AJNR. American journal of neuroradiology最新文献

{"title":"Unveiling the New Digital <i>AJNR:</i> Personalized and Interactive.","authors":"","doi":"10.3174/ajnr.A8541","DOIUrl":"10.3174/ajnr.A8541","url":null,"abstract":"","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":"46 1","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Emergent Carotid Stenting Performed before or after Mechanical Thrombectomy in the Endovascular Management of Patients with Tandem Lesions: A Multicenter Retrospective Matched Analysis.","authors":"Luca Scarcia, Francesca Colò, Andrea M Alexandre, Valerio Brunetti, Alessandro Pedicelli, Francesco Arba, Maria Ruggiero, Mariangela Piano, Joseph D Gabrieli, Valerio Da Ros, Daniele G Romano, Anna Cavallini, Giancarlo Salsano, Pietro Panni, Nicola Limbucci, Antonio A Caragliano, Riccardo Russo, Guido Bigliardi, Luca Milonia, Vittorio Semeraro, Emilio Lozupone, Luigi Cirillo, Frederic Clarençon, Andrea Zini, Aldobrando Broccolini","doi":"10.3174/ajnr.A8421","DOIUrl":"10.3174/ajnr.A8421","url":null,"abstract":"<p><strong>Background and purpose: </strong>Mechanical thrombectomy (MT) along with emergent carotid stent placement (eCAS) has been suggested to have a greater benefit in patients with tandem lesions (TL), compared with other strategies of treatment. Nonetheless, there is no agreement on whether the intracranial occlusion should be treated before the cervical ICA lesion, or vice versa. In this retrospective multicenter study, we sought to compare clinical and procedural outcomes of the 2 different treatment approaches in patients with TL.</p><p><strong>Materials and methods: </strong>The prospective databases of 17 comprehensive stroke centers were screened for consecutive patients with TL who received MT and eCAS. Patients were divided in 2 groups based on whether they received MT before eCAS (MT-first approach) or eCAS before MT (eCAS-first approach). Propensity score matching was used to estimate the effect of the retrograde-versus-anterograde approach on procedure-related and clinical outcome measures. These included the modified TICI score 2b-3, other procedure-related parameters and adverse events after the endovascular procedure, and the ordinal distribution of the 90-day mRS scores.</p><p><strong>Results: </strong>A total of 295 consecutive patients were initially enrolled. Among them, 208 (70%) received MT before eCAS. After propensity score matching, 56 pairs of patients were available for analysis. In the matched population, the MT-first approach resulted in a higher rate of successful intracranial recanalization (91% versus 73% in the eCAS-first approach, <i>P </i>= .025) and a mean shorter groin-to-reperfusion time (72 [SD, 38] minutes versus 93 [SD, 50] minutes in the anterograde approach, <i>P </i>= .017). Despite a higher rate of efficient recanalization in the MT-first group, we did not observe a significant difference regarding the ordinal distribution of the 90-day mRS scores. Rates of procedure-related adverse events and the occurrence of both parenchymal hemorrhage types 1 and 2 were comparable.</p><p><strong>Conclusions: </strong>Our study demonstrates that in patients with TL undergoing endovascular treatment, prioritizing the intracranial occlusion is associated with an increased rate of efficient MT and faster recanalization time. However, this strategy does not have an advantage in long-term clinical outcome. Future controlled studies are needed to determine the optimal treatment technique.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"96-101"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuroradiologic, Clinical, and Genetic Characterization of Cerebellar Heterotopia: A Pediatric Multicentric Study.","authors":"Ludovica Pasca, Filippo Arrigoni, Romina Romaniello, Maria Savina Severino, Davide Politano, Fulvio D'Abrusco, Jessica Garau, Valentina De Giorgis, Adriana Carpani, Sabrina Signorini, Simona Orcesi, Felice D'Arco, Enrico Alfei, Elisa Cattaneo, Elisa Rognone, Sara Uccella, Maria Teresa Divizia, Paolo Infantino, Enza Maria Valente, Renato Borgatti, Anna Pichiecchio","doi":"10.3174/ajnr.A8450","DOIUrl":"10.3174/ajnr.A8450","url":null,"abstract":"<p><strong>Background and purpose: </strong>Cerebellar heterotopia (CH) is a neuroradiologic abnormality that is poorly reported and investigated in the literature. It can be observed as an isolated finding, but it has been mainly reported in the context of cerebellar dysgenesis and syndromic conditions. This study aims to provide a comprehensive neuroradiologic, clinical, and genetic characterization of a cohort of pediatric patients with CH.</p><p><strong>Materials and methods: </strong>Patients with a diagnosis of CH were systematically selected from the neuroimaging databases of the 4 Italian centers participating in this retrospective study. For each patient, information regarding demographic, clinical, genetic, and neuroradiologic data was collected.</p><p><strong>Results: </strong>Thirty-two pediatric patients were recruited and subdivided into 2 groups: patients with isolated CH and/or cerebellar malformations (<i>n</i> = 18) and patients with CH associated with cerebral malformations (<i>n</i> = 14). Isolated CH consistently showed a peripheral subcortical localization in the inferior portion of cerebellar hemispheres, with either unilateral or bilateral distribution. Ten patients belonging to the second group had a diagnosis of CHARGE syndrome, and their nodules of CH were mainly but not exclusively bilateral, symmetric, located in the peripheral subcortical zone and the inferior portion of the cerebellar hemispheres. The remaining 4 patients of the second group showed either bilateral or unilateral CH, located in both the peripheral cortex and deep white matter and the superior and inferior portions of cerebellum. Patients with isolated CH showed a high prevalence of language development delay; neurodevelopmental disorders were the most represented clinical diagnoses. Recurring features were behavioral problems and motor difficulties. A conclusive genetic diagnosis was found in 18/32 patients.</p><p><strong>Conclusions: </strong>We found distinctive neuroradiologic patterns of CH. Genetic results raise the possibility of a correlation between cerebellar morphologic and functional developmental disruption, underscoring the importance of CH detection and reporting to orient the diagnostic path.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"170-177"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142482795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State of Practice on Transcranial MR-Guided Focused Ultrasound: A Report from the ASNR Standards and Guidelines Committee and ACR Commission on Neuroradiology Workgroup.","authors":"Bhavya R Shah, Jody Tanabe, John E Jordan, Drew Kern, Stephen C Harward, Fabricio S Feltrin, Padraig O'Suilliebhain, Vibhash D Sharma, Joseph A Maldjian, Alexandre Boutet, Raghav Mattay, Leo P Sugrue, Kazim Narsinh, Steven Hetts, Lubdha M Shah, Jason Druzgal, Vance T Lehman, Kendall Lee, Shekhar Khanpara, Shivanand Lad, Timothy J Kaufmann","doi":"10.3174/ajnr.A8405","DOIUrl":"10.3174/ajnr.A8405","url":null,"abstract":"<p><p>Transcranial focused ultrasound (FUS) is a versatile, MR-guided, incisionless intervention with diagnostic and therapeutic applications for neurologic and psychiatric diseases. It is currently FDA-approved as a thermoablative treatment of essential tremor and Parkinson disease. However, other applications of FUS including BBB opening for diagnostic and therapeutic applications, sonodynamic therapy, histotripsy, and low-intensity focused ultrasound neuromodulation are all in clinical trials. While FUS targeting for essential tremor and Parkinson disease has classically relied on an indirect, landmark-based approach, development of novel, advanced MR imaging techniques such as DTI tractography and fast gray matter acquisition T1 inversion recovery has the potential to improve individualized targeting and thus potentially enhance treatment response, decrease treatment times, and avoid adverse effects. As the technology advances and the number of clinical applications increases, the role of the neuroradiologist on a multidisciplinary team will be essential in pairing advanced structural and functional imaging to further this image-guided procedure via a precision medicine approach. This multi-institutional report, written by an experienced team of neuroradiologists, neurosurgeons, and neurologists, summarizes current practices, the use of advanced imaging techniques for transcranial MR-guided high-intensity FUS, recommendations for clinical implementation, and emerging clinical indications.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"2-10"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735448/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-Guided Epidural Contrast Injection for the Identification of Dural Defects.","authors":"Ian T Mark, Michael Oien, John C Benson, Jared Verdoorn, Ben Johnson-Tesch, D K Kim, Jeremy Cutsforth-Gregory, Ajay A Madhavan","doi":"10.3174/ajnr.A8437","DOIUrl":"10.3174/ajnr.A8437","url":null,"abstract":"<p><p>Post-dural puncture headache is an increasingly recognized cause of chronic headache. Outside of clinical history and myelography that requires an additional dural puncture, there is no reliable diagnostic test to evaluate for persistent dural defects. We describe the injection of iodinated contrast into the dorsal epidural space under CT guidance in 5 patients as a potential tool to visualize persistent dural defects.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"207-210"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cortically Based Brain Tumors in Children: A Decision-Tree Approach in the Radiology Reading Room.","authors":"V Rameh, U Löbel, F D'Arco, A Bhatia, K Mankad, T Y Poussaint, C A Alves","doi":"10.3174/ajnr.A8477","DOIUrl":"10.3174/ajnr.A8477","url":null,"abstract":"<p><p>Cortically based brain tumors in children constitute a unique set of tumors with variably aggressive biologic behavior. Because radiologists play an integral role on the multidisciplinary medical team, a clinically useful and easy-to-follow flow chart for the differential diagnoses of these complex brain tumors is essential. This proposed algorithm tree provides the latest insights into the typical imaging characteristics and epidemiologic data that differentiate the tumor entities, taking into perspective the 2021 World Health Organization's classification and highlighting classic as well as newly identified pathologic subtypes by using current molecular understanding.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"11-23"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Performance of TOF, 4D MRA, Arterial Spin-Labeling, and Susceptibility-Weighted Angiography Sequences in the Post-Radiosurgery Monitoring of Brain AVMs.","authors":"Shahriar Kolahi, Mohammadreza Tahamtan, Masoumeh Sarvari, Diana Zarei, Mahshad Afsharzadeh, Kavous Firouznia, David M Yousem","doi":"10.3174/ajnr.A8420","DOIUrl":"10.3174/ajnr.A8420","url":null,"abstract":"<p><strong>Background: </strong>Brain AVMs are congenital anomalies of the cerebrovascular system, often discovered incidentally or through symptomatic presentations such as intracranial hemorrhage, seizure, headache, or neurologic deficits. Various treatment modalities exist for AVMs, including radiosurgery, a treatment technique that is noninvasive and efficient. Accurate imaging is crucial for risk assessment, treatment planning, and monitoring of these patients before and after radiosurgery.</p><p><strong>Purpose: </strong>Currently, DSA is the preferred imaging technique. Despite its efficacy, DSA is notably invasive, presenting inherent risks to the patients. This systematic review and meta-analysis aimed to evaluate the efficacy of MRI sequences for monitoring brain AVMs after radiosurgery.</p><p><strong>Data source: </strong>We performed a comprehensive search of PubMed, Scopus, Web of Science, and EMBASE databases and a methodologic quality assessment with the QUADAS-2 checklist diagnostic test accuracy.</p><p><strong>Study selection: </strong>According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 3,220 abstracts were screened, 98 articles were reviewed in full text, and 14 articles met the inclusion criteria.</p><p><strong>Data analysis: </strong>We used the bivariate random-effects meta-analysis model with STATA/MP 17 software for data analysis.</p><p><strong>Data synthesis: </strong>No publication bias was detected. Fourteen studies were eligible for qualitative and quantitative analysis. MRI offers high sensitivity (85%) and specificity (99%) in detecting residual AVMs. Different MRI sequences, including 3D TOF-MRA, 4D MRA, and arterial spin-labeling (ASL) demonstrated varying diagnostic accuracies with areas under the curve of 0.92, 0.97, and 0.96, respectively. 4D MRA had a sensitivity of 72% and specificity of 99%, ASL showed a sensitivity of 90% and specificity of 92%, while 3D TOF-MRA had 90% sensitivity and 87% specificity.</p><p><strong>Limitations: </strong>Meta-regression did not fully explain the sources of heterogeneity. Only 1 study assessed the susceptibility-weighted angiography (SWAN) method, and most studies involved small participant groups with varied MR techniques and sequences. Additionally, the retrospective nature of most studies may introduce bias, warranting cautious interpretation of the results.</p><p><strong>Conclusions: </strong>MRI sequences show acceptable diagnostic performance in postradiosurgery monitoring of brain AVMs, with ASL and 4D MRA showing acceptable diagnostic accuracy. Combining different MRI sequences may further enhance diagnostic reliability. However, further investigation is needed to assess whether MRI sequences can serve as a feasible substitute for DSA, considering their risk-benefit profile, with the potential to establish them as the recommended standard.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"57-65"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141725257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Arterial Spin-Labeling and DSC Perfusion MR Imaging in Pediatric Brain Tumors: A Systematic Review and Meta-Analysis.","authors":"Stephanie Vella, Josef Lauri, Reuben Grech","doi":"10.3174/ajnr.A8442","DOIUrl":"10.3174/ajnr.A8442","url":null,"abstract":"<p><strong>Background: </strong>Brain tumors are a leading cause of mortality in children. Accurate tumor grading is essential to plan treatment and for prognostication. Perfusion imaging has been shown to correlate well with tumor grade in adults, however there are fewer studies in pediatric patients. Moreover, there is no consensus regarding which MR perfusion technique demonstrates the highest accuracy in the latter population.</p><p><strong>Purpose: </strong>We sought to compare the diagnostic test accuracy of DSC and arterial spin-labeling (ASL), in their ability to differentiate between low- and high-grade pediatric brain tumors at first presentation.</p><p><strong>Data sources: </strong>Articles were retrieved from online electronic databases: MEDLINE (Ovid), Web of Science Core Collection, and Scopus.</p><p><strong>Study selection: </strong>Studies in pediatric patients with a treatment-naïve diagnosed brain tumor and imaging including either ASL or DSC or both, together with a histologic diagnosis were included. Studies involving adult patient or mixed age populations, studies with incomplete data, and those that used dynamic contrast-enhanced perfusion were excluded.</p><p><strong>Data analysis: </strong>The sensitivities and specificities obtained from each study were used to calculate the true-positive, true-negative, false-positive, and false-negative count. A case was defined as a histologically proved high-grade tumor. The random-effect model was used to merge statistics. Significance level was set at <i>P</i> < .05.</p><p><strong>Data synthesis: </strong>Forest plots showing pairs of sensitivity and specificity, with their 95% CIs, were constructed for each study. The bivariate model was applied to account for between-study variability. The summary receiver operating characteristics (SROC) plots were constructed from the obtained data sets. The area under the curve for the SROC of all studies was estimated to determine the overall diagnostic test accuracy of perfusion MRI, followed by a separate comparison of the SROC of ASL versus DSC studies.</p><p><strong>Limitations: </strong>There was a small and heterogeneous sample size.</p><p><strong>Conclusions: </strong>The diagnostic accuracy of ASL was found to be comparable and not inferior to DSC, thus its use in the diagnostic assessment of pediatric patients should continue to be supported.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"178-185"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inter- and Intrarater Agreement of CT Brain Calcification Scoring in Primary Familial Brain Calcification.","authors":"Birgitta M G Snijders, Huiberdina L Koek, Mike J L Peters, Willem P T M Mali, Michelle M van Beek, Merel J C Betman, Nienke M S Golüke, Tijl Kruyswijk, Stéphanie V de Lange, Bouke D W T Lith, Ruth M Pekelharing, Marvin J Roos, Dirk R Rutgers, Simone M Uniken Venema, Wouter R Verberne, Marielle H Emmelot-Vonk, Pim A de Jong","doi":"10.3174/ajnr.A8446","DOIUrl":"10.3174/ajnr.A8446","url":null,"abstract":"<p><strong>Background and purpose: </strong>The total calcification score (TCS) is a visual rating scale to measure primary familial brain calcification (PFBC)-related calcification severity on CT. We investigated the inter- and intrarater agreement of a modified TCS.</p><p><strong>Materials and methods: </strong>Patients aged ≥18 years with PFBC or Fahr syndrome who visited the outpatient clinic of a Dutch academic hospital were included. The TCS was modified, for example, by adding hippocampal calcification, and ranged from 0 to 95 points. Fifteen raters evaluated all CTs, of whom 3 evaluated the CTs twice. Their entrustable professional activity (EPA) level ranged from II (medical student) to V (neuroradiologist). Agreement was assessed by using the intraclass correlation coefficient (ICC) for the total score. Kendall's W and weighted Cohen κ were used to determine the inter- and intrarater agreement for individual locations, respectively.</p><p><strong>Results: </strong>Forty patients were included (mean age 60 years, 53% women). The median modified TCS was 34 (range 4-76). For all EPA levels, the interrater agreement of the modified TCS was excellent (ICC = 0.97 [95% CI 0.95-0.98]). The Kendall W values were good to excellent for commonly affected locations, but poor to moderate for less commonly affected locations for raters with lower levels of expertise. The intrarater agreement of the modified TCS was excellent. The Cohen κ of most locations were substantial to almost perfect.</p><p><strong>Conclusions: </strong>The modified TCS can be used with excellent reproducibility of the overall amount of brain calcifications and with limited training, although for some individual calcification locations more expertise is needed.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"147-152"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing CT-like bone images based on FRACTURE MR with CT in pediatric congenital vertebral anomalies.","authors":"Hirva N Manek, Foram B Gala","doi":"10.3174/ajnr.A8639","DOIUrl":"https://doi.org/10.3174/ajnr.A8639","url":null,"abstract":"<p><strong>Background and purpose: </strong>Congenital vertebral anomalies are commonly associated with underlying spinal cord anomaly which necessitates imaging both the spinal cord and the bony vertebral column to understand the extent of the deformity better. While MRI is the gold standard for spinal cord imaging, it does not provide CT-like bone details. Many MR bone imaging techniques have been tested in various adult spine conditions in the past decade but not much has been described on their reliability in pediatric spine. We elaborate on our experience with Fast field echo resembling a CT using restricted echo spacing (FRACTURE) MR bone imaging in congenital vertebral anomalies in children.</p><p><strong>Materials and methods: </strong>11 pediatric patients referred to the imaging department for CT and MR study of congenital vertebral anomaly were prospectively included. After receiving informed consent from these patient's guardians, both studies were performed in a single setting and under a single sedation. FRACTURE MR was accelerated using the compressed SENSE technique to reduce the imaging time. We then compared FRACTURE MR and CT images for image quality and studied parameters like formation or segmentation anomalies, anomalous shape of vertebrae, and alignment deformities.</p><p><strong>Results: </strong>FRACTURE MR showed acceptable image quality with diagnostically limiting artifacts in only 1 patient. The inter-reader agreement was perfect in the assessment of vertebral body segmentation or formation anomaly and alignment abnormalities, and it was substantial for posterior element anomalies. The bone signal was lower in children under the age of 3 years of age due to a more immature and cartilaginous skeleton.</p><p><strong>Conclusions: </strong>FRACTURE MR provides images of acceptable quality in pediatric spinal anomalies. The addition of this novel sequence can be complementary to conventional MR in providing osseous details and CT can be reserved for certain specific indications like post operative cases. This can help in reducing the radiation dose to this group of pediatric patients who will be serially followed up with imaging during their management.</p><p><strong>Abbreviations: </strong>FRACTURE - Fats field echo resembling a CT using restricted echo spacing, CS - Compressed SENSE, KF - Klippel Feil, GRE - Gradient echo, UTE - Ultrashort Time to echo, ZTE - Zero Time to echo, CNR - Contrast-to-noise ratio, SNR - Signal-tonoise ratio, MSK -Musculoskeletal.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901075","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}