AJNR. American journal of neuroradiology最新文献

{"title":"Association Between Distal Stent Retriever Deployment Distance and First-Pass Effect and Hemorrhagic Complications in Combined Thrombectomy.","authors":"Koji Yoshida, Yosuke Akamatsu, Hiromu Sasaki, Kazumasa Dobashi, Masahiro Yabuki, Daisuke Oomori, Suguru Igarashi, Tatsuhiko Takahashi, Takayuki Chiba, Yasushi Ogasawara, Toshinari Misaki, Hiromu Konno, Kuniaki Ogasawara","doi":"10.3174/ajnr.A9391","DOIUrl":"https://doi.org/10.3174/ajnr.A9391","url":null,"abstract":"<p><strong>Background and purpose: </strong>Longer stent retrievers (SR) are associated with higher first-pass effect (FPE) rates, but the underlying mechanism remains unclear. We investigated whether stent retriever distance (SRD), defined as the distance between the distal thrombus end and the distal tip of the SR, is associated with modified FPE (mFPE) and post-thrombectomy SAH.</p><p><strong>Materials and methods: </strong>This retrospective analysis included patients with MCA occlusion (distal M1 or M2 segments) treated using a combined thrombectomy technique with a Solitaire X 3 × 40 mm SR at a single center. The co-primary endpoints were mFPE and post-thrombectomy SAH. Multivariable logistic regression identified independent predictors of mFPE and post-thrombectomy SAH.</p><p><strong>Results: </strong>Forty-three patients were included, with a median age of 81 years. mFPE was achieved in 27 patients (62.8%), and post-thrombectomy SAH occurred in 14 patients (32.6%). SRD was significantly longer in patients achieving mFPE than in those without mFPE (16.4 ± 6.8 mm vs 9.4 ± 5.6 mm, P = .001). In multivariable analysis, longer SRD was independently associated with achieving mFPE (adjusted odds ratio [OR] per 1-mm increase, 1.27; 95% confidence interval [CI], 1.04-1.52; P = .02). Patients achieving mFPE required fewer device passes than those without mFPE (median 1 [IQR, 1-1] vs 2 [IQR, 2-3], P < .001). SRD was significantly shorter in patients with post-thrombectomy SAH than in those without SAH (10.5 ± 5.3 mm vs 15.4 ± 7.6 mm, P = .04). In multivariable analysis, a higher number of device passes was independently associated with post-thrombectomy SAH (adjusted OR, 4.9; 95% CI, 1.42-17.00; P = .01), whereas SRD was no longer significantly associated with post-thrombectomy SAH after adjustment. Post-thrombectomy SAH was not significantly associated with unfavorable functional outcome at 3 months (mRS 4-6).</p><p><strong>Conclusions: </strong>Longer SRD was independently associated with a higher likelihood of mFPE during combined thrombectomy for MCA occlusions, although these findings should be interpreted with caution given the limited sample size. Repeated device passes were independently associated with post-thrombectomy SAH.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847257","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":"Enhancing 1p/19q Classification in Brain Gliomas Using IDH Status: A Deep Learning Study.","authors":"Jason E Bowerman, Ashwath S Kapilavai, Benjamin C Wagner, Nghi C D Truong, James M Holcomb, Divya D Reddy, Niloufar Saadat, Kimmo J Hatanpaa, Toral R Patel, Baowei Fei, Matthew D Lee, Rajan Jain, Richard J Bruce, Marco C Pinho, Chandan Ganesh Bangalore Yogananda, Joseph A Maldjian","doi":"10.3174/ajnr.A9400","DOIUrl":"https://doi.org/10.3174/ajnr.A9400","url":null,"abstract":"<p><strong>Background and purpose: </strong>IDH mutation & 1p/19q codeletion are critical biomarkers for glioma diagnosis & therapy. 1p/19q codeletion occurs exclusively in IDH-mutated gliomas. In this study, we developed a 2-stage, non-invasive, MRI-based deep learning method that leverages IDH status to enhance 1p/19q predictions.</p><p><strong>Materials and methods: </strong>Multi-contrast brain tumor MRI & genomic information were obtained from five publicly available (TCIA, UCSF, EGD, UPenn & LGG), and three in-house/collaborator institutions (UTSW, NYU, UWM). Subjects were screened for the availability of IDH & 1p/19q status as well as T1, T1CE, T2, FLAIR MR images. For training purposes, missing T1 and FLAIR contrasts for the LGG database were generated using an in-house multi-contrast simulator. Two separate <i>U-Nets</i> were developed for 1p/19q-classification: a multi-contrast network (<i>MC-Net)</i> and a T2w-only network (<i>T2-Net</i>). A separate <i>U-Net</i> was developed for IDH classification (<i>IDH-net</i>). A total of 2044 subjects were used in training and testing <i>IDH-N</i>et, and 1426 subjects were used in training and testing the 1p/19q models. The <i>IDH-Net</i> was trained using subjects from TCIA, UTSW, and UPenn. The 1p/19q networks were trained using subjects from TCIA, UTSW, and LGG. The trained networks were tested on true held-out cases from NYU, UWM, EGD, and UCSF. In the 2-stage approach, subjects were initially classified for IDH status using <i>IDH-Net.</i> Predicted IDH-wildtype cases default to 1p/19q non-codeleted. Then the IDH-mutated cases were further classified for 1p/19q status using the 1p/19q-networks.</p><p><strong>Results: </strong><i>IDH-Net</i> achieved a classification accuracy of 93.7%. 1p/19q <i>MC-Net</i> & <i>T2-Net</i> achieved classification accuracies of 86.5% & 86.0%, respectively. In the 2-stage approach, 1p/19q <i>MC-Net</i> and <i>T2-Net</i> achieved accuracies of 91.5% & 91.2% respectively, improving the classification accuracy by ∼5%.</p><p><strong>Conclusions: </strong>This study demonstrates the effectiveness of leveraging IDH status to enhance 1p/19q classification. A ∼5% increase in classification accuracy was achieved when using the 2-stage approach, using <i>IDH-Net</i> to gate 1p/19q predictions. The developed method offers a reliable, non-invasive approach to determine important biomarkers for glioma diagnosis.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847300","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":"Subtraction Iodine Imaging Generated from Dual-Energy CT: Optimal Energy Determination and Evaluation of Sinonasal and Nasopharyngeal Malignancies.","authors":"Takashi Hiyama, Yusuke Miyasaka, Akihito Nakajima, Hirofumi Kuno, Kotaro Sekiya, Shioto Oda, Tomoaki Sasaki, So Tsushima, Tatsushi Kobayashi","doi":"10.3174/ajnr.A9124","DOIUrl":"10.3174/ajnr.A9124","url":null,"abstract":"<p><strong>Background and purpose: </strong>Subtraction iodine imaging (SII) and dual-energy CT-derived iodine imaging (DEII) have been proposed to enhance tumor delineation in head and neck cancers. However, the optimal energy for SII and the added diagnostic value of SII or DEII combined with conventional CT (CCT) remain uncertain. We aimed to determine the optimal energy for SII and to evaluate its incremental diagnostic benefits, as well as those of DEII.</p><p><strong>Materials and methods: </strong>Thirty-nine patients with histologically confirmed sinonasal or nasopharyngeal malignancies who underwent dual-energy CT (DECT) and contrast-enhanced MRI were included in this retrospective study. SII was generated by subtracting pre- and postcontrast virtual monochromatic images from the DECT images (45-75 keV, in 5-keV increments). Contrast-to-noise ratios (CNRs) were measured in the brain, prevertebral muscles, and skull base. Tumor delineation was assessed on a 5-point scale by 2 blinded radiologists, and the diagnostic performance for local tumor extension was evaluated using clustered receiver operating characteristic analysis with bootstrap resampling.</p><p><strong>Results: </strong>The highest CNR across all anatomic sites was consistently achieved with SII at 65 keV. Tumor delineation scores were significantly higher with SII than with DEII (median, 4.5 versus 2.0; <i>P</i> < .001). Receiver operating characteristic analysis showed that CCT combined with SII yielded the highest diagnostic accuracy (area under the curve [AUC], 0.954), significantly outperforming CCT alone (AUC, 0.929; difference in AUC = 0.024; <i>P</i> = .02). The CCT combined with DEII did not show any significant improvements.</p><p><strong>Conclusions: </strong>SII at 65 keV provided optimal image quality, superior tumor delineation, and significantly improved diagnostic accuracy more than CCT did. Incorporating this imaging technique into CCT protocols may enhance the evaluation of tumor extension in sinonasal and nasopharyngeal malignancies.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145656332","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":"Coil Sensitivity-Guided Denoising of Non-Brain-Origin Fluctuations in fMRI.","authors":"Yul-Wan Sung, Masaki Fukunaga, Uk-Su Choi, Yuko Kawai, Daehun Kang, Kyoung-Nam Kim, Seiji Ogawa","doi":"10.3174/ajnr.A9394","DOIUrl":"https://doi.org/10.3174/ajnr.A9394","url":null,"abstract":"<p><p>Noise suppression is essential for improving the reliability of functional MRI (fMRI), particularly at ultra-high field strengths where system- and receiver-related fluctuations become prominent. We introduce a hardware-informed denoising method, Coil Sensitivity Filter (CsFilter), which exploits spatial sensitivity relationships among receiver coil elements to identify and suppress non-brain-origin signal components. CsFilter operates in the frequency domain by retaining temporal fluctuations whose coil-amplitude ordering is consistent with receiver sensitivity profiles. Using 7T task-based fMRI data acquired with a 32-channel head coil, CsFilter produced robust increases in voxel-wise temporal signal-to-noise ratio relative to conventional high-pass filtering, with more than 62% of voxels showing greater than twofold improvement. Task-based analyses showed increased statistical strength, with mean t-values rising from 4.68 to 5.74 and median t-values from 4.39 to 5.28. These results indicate that coil-sensitivity-guided filtering provides an effective and complementary strategy for suppressing additive non-brain-origin fluctuations in multi-channel fMRI data.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847292","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":"Relationship of Inferior Frontal Sulcal Hyperintensities with Amyloid-Related Imaging Abnormalities.","authors":"Saurabh Rohatgi, Nima Omid-Fard, Shenghua Zhu, Rafael Eduardo Martinez Imbett, Jeremy N Ford, Thomas P Dowling, John E Kirsch, Javier M Romero","doi":"10.3174/ajnr.A9395","DOIUrl":"https://doi.org/10.3174/ajnr.A9395","url":null,"abstract":"<p><strong>Objective: </strong>Anti-amyloid immunotherapies used to treat Alzheimer's disease (AD) are often associated with amyloid-related imaging abnormalities (ARIA). We aim to indirectly assess glymphatic function by using inferior frontal sulcal hyperintensity (IFSH) as a biomarker in patients receiving anti-amyloid therapy, both with and without ARIA, as well as in healthy controls. We hypothesize that patients who develop ARIA will have higher IFSH scores than non-ARIA patients and healthy controls.</p><p><strong>Methods: </strong>Eligible AD patients who received anti-amyloid treatment were included in our retrospectively collected dataset. Only scans performed at 3T were used. Inter-rater reliability was evaluated and statistical analyses of IFSH scores and demographic data were performed to compare between groups. Additionally, within-subject analysis was used to compare the baseline and ARIA scans. Significance set at P < 0.05.</p><p><strong>Results: </strong>A total of 104 patients were selected based on the study criteria, of whom 60 had a clinical diagnosis of dementia. 36 patients developed ARIA, while 24 did not develop ARIA. 23 were age-matched healthy controls, and 21 were young healthy controls. Inter-rater reliability between the two readers was concordant when using quadratic weights appropriate for ordinal data (κ (w) = 0. 91, 95% CI 0.86-0.95). IFSH was significantly higher in the older age cohorts compared to young healthy controls (median 3.5 [IQR 2.5-5] versus 0 [0-1], P<0.001), with no significant difference between the dementia and healthy elderly groups (3.25 [3-4.875] versus 3.5 [2.5-5]). Among dementia patients on anti-amyloid therapy, significantly higher IFSH was observed in ARIA patients (at time of ARIA scan) compared to their non-ARIA counterparts (3.75 [3-5] versus 3 [2-4], P= 0.04). There was no significant difference in IFSH score between baseline and ARIA scans (P = 0.16).</p><p><strong>Conclusion: </strong>IFSH was higher among dementia patients on anti-amyloid therapy with ARIA than among their non-ARIA counterparts. This supports its role as a potential biomarker of glymphatic dysfunction, although its utility on an individual basis is limited. Future prospective studies could benefit from incorporating IFSH as a variable, particularly if glymphatic therapies become a reality.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847393","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":"Erratum.","authors":"","doi":"10.3174/ajnr.A9331","DOIUrl":"https://doi.org/10.3174/ajnr.A9331","url":null,"abstract":"","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847401","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":"Diagnostic Yield of CT Myelography for the Identification of CSF Leaks in Patients with Post Dural Puncture Headache.","authors":"Derrek Schartz, Peter G Kranz, Michael D Malinzak, Jay Willhite, Ajay A Madhavan, Linda Gray, Timothy J Amrhein","doi":"10.3174/ajnr.A9119","DOIUrl":"10.3174/ajnr.A9119","url":null,"abstract":"<p><strong>Background and purpose: </strong>Post dural puncture headache (PDPH) refractory to conservative measures can be clinically debilitating, and diagnostic evaluation with spinal imaging including CT myelography (CTM) may be performed to localize a CSF leak and guide treatment. The purpose of this study is to determine the diagnostic yield of CTM for detecting a CSF leak in patients with persistent PDPH.</p><p><strong>Materials and methods: </strong>This is a single-center, retrospective cohort study of patients referred for CTM between September 2013 and August 2025 to localize and/or identify a CSF leak in patients with PDPH. Brain MRIs were categorized as either positive or negative for findings of intracranial hypotension. CTMs were categorized as either positive or negative for the presence of a CSF leak or arachnoid bleb. The overall rate of CTM positivity in patients with PDPH was calculated. Logistic regression analysis was used to investigate variables that were associated with positive CTM.</p><p><strong>Results: </strong>A total of 118 patients with PDPH were included in the analysis (81% women, mean age of 40 ± 12 years). Brain MRIs were negative for findings of intracranial hypotension in 92% of cases. Overall, CTM was positive in only 7 cases (5.9%, 7/118). Four were extradural fluid collections consistent with a CSF leak, and 3 were arachnoid blebs at the site of prior dural puncture. In 3 positive cases where both spine MRI and CTM were available, the abnormality was also seen on MRI in 2 cases. On logistic regression, only a positive brain MRI was independently associated with a significantly higher odds of a positive CTM (OR: 12.6 [95% CI, 1.8-90]; <i>P</i> = .012).</p><p><strong>Conclusions: </strong>CTM has a low diagnostic yield in patients with PDPH, uncommonly identifying specific leak related findings. Because CTM necessarily involves repeat dural puncture, and given this low yield, it should be used sparingly in patients with refractory PDPH, especially when signs of intracranial hypotension are absent on brain MRI. As some findings on CTM are also seen on spinal MRI, which is noninvasive, further research is needed to compare the yield of MRI and CTM to determine whether and when CTM provides additional diagnostic information in this population.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145598337","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":"Optimized Time-Dependent Diffusion MRI for Preoperative Molecular Subtyping of Adult Diffuse Gliomas.","authors":"Xin Ge, Ying Shen, Guangyao Liu, Tiejun Gan, Wanjun Hu, Yuping Han, Yuhui Xiong, Min Li, Wen Wang, Jing Zhang","doi":"10.3174/ajnr.A9392","DOIUrl":"https://doi.org/10.3174/ajnr.A9392","url":null,"abstract":"<p><strong>Background and purpose: </strong>Isocitrate dehydrogenase (IDH) mutation and 1p/19q codeletion guide preoperative management in adult diffuse gliomas but are usually unknown before tissue sampling, and conventional ADC-based surrogates lack specificity. We evaluated whether an optimized time-dependent diffusion MRI (TDD-MRI) protocol integrating oscillating-gradient spin-echo (OGSE) and pulsed-gradient spin-echo (PGSE) acquisitions with Bayesian IMPULSED mapping can predict these markers preoperatively and validated imaging indices against digital histopathology.</p><p><strong>Materials and methods: </strong>In this study (February 2023-December 2024), adults with suspected intracranial tumors underwent preoperative 3.0-T MRI with high-performance gradients. TDD-MRI included OGSE (20 and 40-Hz) and PGSE acquisitions. Bayesian IMPULSED generated voxelwise extracellular diffusivity (<i>Dex</i>), intracellular volume fraction (<i>f_in</i> ), cell diameter (Diameter), and Cellularity; multi-time ADC and ADC_ratio were also computed. Diagnostic performance was evaluated using logistic regression and receiver-operating-characteristic analysis. Imaging-pathology associations were evaluated using digital hematoxylin-and-eosin metrics.</p><p><strong>Results: </strong>Among 119 adult diffuse gliomas (mean age, 51.9±9.1 years), tumors were classified as IDH-wildtype glioblastoma (IDHwt; n=53), IDH-mutant oligodendroglioma with 1p/19q codeletion (IDHmut-codel; n=33), or IDH-mutant astrocytoma with intact 1p/19q (IDHmut-intact; n=33). The intra- and inter-observer reproducibility of ROI measurements by the radiologists was excellent (intraclass correlation coefficients, 0.89-0.97). All microstructural parameters showed significant group differences on overall analysis (<i>P</i><0.05). In Bonferroni-adjusted post hoc comparisons, IDHwt exhibited higher ADC_ratio, <i>f_in</i> , and Cellularity and lower <i>Dex</i> than other groups, whereas IDHmut-codel had the lowest Cellularity. Among single parameters, ADC_ratio and Cellularity performed best. Multivariable models achieved AUC 0.95 (95% CI: 0.91-0.99) for identifying IDHmut-codel and 0.95 (95% CI: 0.92-0.99) for IDHwt, each outperforming single-time ADC (<i>P</i><0.05); performance for IDHmut-intact was moderate (AUC 0.68; 95% CI: 0.59-0.78). Bayesian fitting yielded higher AUCs and more stable maps than nonlinear least squares. Imaging-derived <i>f_in</i> , Diameter, and Cellularity correlated with pathology (<i>r</i> = 0.684-0.769, all <i>P</i><0.001).</p><p><strong>Conclusions: </strong>Optimized TDD-MRI with Bayesian IMPULSED provided quantitative microstructural mapping with strong histopathologic concordance and showed promise for the preoperative molecular subtyping of adult diffuse gliomas.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847414","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":"Altered Effective Connectivity in Supraspinal Somatosensory Networks Reveals Divergent Adaptation Mechanisms in Complete and Incomplete Spinal Cord Injury.","authors":"Haotian Xin, Yang Beining, Yu Wang, Ling Wang, Qunya Qi, Xianglin Guo, Yulong Jia, Weimin Zheng, Xin Chen, Fang Li, Chuchu Sun, Jie Lu, Nan Chen","doi":"10.3174/ajnr.A9390","DOIUrl":"https://doi.org/10.3174/ajnr.A9390","url":null,"abstract":"<p><strong>Background and purpose: </strong>Supraspinal somatosensory pathways neuroplasticity critically influences sensory recovery after spinal cord injury (SCI) and offers promising neuromodulation targets. However, distinctions between complete SCI (CSCI) and incomplete SCI (ISCI) patients remain unclear. We aimed to delineate injury severity-dependent neuroplasticity patterns in somatosensory pathways, and provide mechanistic insights for developing targeted rehabilitation strategies.</p><p><strong>Materials and methods: </strong>Resting-state effective connectivity (EC) within supraspinal somatosensory pathways was analyzed using spectral dynamic causal modelling in 17 CSCI patients, 17 ISCI patients, and 37 healthy controls. The primary somatosensory cortex (S1), second somatosensory cortex (S2), thalamus (THA), insula (INS), cerebellar lobule VI (CB6) and primary motor cortex were employed as the regions of interest. A fully connected model was specified for each participant, and group-level differences in EC were assessed using parametric empirical Bayes. Connections with a posterior probability > 0.95 were considered significant. Additionally, correlation analyses were performed between significant EC and sensory scores.</p><p><strong>Results: </strong>Both CSCI and ISCI groups exhibited impaired basic somatosensory conduction, including dysfunction from the THA to the S1 and dysregulation along the S1-S2-INS pathway. However, their specific connectivity patterns diverged. The CSCI group showed weakened self-inhibition within the THA and S1. The ISCI group exhibited stronger inhibitory EC from S2 to INS and from CB6 to S1.</p><p><strong>Conclusions: </strong>CSCI and ISCI patients predominantly exhibit decreased and increased EC within the supraspinal somatosensory pathways, respectively. The CSCI patients showed reduced THA/S1 self-inhibition, whereas ISCI patients exhibited strengthened S2-INS/CB6-S1 connectivity, possibly compensating for sensory deficits and suggesting neuromodulation targets for somatosensory recovery.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847306","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":"Recent Advances in Hypothalamic Segmentation for Neuroimaging: A Comprehensive Review.","authors":"J Z Hu, Z P Chen, C Han, X C Pan, D T Tong","doi":"10.3174/ajnr.A9146","DOIUrl":"10.3174/ajnr.A9146","url":null,"abstract":"<p><p>The hypothalamus is a key structure in the human brain, comprising numerous functionally distinct subnuclei that regulate critical physiological processes such as energy balance, stress response, and circadian rhythms. Due to the complexity and functional diversity of its subregions, precise segmentation is essential for elucidating its operational mechanisms. This review systematically summarizes hypothalamic segmentation methods and their applications in physiological and clinical research. Current approaches are categorized into two complementary types: anatomy-based manual segmentation and deep learning-based fully automated segmentation. The former provides a gold standard for algorithm validation through expert knowledge, enabling accurate identification of key functional subregions; the latter offers an efficient solution for large-scale studies, facilitating in-depth exploration of the hypothalamus's heterogeneous functional architecture. The review also highlights major challenges in the field, including the lack of unified segmentation protocols-which hinders cross-study comparability-and a significant methodological gap in pediatric population studies. Moving forward, it is crucial to establish standardized segmentation workflows, reduce subjective bias, improve reproducibility, and address the technical shortcomings in hypothalamic segmentation for children, thereby laying a foundation for comprehensively understanding the structure and function of this critical brain region.ABBREVIATIONS: ARC＝ arcuate nucleus; PVN＝ paraventricular nucleus; VM＝ ventromedial nucleus; DM＝ dorsomedial hypothalamic nucleus; SCh＝ suprachiasmatic nucleus; LH＝ lateral hypothalamus.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783403","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}