AJNR. American journal of neuroradiology最新文献

{"title":"Focused Ultrasound in Brain Tumors: Mechanisms, Imaging Guidance, and Emerging Clinical Applications.","authors":"Ali Nabavizadeh, Kazim Narsinh, Timothy J Kaufmann, HaoLi Liu, Antonios N Pouliopoulos, Francesco Prada, Vijay Agarwal, Benjamin M Ellingson, Francesco Sanvito, Richard G Everson, Ying Meng, Dheeraj Gandhi, Susan M Chang, Patrick Y Wen, Manmeet S Ahluwalia, Nicolle Sul, Lauren Hadley, Suzanne Leblang, Bhavya R Shah, Costas D Arvanitis, Terry C Burns, Shayan Moosa, Graeme F Woodworth","doi":"10.3174/ajnr.A9126","DOIUrl":"10.3174/ajnr.A9126","url":null,"abstract":"<p><p>Focused ultrasound (FUS) is an emerging therapeutic and diagnostic technology in neuro-oncology, offering new strategies for molecular diagnosis, drug delivery, and tumor ablation across a range of brain tumors, including glioblastoma (GBM), brain metastases, and diffuse intrinsic pontine glioma (DIPG). The prognosis for aggressive brain tumors remains poor, despite advances in surgery, radiation, and chemotherapy. A considerable challenge is the limited ability to deliver therapeutics across the blood-brain barrier (BBB), particularly to infiltrative or non-enhancing tumor regions. FUS introduces an incisionless approach to the molecular subtyping of brain tumors, enhancing therapeutic delivery, and offers novel therapeutic approaches such as sonodynamic therapy (SDT). This review summarizes the FUS mechanisms and highlights the critical role of imaging modalities confirming target engagement, assessing bioeffects and outcomes, and ensuring safety. We also explore future directions, including the integration of liquid biopsy, artificial intelligence, and outpatient-ready FUS platforms, which will position FUS as a promising adjunct to standard neuro-oncologic care.ABBREVIATIONS: GBM = glioblastoma; FUS = focused ultrasound; HIFU = high-intensity focused ultrasound; LIFU = low-intensity focused ultrasound; MRgFUS = magnetic resonance guided focused ultrasound; BBBO = blood brain barrier opening; SDT = sonodynamic therapy; 5-ALA = 5-aminolevulinic acid.</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":"145710395","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":"Implementation Science: Definition, Importance, and Application in Neuroradiology.","authors":"Ali Rashidi, Gelareh Sadigh","doi":"10.3174/ajnr.A9104","DOIUrl":"10.3174/ajnr.A9104","url":null,"abstract":"<p><p>Neuroradiologists are constantly asked to adapt their practice and implement changes that align with the latest scientific evidence, such as new stroke imaging guidelines and innovative imaging sequences. Translation of evidence-based practices (EBPs) to clinical practice requires sustainable, replicable, locally relevant, equitable, and externally valid systems. Implementation science provides a conceptual framework for new practice adoption by identifying and addressing barriers. This brief narrative review defines implementation and de-implementation science, contrasting implementation science with quality improvement, and describes common implementation science frameworks with examples applicable to neuroradiology. The role of artificial intelligence in implementation science is also included.ABBREVIATIONS: AI = Artificial intelligence; CFIR = Consolidated Framework for Implementation Research; EBP = Evidence-based practice; EMR = Electronic medical record; RE-AIM = Reach Effectiveness Adoption Implementation Maintenance.</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":"145524716","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":"Stage-Related Alterations in Cortical Functional Connectivity Gradients in Non-Dialysis Patients With Chronic Kidney Disease.","authors":"Siyuan Lu, Shi Nian, Anqi Qiu, Liu Zhonglin, Liu Zhenni, Tianyu Li, Ao Ruan, Yuting Zhang, Daming Shen, Song'an Shang, Wenjin Liu, Jing Ye","doi":"10.3174/ajnr.A9389","DOIUrl":"https://doi.org/10.3174/ajnr.A9389","url":null,"abstract":"<p><strong>Background and purpose: </strong>Chronic kidney disease (CKD) is associated with brain dysfunction and an increased risk of cognitive impairment. However, it remains unclear whether functional hierarchical abnormalities are detectable in early-stage CKD and how they differ between early-stage and advanced non-dialysis CKD.</p><p><strong>Materials and methods: </strong>In this cross-sectional study, 96 patients with early-stage CKD (CKD1-3a), 80 patients with advanced CKD (CKD3b-5), and 75 healthy controls were enrolled. Resting-state functional magnetic resonance imaging data were analyzed using the functional connectivity gradient (FCG) framework to characterize stage-related alterations in cortical functional hierarchy. Associations among abnormal gradient metrics, Montreal Cognitive Assessment (MoCA) scores, and estimated glomerular filtration rate (eGFR) were further examined.</p><p><strong>Results: </strong>Early-stage CKD showed limited abnormalities in FCG metrics, mainly involving reduced global principal gradient range and variance and lower gradient values in the default mode network. No significant regional differences remained after FDR correction in the direct comparison between early-stage CKD and healthy controls. In contrast, advanced CKD showed more extensive abnormalities across the global, network, and regional levels. In advanced CKD, abnormal principal gradient metrics were associated with lower eGFR and poorer cognitive performance. Cross-sectional statistical mediation analysis further suggested a possible indirect association pattern among renal dysfunction, reduced principal gradient range, and cognitive performance.</p><p><strong>Conclusions: </strong>Non-dialysis CKD is associated with stage-related alterations in functional brain hierarchy. Early-stage CKD is characterized by relatively limited abnormalities, whereas advanced CKD shows more widespread disruption. These findings support FCG metrics as promising neuroimaging markers of CKD-related alterations in brain functional organization.</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":"147847351","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":"Prolonged Venous Transit on Perfusion Imaging: An Evolving Marker of Outcomes in Large Vessel Occlusion Stroke - A Comprehensive Review.","authors":"Jay Kakadiya, Dhairya A Lakhani, Hamza A Salim, Manisha Koneru, Dylan Wolman, Shyam Majmundar, Ferdinand Hui, Hanzhang Lu, Adam A Dmytriw, Adrien Guenego, Jeremy J Heit, Gregory W Albers, Tobias D Faizy, Vivek S Yedavalli","doi":"10.3174/ajnr.A9100","DOIUrl":"10.3174/ajnr.A9100","url":null,"abstract":"<p><p>Stroke remains a leading cause of death and disability worldwide, with anterior circulation large-vessel occlusion (AIS-LVO) representing a major contributor. While arterial parameters such as cerebral blood flow (CBF), cerebral blood volume (CBV), and time-to-maximum (Tmax) have traditionally been used to assess perfusion, they often fail to capture microvascular dysfunction following mechanical thrombectomy (MT). Emerging evidence highlights venous outflow (VO) parameters, particularly prolonged venous transit (PVT), as reliable predictors of functional outcomes. PVT, defined as delayed opacification (Tmax ≥ 10 s) of major dural venous sinuses on perfusion imaging, reflects impaired microcirculatory drainage and tissue hypoxia. Studies have demonstrated strong interobserver agreement and consistent associations between PVT+ status and worse NIHSS scores, larger infarct volumes, higher mortality, and poor 90-day modified Rankin Scale outcomes. Compared with arterial metrics, PVT offers superior prognostic performance and can complement established VO scores such as COVES, PRECISE, and CVO. Despite study heterogeneity, current evidence supports PVT as a simple, reproducible, and clinically meaningful biomarker. Standardization of PVT measurement and integration into multimodal prognostic models could refine post-recanalization risk stratification, guide adjunctive therapies, and improve patient outcomes in acute ischemic stroke.ABBREVIATIONS: AIS LVO - Acute Ischemic Stroke due to Large Vessel Occlusion; PVT - Prolonged Venous Transit; LOS - Length of Stay; COVES - Cortical Vein Opacification Score; PRECISE - Predicting Recanalization Effectiveness in Cortical Intravenous Sinus Embolism; CVO - Comprehensive Venous Outflow score; HIR - Hypoperfusion Intensity Ratio; SSS - Superior Sagittal Sinus.</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":"145514681","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 Incidence of Calcified Pituitary Macroadenomas: Challenging the Craniopharyngioma Assumption.","authors":"Ian T Mark, Joe George, Parnian Habibi, Yuki Shinya, Paul Farnsworth, Michael Oien, Jamie Van Gompel","doi":"10.3174/ajnr.A9064","DOIUrl":"10.3174/ajnr.A9064","url":null,"abstract":"<p><strong>Background and purpose: </strong>Large sellar/suprasellar masses containing calcifications are classically associated with craniopharyngiomas. In our practice, however, we have noticed that some giant pituitary macroadenomas have calcifications. The purpose of our study was to evaluate the incidence and characteristics of calcifications in pituitary macroadenomas.</p><p><strong>Materials and methods: </strong>We reviewed an internal database for pathology-proven giant macroadenomas (≥4 cm). Basic patient demographics were collected, including age and sex. Adenoma subtype and maximum adenoma dimension were recorded. Preoperative CT images were reviewed for capsular (none, thin, coarse, or mixed) and internal calcifications (none, thin, coarse, or mixed). Preoperative MR images were also reviewed to further characterize the adenoma (solid, cystic, and mixed; T1 signal).</p><p><strong>Results: </strong>Forty-five macroadenomas were included. The mean size was 47.4 mm (SD, 6.2 mm; range, 40-70 mm); 44.4% (95% CI, 30.9%-58.8%) of macroadenomas (20/45) had surrounding calcification. Ten (22%; 95% CI, 12.5%-36.3%) were from the expanded or destroyed dorsum sella, not the adenoma. Ten (22%; 95% CI, 12.5%-36.3%) cases had calcification directly from the adenoma. No cases had internal calcification. All were thin capsular calcification: 6 were thin, 3 were coarse, and 1 was mixed.</p><p><strong>Conclusions: </strong>Large sellar/suprasellar masses that contain calcification are classically associated with craniopharyngiomas. We evaluated pathology-confirmed giant adenomas and found that 22% demonstrated the presence of calcifications on CT.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1325-1327"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145369330","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":"Predicting Intracranial Aneurysm Rupture Risk and Intervention Outcomes Using Denoising-Enhanced CTA.","authors":"Hai Jin, Ligang Chen, Tingzhun Zhu, Guangxin Chu, Liang Ma, Guobiao Liang, Zheng Zou, Chunyong Yu","doi":"10.3174/ajnr.A9093","DOIUrl":"10.3174/ajnr.A9093","url":null,"abstract":"<p><strong>Background and purpose: </strong>Our aim was to develop a comprehensive multimodal framework for assessing the rupture risk of intracranial aneurysms and predicting intervention outcomes. In addition, it seeks to a novel denoising algorithm to enhance the quality of CTA images, thereby improving morphologic profiling.</p><p><strong>Materials and methods: </strong>This retrospective multicenter study included 352 patients with intracranial aneurysms who underwent CTA. A multimodal framework was developed, integrating 3 complementary feature sets: clinical variables, radiomic texture features, and deep learning-derived aneurysm morphologic data. A novel denoising algorithm was applied to improve image quality, thereby enhancing prediction performance. Model validation was performed through cross-validation, using multiple end points, including the Hunt-Hess, World Federation of Neurosurgical Societies (WFNS), and mRS grading systems.</p><p><strong>Results: </strong>The multimodal framework demonstrated robust performance, achieving an area under the curve (AUC) of 0.896 [0.819-0.973] for aneurysm rupture prediction, outperforming conventional single-technique models (radiomics-based model: 0.752 [0.693-0.809]; deep learning-based model: 0.823 [0.789-0.827]). Incorporating the denoising technique further enhanced performance, with the AUC for rupture prediction increasing to 0.908 [0.836-0.981]. In clinical grading tasks, the model showed strong efficacy, achieving an AUC of 0.907 [0.845-0.968] for Hunt-Hess grading, 0.883 [0.662-0.988] for World Federation of Neurosurgical Societies grading, and 0.926 [0.879-0.973] for mRS.</p><p><strong>Conclusions: </strong>Our system demonstrates promising performance in predicting aneurysm rupture and clinical grading assessments, indicating its potential for comprehensive aneurysm evaluation. Moreover, the proposed denoising method effectively mitigates noise interference, enhances morphologic edge features, and improves the accuracy of existing models.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1250-1258"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491151","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":"Microcirculatory Collaterals Modulate Ischemic Core Heterogeneity on Diffusion-Weighted Imaging.","authors":"Aroosa Zamarud, Michael Mlynash, Nicole Yuen, Henk van Voorst, Adrien Ter Schiphorst, Pierre Seners, Anke Wouters, Maya Schwartz, Greg W Albers, Bruce Campbell, Seena Dehkharghani, Maarten G Lansberg, Jeremy J Heit","doi":"10.3174/ajnr.A9178","DOIUrl":"10.3174/ajnr.A9178","url":null,"abstract":"<p><strong>Background and purpose: </strong>Endovascular thrombectomy (EVT) is an effective treatment for acute ischemic stroke due to large vessel occlusion (AIS-LVO). The ischemic core is best determined on DWI, which is commonly thresholded for automated analysis using ADC maps. However, there may be substantial heterogeneity in ADC values within the ischemic core. We determined how tissue-level collaterals, measured by hypoperfusion intensity ratio (HIR) on cerebral perfusion imaging, influences ischemic core heterogeneity.</p><p><strong>Materials and methods: </strong>We performed a post hoc analysis of the CT Perfusion to Predict Response to Recanalization in Ischemic Stroke Project 2 (CRISP 2) study of patients with AIS-LVO who underwent baseline CT/CTP and follow-up MRI/MR perfusion (MRP) prior to EVT. Patients were dichotomized into favorable (HIR ≤0.5) and unfavorable (HIR >0.5) groups, and variability in ADC reduction was determined across an ischemic core defined by standard thresholds of ADC ≤620 × 10-6 mm²/s.</p><p><strong>Results: </strong>One hundred ninety-seven CRISP 2 patients met criteria: 113 (57%) favorable HIR and 84 (43%) unfavorable HIR. Favorable HIR patients had lower baseline NIHSS scores (median 14 versus 16; <i>P</i> = .012), smaller hypoperfusion volumes (time-to-maximum >6 seconds and >10 seconds), smaller ischemic core volumes (27 mL versus 50 mL; <i>P</i> < .001), and were less frequently treated with IV thrombolysis (29% versus 45%; <i>P</i> = .016). ADC heterogeneity was lower in favorable HIR (standard deviation: 167.2 versus 193.5; <i>P</i> = .01), but the mean ADC was similar between groups. Clinical outcomes were not different between favorable and unfavorable HIR groups. Multivariable analysis showed HIR was independently associated with ADC standard deviation (<i>P</i> = .002) and coefficient of variation (<i>P</i> = .003) at the comprehensive stroke center.</p><p><strong>Conclusions: </strong>Favorable tissue-level collaterals (low HIR) are associated with reduced ischemic core ADC heterogeneity.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1222-1227"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824608","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":"MRI and Clinical Features of Nonenhancing <i>IDH</i>-Wild-Type Glioblastomas: How to Make an Early Diagnosis and Distinguish from Mimics.","authors":"James Ryan Loftus, Kanwar P Singh, Sohil H Patel, Matthew D Lee, Matija Snuderl, Daniel Orringer, Rajan Jain","doi":"10.3174/ajnr.A9272","DOIUrl":"https://doi.org/10.3174/ajnr.A9272","url":null,"abstract":"<p><strong>Background and purpose: </strong>A small subset of <i>isocitrate dehydrogenase</i>-wild-type (<i>IDH</i>-wt) glioblastomas (GBMs) initially present as nonenhancing, T2 FLAIR hyperintense cortical/superficial lesions on MRI, potentially leading to misdiagnosis on the initial imaging and hence delayed treatment. This study aimed to characterize the clinical and MRI features of nonenhancing <i>IDH</i>-wt GBMs to help radiologists in differentiating them from nonmalignant mimic diagnoses (eg, encephalitis). Additionally, the histologic, genomic, and survival profiles of nonenhancing GBMs were compared with those of enhancing GBMs.</p><p><strong>Materials and methods: </strong>Clinical and MRI features from 32 patients, each with nonenhancing and enhancing GBMs, and 16 patients with nonmalignant mimic differential diagnoses from a single institution and publicly available data set were retrospectively analyzed. Imaging features were reviewed using the Visually Accessible Rembrandt Images features and the split ADC sign. χ² tests and a binary logistic regression model were used to compare nonenhancing <i>IDH</i>-wt GBMs with nonmalignant mimics. Histopathologic and genomic analyses were performed on institutional cases. Overall survival between nonenhancing and enhancing GBMs was compared using Kaplan-Meier analysis.</p><p><strong>Results: </strong>No significant difference in age, clinical presentation, or duration of symptoms was found between nonenhancing GBMs and nonmalignant mimics. Imaging features favoring nonenhancing GBMs included a greater proportion of non-contrast-enhancing tumor (OR, 7.4), larger anterior-posterior tumor dimension (OR, 8.4), restricted diffusion (OR, 3.6), and eloquent brain involvement (OR, 3.0) while features favoring mimics included greater edema (OR, 0.07), infiltrative T1 FLAIR ratio (OR, 0.68), hemorrhage (OR, 0.76), satellite lesions (OR, 0.84), and the split ADC sign (OR, 0.89). The logistic regression model achieved a mean area under the receiver operator characteristic curve of 0.89 (SD, 0.20) (accuracy 0.84, sensitivity 0.91, specificity 0.70, and precision 0.88). Twelve of 18 nonenhancing GBMs lacked histologic evidence of necrosis or microvascular proliferation (\"molecular GBMs\"). Genomic profiles were similar between nonenhancing and enhancing GBMs. Median overall survival was nonsignificantly longer in nonenhancing GBMs compared with enhancing GBMs (39 versus 21 months, <i>P</i> = .078).</p><p><strong>Conclusions: </strong>Nonenhancing GBMs demonstrate distinct MRI features that must be recognized for early diagnosis and differentiation from nonmalignant mimics. Nonenhancing GBMs demonstrated longer overall survival compared with enhancing GBMs, though they were not statistically significant.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":"47 5","pages":"1289-1295"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847073","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":"Prevalence and Radiologic Manifestations of Internal Jugular Venous Stenosis in Patients with Pulsatile Tinnitus: A Case-Control Study.","authors":"Zhongyuan Zhang, Piers Klein, Bindu Setty, Pamela Semaan, Benjamin Soares, Thanh N Nguyen, Harprit Bedi, Osamu Sakai, Mohamad Abdalkader","doi":"10.3174/ajnr.A9092","DOIUrl":"10.3174/ajnr.A9092","url":null,"abstract":"<p><strong>Background and purpose: </strong>The role of internal jugular venous stenosis (IJVS) in the development of pulsatile tinnitus (PT) is unclear. In this study, we aim to assess the prevalence of IJVS and to analyze the associated imaging findings in patients with and without PT.</p><p><strong>Materials and methods: </strong>We conducted a case-control study of consecutive adult patients with PT who underwent imaging evaluation with CTA/CTV with contrast between February 2018 and March 2022. Age- and sex-matched controls who received CTA and/or CTV for an indication other than PT, headache, or visual disturbance were included. We compared the clinical and imaging findings between the PT and control groups. The prevalence and severity of IJVS were also analyzed.</p><p><strong>Results: </strong>A total of 148 patients with PT and 98 control patients were included. There was no difference in the prevalence of IJVS between groups (<i>P</i> = .19). No difference in stenosis grade was observed between patients with PT and those in the control group with IJVS (<i>P</i> = .61). Empty sella turcica, optic nerve tortuosity, optic nerve sheath prominence, transverse sinus stenosis (TSS), and sigmoid sinus wall abnormalities (SSWA) were greater in the PT group than in controls (all, <i>P</i> < .01). Among patients with PT, imaging findings of idiopathic intracranial hypertension (IIH) were not associated with IJVS. Among patients with IJVS, TSS and empty sella turcica were more common in patients with PT than in controls.</p><p><strong>Conclusions: </strong>IJVS was common in patients with PT and controls, with similar prevalence and severity observed in both groups. TSS and SSWA were significantly more common in patients with PT compared with controls. Among patients with PT, there was no association between imaging findings of IIH and IJVS. Other causes of PT should be sought before considering intervention for IJVS.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1320-1324"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491186","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":"Hippocampal Subfield Susceptibility Alterations in Mild Cognitive Impairment Revealed by 7T MRI.","authors":"Gaoxing Zheng, Fang Frank Yu, Yujia Huang, Snehal Mazumder, Sophia L Vargas, Paul G Unschuld, Sonja M Kagerer, Xu Li, Jiaen Liu","doi":"10.3174/ajnr.A9094","DOIUrl":"10.3174/ajnr.A9094","url":null,"abstract":"<p><strong>Background and purpose: </strong>Hippocampal magnetic susceptibility alterations may serve as early neurodegenerative biomarkers of Alzheimer disease (AD), but subfield-level evidence in mild cognitive impairment (MCI) remains limited. This study uses submillimeter high-resolution quantitative susceptibility mapping (QSM) to investigate hippocampal subfield susceptibility changes in MCI.</p><p><strong>Materials and methods: </strong>Thirteen individuals with MCI and 13 cognitively normal controls (NC) underwent 7T MRI scans including MP2RAGE and multiecho gradient echo imaging (for QSM). The visibility of hippocampal strata radiatum, lacunosum, and moleculare (SRLM) was assessed using a visual rating scale. Hippocampal subfields (Cornu Ammonis 1 [CA1], CA2, CA3, dentate gyrus [DG], and subiculums) were segmented, and magnetic susceptibility values (χ) were extracted for each subfield. The susceptibility difference between the DG and other subfields was also calculated. Associations between subfield susceptibility measures and cognitive performance were then assessed.</p><p><strong>Results: </strong>Qualitative analysis revealed a distinct hyperintense curved pattern in the hippocampus on the 7T QSM image, corresponding to the SRLM. In NC, this pattern was clearly visible exhibiting consistently delineated boundaries, while it appeared blurred or absent in most subjects with MCI. The visual rating results showed that NC had significantly higher scores than subjects with MCI (Hedgesg = 1.43, 95% confidence interval) [95% CI, 0.60-2.35; <i>P</i> = .003], with most NC rating 3-4 and most subjects with MCI rating 1-2. Quantitative analysis of hippocampal subfield susceptibility revealed significantly elevated susceptibility [χ] in the left DG in those with MCI compared with NC (Hedgeg = 0.88, 95% CI, 0.10-1.72; <i>P</i> = .03), leading to reduced susceptibility contrast between the SRLM and adjacent CA1-CA3 or DG. Furthermore, regional differences of susceptibility between key subfields (left CA1 versus DG and subiculum versus DG) were significantly reduced in MCI, reflecting a loss of subfield contrast. These quantitative changes were significantly associated with lower cognitive performance, even when controlling for age.</p><p><strong>Conclusions: </strong>7T QSM reveals susceptibility changes in hippocampal substructures in individuals with MCI, providing a potential early biomarker for AD.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1308-1314"},"PeriodicalIF":0.0,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12797140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491108","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}