AJNR. American journal of neuroradiology最新文献

{"title":"A Review of Intracranial Aneurysm Imaging Modalities, from CT to State-of-the-Art MR.","authors":"Sammy Allaw, Kameel Khabaz, Tyler C Given, Dominic Montas, Roberto J Alcazar-Felix, Abhinav Srinath, Tareq Kass-Hout, Timothy J Carroll, Michael C Hurley, Sean P Polster","doi":"10.3174/ajnr.A8549","DOIUrl":"10.3174/ajnr.A8549","url":null,"abstract":"<p><p>Traditional guidance for intracranial aneurysm (IA) management is dichotomized by rupture status. Fundamental to the management of ruptured aneurysm is the detection and treatment of SAH, along with securing the aneurysm by the safest technique. On the other hand, unruptured aneurysms first require a careful assessment of their natural history versus treatment risk, including an imaging assessment of aneurysm size, location, and morphology, along with additional evidence-based risk factors such as smoking, hypertension, and family history. Unfortunately, a large proportion of ruptured aneurysms are in the lower risk size category (<7 mm), putting a premium on discovering a more refined noninvasive biomarker to detect and stratify aneurysm instability before rupture. In this review of aneurysm work-up, we cover the gamut of established imaging modalities (eg, CT, CTA, DSA, FLAIR, 3D TOF-MRA, contrast-enhanced-MRA) as well as more novel MR techniques (MR vessel wall imaging, dynamic contrast-enhanced MRI, computational fluid dynamics). Additionally, we evaluate the current landscape of artificial intelligence software and its integration into diagnostic and risk-stratification pipelines for IAs. These advanced MR techniques, increasingly complemented with artificial intelligence models, offer a paradigm shift by evaluating factors beyond size and morphology, including vessel wall inflammation, permeability, and hemodynamics. Additionally, we provide our institution's scan parameters for many of these modalities as a reference. Ultimately, this review provides an organized, up-to-date summary of the array of available modalities/sequences for IA imaging to help build protocols focused on IA characterization.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1082-1092"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142514454","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":"Accuracy of Financial Disclosures by Scientific Presenters/Authors at the ASNR 2024 Annual Meeting.","authors":"Ajay Malhotra, Dheeman Futela, Varun Sheoran, Keervani Kandala, Mihir Khunte, Chris Lee, Seyedmehdi Payabvash, Dheeraj Gandhi","doi":"10.3174/ajnr.A8600","DOIUrl":"10.3174/ajnr.A8600","url":null,"abstract":"<p><p>Physician-industry financial relationships can drive research and innovation, improving patient care and outcomes, but also potentially raise ethical concerns if not disclosed appropriately. This study shows high rates of nondisclosures by authors/presenters at the American Society of Neuroradiology 2024 annual meeting, despite strict requirements. A total of 86.4% of presenters/authors with records in the open payments database failed to disclose any financial relationship, and 89.9% of total industry payment value was not disclosed. Greater awareness should help improve disclosures and transparency, reducing the risk and perception of bias.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1100-1102"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694066","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":"A Tribute to Apostolos John Tsiouris, MD, January 12, 1972 - March 11, 2025, Recipient of the ASNR's 2025 Outstanding Contributions in Neuroradiology Education Award.","authors":"Jana Ivanidze, Pina C Sanelli","doi":"10.3174/ajnr.A8752","DOIUrl":"10.3174/ajnr.A8752","url":null,"abstract":"","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1287-1288"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002187","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":"Conebeam CT Myelography for the Detection of Spinal CSF Leaks.","authors":"Ajay A Madhavan, Michelle L Kodet, Waleed Brinjikji, Ian T Mark, Wouter I Schievink","doi":"10.3174/ajnr.A8820","DOIUrl":"10.3174/ajnr.A8820","url":null,"abstract":"<p><p>Spinal CSF leaks are the primary cause of spontaneous intracranial hypotension, with the most common types of leaks including CSF-venous fistulas and dural tears.¹ These leaks necessitate advanced myelographic techniques for accurate localization. Digital subtraction myelography is one such technique used at some institutions.² Although digital subtraction myelography has excellent temporal and spatial resolution, it does not provide high-resolution cross-sectional images. Here, we describe our technique for conebeam CT myelography performed immediately after digital subtraction myelography, which generates high-resolution cross-sectional images.^3-6 We illustrate how this technique enhances detection and characterization of some spinal CSF leaks.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1282"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086555","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":"Association of MRI visible Perivascular Spaces with Early White Matter Injury.","authors":"Arturo R Toro, Frances Rodriguez Lara, Adlin Pinheiro, Serkalem Demissie, Charles Decarli, Pedram Parva, Mohammad Habes, Andreas Charidimou, Sudha Seshadri, Pauline Maillard, Jose R Romero","doi":"10.3174/ajnr.A8823","DOIUrl":"https://doi.org/10.3174/ajnr.A8823","url":null,"abstract":"<p><strong>Background and purpose: </strong>MRI Visible Perivascular Spaces (PVS) are considered markers of cerebral small vessel disease (CSVD) and may reflect dysfunction of brain perivascular drainage. White matter integrity assessed with Diffusion Tensor Imaging (DTI) provides a sensitive assessment of early brain injury, related vascular risk factors and risk of stroke and dementia. We investigated the relation between PVS and white matter integrity in community-dwelling participants.</p><p><strong>Materials and methods: </strong>Framingham Heart Study (FHS) participants with brain MRI, PVS ratings and DTI measures were included. PVS were rated in the basal ganglia (BG) and centrum semiovale (CS) and categorized into grades I-IV based on counts. We related PVS burden to global DTI measures (free water fraction [FW], fractional anisotropy [FA], peak skeletonized mean diffusivity [PSMD]), Diffusion along perivascular spaces (DTI-ALPS) and voxel-based measures using multivariable linear regression analyses.</p><p><strong>Results: </strong>Among 3,077 participants (57.2 mean age; 53% women), 7% had high burden PVS in the BG and 13% had high burden in the CS. High PVS burden in either or both regions was associated with higher global FW, PSMD, lower global FA and lower DTI-ALPS index in fully adjusted models (p<0.001). Voxel analyses revealed significant associations between high PVS burden in both regions and FW involving ascending, descending, inter and intra-hemispheric tracts (p<0.0001), but not with FA.</p><p><strong>Conclusions: </strong>PVS burden was associated with early signs of global white matter injury after adjustment for vascular risk factors, suggesting that high PVS burden may represent early brain injury related to CSVD or impaired perivascular function.</p><p><strong>Abbreviations: </strong>ALPS = Along the perivascular space; PVS = Perivascular Space; CSVD = Cerebral Small Vessel Disease; FW = Free Water; FA = Fractional Anisotropy; MD = Mean Diffusivity; DTI-ALPS = diffusion along perivascular spaces; FHS = Framingham Heart Study; CS = Centrum Semiovale; BG = Basal Ganglia; PSMD = Peak Skeletonized Mean Diffusivity.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217829","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":"Deep Medullary Vein Integrity and Relationships with Small Vessel Disease and Interstitial Diffusivity Measures in Patients with a Recent Small Subcortical Infarct.","authors":"Carla Brenlla, Caterina Sozzi, Andrés Girona, Emma Muñoz-Moreno, Carlos Laredo, Alejandro Rodríguez-Vázquez, Sergio Amaro, Arturo Renú, Antonio Doncel-Moriano, Laura Llull, Xabier Urra, Salvatore Rudilosso, Ángel Chamorro","doi":"10.3174/ajnr.A8591","DOIUrl":"10.3174/ajnr.A8591","url":null,"abstract":"<p><strong>Background and purpose: </strong>The role of the venous compartment in cerebral small vessel disease has yet to be fully understood. As such, we evaluated how deep medullary vein (DMV) integrity relates to MRI-based small vessel disease severity markers and glymphatic function assessed by DTI measures in patients with a recent small subcortical infarct.</p><p><strong>Materials and methods: </strong>We gathered demographic, clinical, and 3T MRI imaging data from 50 patients with a recent small subcortical infarct. We evaluated the venular integrity by using 2 visual scales based on their appearance on SWI. We assessed the number of lacunes and microbleeds, white matter hyperintensities volume, perivascular spaces volume in basal ganglia and white matter, summary small vessel disease score, and brain volume. Diffusivity measures in normal-appearing white matter included free water fraction, mean diffusivity and fractional anisotropy with and without free water correction, and DTI along the perivascular spaces. After categorizing the cohort in quartiles according to both venular scores, we assessed their correlations with small vessel disease markers and diffusivity measures by using multivariable ordinal regression analyses adjusting for age, sex, smoking, and summary small vessel disease score.</p><p><strong>Results: </strong>In univariate analysis most of the imaging variables, except for microbleeds, perivascular spaces in white matter, and DTI along the perivascular spaces, were associated with 1 or both venular scores. In multivariate analysis, free water (OR, 1.33, 95% CI, 1.03-1.73), mean diffusivity (OR, 4.56, 95% CI, 1.32-15.81), fractional anisotropy (OR, 0.77, 95% CI, 0.63-0.93), free water-corrected mean diffusivity and fractional anisotropy (OR, 2.39, 95% CI, 1.06-5.39; OR 0.78, 95% CI, 0.65-0.94, respectively), associated with vein appearance, while only brain volume (OR, 0.48, 95% CI, 0.25-0.94), fractional anisotropy with and without free water correction (OR, 0.82, 95% CI, 0.86-0.99; OR, 0.83, 95% CI, 0.7-0.99, respectively) remained robust for vein count.</p><p><strong>Conclusions: </strong>In patients with a recent small subcortical infarct, disruption of the DMVs, increased extracellular water, and white matter injury appear to be associated.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1103-1111"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689926","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":"Evaluation of Vestibular Schwannoma Size across Time: How Well Do the Experts Perform and What Can Be Improved?","authors":"Girish Bathla, Parv M Mehta, Neetu Soni, Mathew Johnson, John C Benson, Steven A Messina, Paul Farnsworth, Amit Agarwal, Matthew L Carlson, John I Lane","doi":"10.3174/ajnr.A8614","DOIUrl":"10.3174/ajnr.A8614","url":null,"abstract":"<p><strong>Background and purpose: </strong>2D linear measurements are often used in routine clinical practice during vestibular schwannoma (VS) follow-up, primarily due to wider availability and ease of use. We sought to determine the radiologist's performance compared with 3D-volumetry, along with the impact of the number of linear measurements, slice thickness, and tumor volumes on these parameters.</p><p><strong>Materials and methods: </strong>Specificity and accuracy estimates and 95% confidence intervals were calculated for the entire cohort and subgroups on the basis of volumes (<400, 400-800, >800 mm³), slice thickness (≤1.5 mm or >1.5 mm), and number of linear dimensions measured in the radiology report (0-1 or 2-3).</p><p><strong>Results: </strong>There was weak agreement between the radiologist's inference and VS volumetry (0.45; 95% CI. 0.41-00.53). Agreement was lower when 0-1 tumor dimension was measured (0.29; 95% CI, 0.21-0.42), for smaller tumors of <400 mm³ (0.37; 95% CI, 0.28-0.45), and for thick-section imaging of >1.5 mm (0.36; 95% CI, 0.25-0.46). The reader sensitivity was modest (0.49-0.54), while the accuracy for detecting ≤ ±25% interval change was weak (0.32-0.38). Reader performance trended toward improvement with thin-section imaging, measurement of 2-3 VS dimensions, and larger tumors.</p><p><strong>Conclusions: </strong>In routine practice, radiologists show poor agreement with volumetric results and sensitivity to detect interval change and overall poor accuracy for volumetric changes of ≤ ± 25% in volume. In the absence of volumetric measurements, radiologists need to be more diligent when evaluating interval changes in VS.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1249-1254"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787879","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":"Low- and Intermediate-Grade Lateral Sinus Dural Arteriovenous Fistulas: Factors Affecting the Outcome of Endovascular Treatment over 18-Year Experience in a High-Volume Neurovascular Center.","authors":"Guoli Duan, Yuhang Zhang, Yang Wang, Zhe Li, Chenghao Shang, Rundong Chen, Rui Zhao, Pengfei Yang, Dongwei Dai, Yibin Fang, Qinghai Huang, Bo Hong, Yi Xu, Qiang Li, Jianmin Liu","doi":"10.3174/ajnr.A8622","DOIUrl":"10.3174/ajnr.A8622","url":null,"abstract":"<p><strong>Background and purpose: </strong>Lateral sinus dural arteriovenous fistulas (LS-DAVFs) carry a higher rate of recurrence after endovascular treatment (EVT). Our objective was to investigate the independent predictors of recurrence and unfavorable functional outcomes of low-and intermediate-grade LS-DAVFs after EVT.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed our database of prospectively collected information for all patients with low- and intermediate-grade LS-DAVFs who underwent EVT from May 2004 to December 2021. Patient demographics, angiographics, treatment, and outcomes were analyzed to identify independent predictors of recurrence and unfavorable outcomes.</p><p><strong>Results: </strong>One hundred and seventeen patients with 117 low- and intermediate-grade LS-DAVFs who underwent EVT were included in this study. The mean age of the patients was 53.0 ± 17.5 years. Immediately complete obliteration was achieved in 103/117 (88%) patients after EVT. Clinical follow-up was available for all 117 patients, with an unfavorable outcome rate of 5.1%. Angiographic follow-up was available in 91 patients (78%). Recurrence occurred in 16 (18%) patients and 8 (6.8%) received retreatment. Contralateral sinus severe stenosis or occlusion was an independent high-risk factor for the unfavorable outcome (OR = 11.7; 95% CI: 1.9-70.9, <i>P</i> < .01) and recurrence (OR = 63.8; 95% CI: 10.3-396.5, <i>P</i> < .01) for low- and intermediate-grade LS-DAVFs at follow-up.</p><p><strong>Conclusions: </strong>Contralateral sinus severe stenosis or occlusion represents a stronger independent risk factor associated with recurrence and unfavorable outcomes in patients with low- and intermediate-grade LS-DAVFs when the involved ipsilateral sinus was occluded after EVT. For patients with LS-DAVFs, the patency of the contralateral sinus should be considered when making therapeutic decisions.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1152-1158"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822974","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":"Supporting Imaging Research: A Framework for Equity and Excellence in Neuroradiology.","authors":"Max Wintermark, Rahul Bhala, Julie Bykowski, Petrice M Cogswell, Todd Emch, Ellen Hoeffner, John Huston, Ho-Ling Liu, Rupa Radhakrishnan, Javier M Romero, Gaurav Saigal, Johnny Sandhu, Maria V Spampinato, Jody Tanabe, Manoj Tanwar, Behroze Vachha, Matthew L White, Greg Zaharchuk, David Zander, Tabassum Kennedy","doi":"10.3174/ajnr.A8744","DOIUrl":"10.3174/ajnr.A8744","url":null,"abstract":"","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1065-1068"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057877","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":"Neuroimaging Reader Study on Clinical Sensitivity and Specificity Using Synthetic MRI Based on MR Quantification.","authors":"J H Miller, D Lefkowitz, G Maulsby, L Mechtler, N Pinter, T Snyder, L Hayes, J Carpenter, K Koral, P Cornejo, S R Levendovszky, J B M Warntjes, P Johansson, E Lange","doi":"10.3174/ajnr.A8631","DOIUrl":"10.3174/ajnr.A8631","url":null,"abstract":"<p><strong>Background and purpose: </strong>Prior large prospective studies have shown 2D synthetic MR image quality to be similar to that of conventional MR imaging across a wide variety of normal and abnormal subjects. This study is the first large, prospective comparison of 3D synthetic to conventional MR imaging performed in routine clinical settings.</p><p><strong>Materials and methods: </strong>A prospective, multicenter, multireader clinical investigation to evaluate the diagnostic performance of 3D synthetic images based on the novel synthetic MRI 3D-QALAS method compared with conventional 3D MRI was performed. Five blinded neuroradiologists evaluated the 3D synthetic and conventional MR images of 189 subjects who presented at clinical sites for neuroimaging. The objectives were to compare sensitivity and specificity of pathologic findings, accuracy of imaging findings, image quality, legibility of anatomic structures, artifact prevalence, and interrater and intermethod agreement of synthetic 3D MR images with conventional 3D images.</p><p><strong>Results: </strong>Both sensitivity and specificity of 3D synthetic and conventional images for pathologic findings and diagnostic accuracy of radiologic findings were very similar, 66/68% and 85/85%, respectively. The individual values for the readers varied between 58%-73%/58%-75% for sensitivity and 72%-98%/77%-94% for specificity. No significant difference could be determined between the methods. Ratings (1-5 scale) of synthetic MR image quality were higher than for T1-weighted images (mean score of 4.6 ± 0.6, with 98.6% having a 3 or higher versus 4.5 ± 0.7, with 97.8% having a 3 or higher) and T2-weighted images (4.4 ± 0.7, with 98.0% having a 3 or higher versus 4.2 ± 0.8, with 97.5% having a 3 or higher).</p><p><strong>Conclusions: </strong>In this study no significant differences were found in the sensitivity and specificity of pathologic findings and accuracy of imaging findings between 3D synthetic T1-weighted and T2-weighted images and 3D conventional images. In addition, 5 blinded neuroradiologists rated 3D synthetic MR images of higher image quality than conventional 3D images.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1196-1202"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129774","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}