin tended to present the BH sign more frequently than that under DOAC. The results also showed that the BH sign is more reliable under warfarin than under DOAC therapy in ICH patients.</p><p><strong>Abbreviations: </strong>AF = atrial fibrillation; BH = black hole; DOAC = direct oral anticoagulants; HU = Hounsfield Unit; ICH= intracerebral hemorrhage.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395916","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":"Comparison of Diffusion-weighted MRI using Singe-Shot Echo-planar Imaging (SS-EPI) and Split Acquisition of Fast Spin Echo Signal (SPLICE) Imaging, a non-EPI technique, in Tumors of the Head and Neck.","authors":"Hedda J van der Hulst, Loes Braun, Bram Westerink, Georgios Agrotis, Leon C Ter Beek, Renaud Tissier, Milad Ahmadian, Roland M Martens, Jan W Casselman, Regina G H Beets-Tan, Michiel W M van den Brekel, Jonas A Castelijns","doi":"10.3174/ajnr.A8529","DOIUrl":"https://doi.org/10.3174/ajnr.A8529","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and purpose: &lt;/strong&gt;Diffusion-weighted imaging (DWI) using single-shot echo planar imaging (DW-EPI) is susceptible to distortions around air-filled cavities and dental fillings, typical for the head and neck area. Non-EPI, Split acquisition of fast spin echo signals for diffusion imaging (DWSPLICE) could reduce these distortions and enhance image quality, thereby potentially improving recurrence assessment in squamous cell carcinoma (SCC) of the head and neck region. This study evaluated whether DW-SPLICE is a viable alternative to DW-EPI through quantitative and qualitative analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;The DW-SPLICE sequence was incorporated into the standard 3.0T head and neck MRI protocol with DW-EPI. Retrospective analysis was conducted on two subgroups: firstly benign or malignant lesions, and secondly post-treatment SCC recurrence. In both subgroups Image quality and distortion were scored by two independent radiologists, blinded for DW-technique, and evaluated using mixed-effect linear models. Lesion apparent diffusion coefficient (ADC) values were assessed with inter-class correlation (ICC) and Bland-Altman analyses. DWI's delineation geometric similarity to T1-weighted post-contrast (T1Wc) MRI was evaluated using the Dice Similarity Coefficient (DSC) before and after registration. Recurrence in post-treatment SCC scans was evaluated by the same two radiologists blinded for DW-technique. Recurrence detection rates were then compared between DW-SPLICE and DW-EPI using mixed logistic regression at six months and at one-year post-scan follow-up data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From August 2020 to January 2022, 55 benign or malignant lesion scans (55 patients) and 74 post-treatment SCC scans (66 patients) were analyzed. DW-SPLICE scored better on image quality and showed less overall distortion than DW-EPI (0.04&lt;p&lt;0.001). There was high ADC measurement reliability (ICC=0.93, p&lt;0.001), though a proportional bias was also observed (β=0.11, p=0.03), indicating the bias increases as ADC values rise. DWSPLICE exhibited greater geometric similarity to T1Wc before registration (DSC 0.63 vs 0.47, p&lt;0.001) and outperformed DW-EPI by more accurately identifying recurrences after one year (OR=0.96, p=0.05) but not after six months (OR=0.72, p=0.13).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;DW-SPLICE surpasses DW-EPI on image distortion and quality and improves diagnostic reliability for detecting recurrent or residual SCC on 3T MRI of the HN. Consistent use of one method for follow-up is advised, as ADC values are not completely interchangeable. Integrating DW-SPLICE can significantly improve tumor assessments in clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Abbreviations: &lt;/strong&gt;ANTs = Advanced Normalization Tools; DSC = Dice Similarity Coefficient; DW-EPI = Diffusion-weighted single-shot echo planar imaging; DW-MS-EPI = Diffusion-weighted multi-shot echo planar imaging; DW-SPLICE = Diffusion-weighted split acqui","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395917","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":"Evidence of small vessel disease in patients with transient global amnesia based on the peak width of skeletonized mean diffusivity.","authors":"Dong Ah Lee, Ho-Joon Lee, Kang Min Park","doi":"10.3174/ajnr.A8530","DOIUrl":"https://doi.org/10.3174/ajnr.A8530","url":null,"abstract":"<p><strong>Background and purpose: </strong>The peak width of skeletonized mean diffusivity (PSMD) is a novel marker of small vessel disease. In this study, we aimed to investigate the presence of small vessel disease in patients with transient global amnesia (TGA) using the PSMD.</p><p><strong>Materials and methods: </strong>We enrolled 75 patients newly diagnosed with TGA and included 65 age-and sex-matched healthy controls. Diffusion tensor imaging (DTI) was performed using a 3T magnetic resonance imaging scanner. We measured the PSMD based on DTI using the FSL program. This measure was compared between patients with TGA and healthy controls. Additionally, we conducted a correlation analysis to explore the relationship between PSMD and clinical factors.</p><p><strong>Results: </strong>A significant difference in the PSMD between patients with TGA and healthy controls was observed. Patients with TGA exhibited higher a PSMD compared to healthy controls (2.297±0.232 vs. 2.188±0.216 ×10^-4 mm²/s, <i>p</i>=0.005). Additionally, patients with TGA but without any vascular risk factors, such as diabetes, hypertension or dyslipidemia, also exhibited higher a PSMD compared to healthy controls (2.278±0.253 vs. 2.188±0.216 ×10^-4 mm²/s, <i>p</i>=0.036). The PSMD positively correlated with age (r=0.248, <i>p</i>=0.032); however, it was not associated with duration of amnesia.</p><p><strong>Conclusions: </strong>This finding underscores the feasibility of using PSMD as a marker for detecting small vessel diseases in patients with neurological disorders. Furthermore, our study also implies the presence of small vessel disease may be present in patients with TGA.</p><p><strong>Abbreviations: </strong>TGA=transient global amnesia; TIA= transient ischemic attack; PSMD= peak width of skeletonized mean diffusivity; DTI= diffusion tensor imaging.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395918","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":"Super-Resolution in Clinically Available Spinal Cord MRIs Enables Automated Atrophy Analysis.","authors":"Blake E Dewey, Samuel W Remedios, Muraleetharan Sanjayan, Nicole Bou Rjeily, Alexandra Zambriczki Lee, Chelsea Wyche, Safiya Duncan, Jerry L Prince, Peter A Calabresi, Kathryn C Fitzgerald, Ellen M Mowry","doi":"10.3174/ajnr.A8526","DOIUrl":"10.3174/ajnr.A8526","url":null,"abstract":"<p><strong>Background and purpose: </strong>Measurement of the mean upper cervical cord area (MUCCA) is an important biomarker in the study of neurodegeneration. However, dedicated high-resolution scans of the cervical spinal cord are rare in standard-of-care imaging due to timing and clinical usability. Most clinical cervical spinal cord imaging is sagittally acquired in 2D with thick slices and anisotropic voxels. As a solution, previous work describes high-resolution T1-weighted brain imaging for measuring the upper cord area, but this is still not common in clinical care.</p><p><strong>Materials and methods: </strong>We propose using a zero-shot super-resolution technique, SMORE, already validated in the brain, to enhance the resolution of 2D-acquired scans for upper cord area calculations. To incorporate super-resolution in spinal cord analysis, we validate SMORE against high-resolution research imaging and in a real-world longitudinal data analysis.</p><p><strong>Results: </strong>Super-resolved images reconstructed using SMORE showed significantly greater similarity to the ground truth than low-resolution images across all tested resolutions (p<0.001 for all resolutions in PSNR and MSSIM). MUCCA results from super-resolved scans demonstrate excellent correlation with high-resolution scans (r>0.973 for all resolutions) compared to low-resolution scans. Additionally, super-resolved scans are consistent between resolutions (r>0.969), an essential factor in longitudinal analysis. Compared to clinical outcomes such as walking speed or disease severity, MUCCA values from low-resolution scans have significantly lower correlations than those from high-resolution scans. Super-resolved results have no significant difference. In a longitudinal real-world dataset, we show that these super-resolved volumes can be used in conjunction with T1-weighted brain scans to show a significant rate of atrophy (-0.790, p=0.020 vs. -0.438, p=0.301 with low-resolution).</p><p><strong>Conclusions: </strong>Super-resolution is a valuable tool for enabling large-scale studies of cord atrophy, as low-resolution images acquired in clinical practice are common and available.</p><p><strong>Abbreviations: </strong>MS=multiple sclerosis; MUCCA=mean upper cervical cord; HR=high-resolution; LR=low-resolution; SR=superresolved; CSC=cervical spinal cord; PMJ=pontomedullary junction; MSSIM=mean structural similarity; PSNR=peak signal-to-noise ratio; EDSS=expanded disability status scale.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376415","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":"Fetal MRI findings, etiology, and outcome in prenatally diagnosed schizencephaly.","authors":"Elizabeth George, Rachel Vassar, Yolanda Yu, Mary E Norton, Dawn Gano, Orit A Glenn","doi":"10.3174/ajnr.A8523","DOIUrl":"10.3174/ajnr.A8523","url":null,"abstract":"<p><strong>Background and purpose: </strong>Schizencephaly is a rare brain anomaly which is increasingly detected in utero. There are limited data on the etiology and outcomes in fetal schizencephaly to guide workup and counselling. We aim to determine the associated imaging findings, etiology, and outcomes in schizencephaly detected in utero.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 22 fetuses with a total of 34 schizencephaly defects identified by keyword search of fetal MRI reports from 1996-2022 followed by image review. Follow-up fetal and postnatal imaging, when available, were reviewed. Data on demographics, etiology, and outcomes were extracted from the electronic medical record.</p><p><strong>Results: </strong>The schizencephaly defect was open in 28/34, most common in the MCA territory (23/34), and commonly involved the frontal (16/34) lobe. Additional intracranial abnormalities were seen in all fetuses including other cortical malformations (CM, 13/22), abnormal posterior fossa (12/22), abnormal corpus callosum (10/20), and intraparenchymal hemorrhage (9/22).The cause of schizencephaly was classified as secondary (as evidenced by intraparenchymal hemorrhage at schizencephaly, monochorionic twin gestation, infection, or maternal/placental risk factor) in 64% (14/22), potentially genetic in 9% (2/22), and unknown in 27% (6/22). Among those liveborn (n=8), the following outcomes were observed: postnatal death (1/8), tube feeding (1/7), shunted hydrocephalus (1/7), epilepsy (4/7). Among those >1 year of age, cerebral palsy (4/5) and speech delay or intellectual disability (3/5) were common. CM remote from schizencephaly was associated with epilepsy (p=0.03). On postnatal imaging, open defects often involuted (8/11) and there were high rates of new/additional findings (4/6).</p><p><strong>Conclusions: </strong>In this cohort, fetal schizencephaly was always associated with additional intracranial abnormalities. In most cases, there was evidence that schizencephaly was likely secondary to prior injury. Imaging characteristics may provide clues regarding neurodevelopmental outcome. Postnatal imaging is crucial in assessing evolution as well as for detection of additional abnormalities.</p><p><strong>Abbreviations: </strong>ICH = intracranial hemorrhage; CM = cortical malformation; VM = ventriculomegaly; DGN = deep grey nuclei; SP = septum pellucidum; IPH = intraparenchymal hemorrhage; CC = corpus callosum; PMG = polymicrogyria; PVNH = periventricular nodular heterotopia; TTTS = twin-twin transfusion syndrome; GA = gestational age; CP = cerebral palsy.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376414","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-based Intra-thrombus and Peri-thrombus Radiomics for Prediction of Prognosis After Endovascular Thrombectomy: A Retrospective Study Across Two Centers.","authors":"Minda Li, Jingxuan Jiang, Gu Hongmei, Hu Su, Wang Jingli, Chunhong Hu","doi":"10.3174/ajnr.A8522","DOIUrl":"10.3174/ajnr.A8522","url":null,"abstract":"<p><strong>Background and purpose: </strong>Complications from endovascular thrombectomy (EVT) can negatively affect clinical outcomes, making the development of a more precise and objective prediction model essential. This research aimed to assess the effectiveness of radiomic features derived from pre-surgical CT scans in predicting the prognosis post- EVT in acute ischemic stroke patients.</p><p><strong>Materials and methods: </strong>This investigation included 336 acute ischemic stroke patients from two medical centers, spanning from March 2018 to March 2024. The participants were split into a training cohort of 161 patients and a validation cohort of 175 patients. Patient outcomes were rated with the mRS: 0-2 for good, 3-6 for poor. A total of 428 radiomic features were derived from intra-thrombus and peri-thrombus regions in non-contrast CT and CT angiography images. Feature selection was conducted using a least absolute shrinkage and selection operator regression model. The efficacy of eight different supervised learning models was assessed using the area under the curve (AUC) of the receiver operating characteristic curve.</p><p><strong>Results: </strong>Among all models tested in the validation cohort, the logistic regression algorithm for combined model achieved the highest AUC (0.87, with a 95% confidence interval of 0.81 to 0.92), outperforming other algorithms. The combined use of radiomic features from both the intra-thrombus and peri-thrombus regions significantly enhanced diagnostic accuracy over models using features from a single region (0.81 vs 0.70, 0.77), highlighting the benefit of integrating data from both regions for improved prediction.</p><p><strong>Conclusions: </strong>The findings suggest that a combined radiomics model based on CT imaging serves as a potent approach to assessing the prognosis following EVT. The logistic regression model, in particular, proved to be both effective and stable, offering critical insights for the management of stroke.</p><p><strong>Abbreviations: </strong>AUC=area under the curve; EVT=endovascular thrombectomy; KNN=k-nearest neighbors; LASSO=least absolute shrinkage and selection operator; LightGBM=Light Gradient Boosting Machine; LR=logistic regression; MLP=multi-layer perceptron; RF=random forest; SVM=support vector machine; XGBoost=extreme gradient boosting.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376413","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}