AJNR. American journal of neuroradiology最新文献

{"title":"Peritumoral Hyperintense Signal on Postcontrast FLAIR Images Surrounding Vestibular Schwannomas following Stereotactic Radiosurgery.","authors":"Sandy T Nguyen, John C Benson, Girish Bathla, Paul J Farnsworth, Matthew L Carlson, Michael J Link, John I Lane","doi":"10.3174/ajnr.A8657","DOIUrl":"10.3174/ajnr.A8657","url":null,"abstract":"<p><strong>Background and purpose: </strong>Prior investigations have noted the presence of peritumoral hyperintense signal (a \"halo\") around vestibular schwannomas on postcontrast 3D T2 FLAIR images. This study evaluated this phenomenon in a cohort of patients undergoing stereotactic radiosurgery.</p><p><strong>Materials and methods: </strong>A retrospective review was completed of consecutive patients with presumed vestibular schwannomas undergoing stereotactic radiosurgery. Tumor size, location, presence or absence of a peritumoral halo, and halo thickness were recorded. Images were reviewed for presence and size of peritumoral hyperintense signal on postcontrast 3D T2 FLAIR images before and after treatment.</p><p><strong>Results: </strong>Twenty-six patients were included in this study, 14 of whom were women (54.0%). Average age was 62 ± 12 years. Before treatment, a postcontrast 3D T2 FLAIR hyperintense peritumoral halo was seen in 85% of patients, averaging 0.8 ± 0.4 mm in thickness. There was a higher incidence of peritumoral halo in posttreatment patients (96%) than pretreatment patients (85%) (<i>P</i> = .017) with a mean follow-up period of 1.2 years (SD 0.35) from November 12, 2019, to September 5, 2023. The average halo thickness was also larger in posttreatment patients (average =1.4 ± 0.4 mm) compared with pretreatment patients (0.8 ± 0.4 mm) (<i>P</i> < .001). Average tumoral size did not significantly change following treatment (<i>P</i> = .10).</p><p><strong>Conclusions: </strong>Vestibular schwannomas treated with stereotactic radiosurgery are more likely to have a peritumoral halo on postcontrast 3D T2 FLAIR images, with larger halo size as compared with pretreatment studies. Further study with a larger tumor cohort and longer follow-up will be necessary to determine if these findings are predictive of subsequent tumor shrinkage.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1453-1457"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980993","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 Value of Quantitative Susceptibility Mapping and Morphometry in the Differential Diagnosis of Parkinsonism.","authors":"Yi Li, Tingting Yuan, Lulu Gao, Wei Sun, Xiaoxiao Du, Zhihui Sun, Kangli Fan, Ruqing Qiu, Ying Zhang","doi":"10.3174/ajnr.A8665","DOIUrl":"10.3174/ajnr.A8665","url":null,"abstract":"<p><strong>Background and purpose: </strong>Differentiating Parkinson disease (PD) from atypical parkinsonism syndrome (APS), including multiple system atrophy (MSA) and progressive supranuclear palsy (PSP), is challenging, and there is no reference standard. Integrating quantitative susceptibility mapping (QSM) and morphometry can help differentiate PD from APS and improve the internal diagnosis of APS.</p><p><strong>Materials and methods: </strong>In this retrospective study, we enrolled 55 patients with PD, 17 with MSA-parkinsonian type (MSA-P), 15 with MSA-cerebellar type (MSA-C), and 14 with PSP. Thirty-three age-matched healthy subjects served as controls. All subjects underwent QSM imaging and 3D T1WI with manual quantification of ROI and morphometry. ROIs were selected in the basal ganglia and brainstem nuclei, such as the putamen (Pu), globus pallidus (GP), and red nucleus (RN). Morphometry included MR Parkinson disease index (MRPI), the midbrain area-pons area ratio (M/P), and the ratio of the vertical line of the long axis of the midbrain and pons (Ratio). Differential variables between groups were extracted and a binary logistic regression was established to differentiate the differential diagnoses of PD and APS and diseases within APS. The diagnostic value was assessed using the area under the curve (AUC), sensitivity, and specificity.</p><p><strong>Results: </strong>The combination of Pu and GP performed best when used to distinguish PD from MSA-P, with an AUC of 0.800 (95% CI: 0.664-0.936). The AUC was optimal when MRPI and M/P were combined to distinguish PD from MSA-C at 0.823 (95% CI: 0.686-0.960). Ratio alone performed best in differentiating PD from PSP, with an AUC of 0.848 (95% CI: 0.711-0.985). The AUC for Ratio alone in distinguishing MSA-P from PSP was 0.871 (95% CI: 0.738-1.0). The AUC when using only M/P to distinguish MSA-C from PSP was 0.931 (95% CI: 0.845-1.0). QSM and morphometry each offer distinct advantages in the differential diagnosis among the aforementioned groups. The combination of QSM and morphometry provided the highest diagnostic value in differentiating PD from APS, highlighting the significance of integrating these 2 imaging techniques for enhanced diagnostic precision in clinical practice. The best indicators described above showed equally high differential diagnostic values in patients with a disease duration of ≤3 years.</p><p><strong>Conclusions: </strong>QSM and morphometry will improve the differential diagnosis between PD and APS, as well as improve the internal diagnosis of APS.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1429-1438"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017794","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":"Application of Deep Learning Accelerated Image Reconstruction in T2-Weighted Turbo Spin-Echo Imaging of the Brain at 7T.","authors":"Zeyu Liu, Xiangzhi Zhou, Shengzhen Tao, Jun Ma, Dominik Nickel, Patrick Liebig, Mahmoud Mostapha, Vishal Patel, Erin M Westerhold, Hamed Mojahed, Vivek Gupta, Erik H Middlebrooks","doi":"10.3174/ajnr.A8662","DOIUrl":"10.3174/ajnr.A8662","url":null,"abstract":"<p><p>Prolonged imaging times and motion sensitivity at 7T necessitate advancements in image acceleration techniques. This study evaluates a 7T deep learning (DL)-based image reconstruction by using a deep neural network trained on 7T data, applied to T2-weighted turbo spin-echo imaging. Raw <i>k</i>-space data from 30 consecutive clinical 7T brain MRI patients was reconstructed by using both DL and standard methods. Qualitative assessments included overall image quality, artifacts, sharpness, structural conspicuity, and noise level, while quantitative metrics evaluated contrast-to-noise ratio (CNR) and image noise. DL-based reconstruction consistently outperformed standard methods across all qualitative metrics (<i>P</i> < .001), with a mean CNR increase of 50.8% (95% CI: 43.0%-58.6%) and a mean noise reduction of 35.1% (95% CI: 32.7%-37.6%). These findings demonstrate that DL-based reconstruction at 7T significantly enhances image quality without introducing adverse effects, offering a promising tool for addressing the challenges of ultra-high-field MRI.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1517-1520"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018004","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":"Arterial Spin-Labeling MRI Identifies Abnormal Perfusion Metric at the Gray Matter/CSF Interface in Cerebral Small Vessel Disease.","authors":"Abdelkader Mahammedi, Ates Fettahoglu, Jeremy J Heit, Joanna M Wardlaw, Greg Zaharchuk","doi":"10.3174/ajnr.A8682","DOIUrl":"10.3174/ajnr.A8682","url":null,"abstract":"<p><strong>Background and purpose: </strong>Cerebral small vessel disease (SVD) is a common cause of stroke and cognitive decline. SVD is characterized by white matter hyperintensities (WMH) and dilated perivascular spaces (PVS). While WMH can be associated with reduced CBF and glymphatic clearance, current clinical and radiologic assessments of these associations remain controversial and mostly qualitative. We aim to identify if arterial spin-labeling (ASL)-based CBF differences, particularly in the cortical surface at the GM/CSF interface, correlate with SVD severity.</p><p><strong>Materials and methods: </strong>We performed a retrospective cohort study of healthy controls with normal cognition who underwent a brain MRI as part of our university's Alzheimer Disease Research Center (ADRC) and an ¹⁵O-water PET study database. Our inclusion criteria included patients aged >50 years with no structural brain abnormalities besides SVD with ASL perfusion images. WMH grading was performed by using the Fazekas scale, WMH score, PVS grade, and manually segmented WMH volume. We identified patients with moderate-to-severe SVD and then selected age-matched samples of patients with minimal or no SVD. CBF of the whole brain (WB), GM, WM, and along the GM/CSF interface were calculated. Several perfusion metrics (WB, GM, and WM) as well as a novel perfusion metric, <u>n</u>ormalized <u>G</u>M/<u>C</u>SF <u>i</u>nterface (nGCI) perfusion metric, which indirectly reflects the relative ASL signal near the GM-CSF boundary, were evaluated by using receiver operating characteristic and correlation analyses.</p><p><strong>Results: </strong>Thirty-two patients met the inclusion criteria (<i>n</i>=11 moderate-to-severe SVD, mean age 72 ± 10 years, 6 women; <i>n</i> = 21 none-to-minimal SVD, mean age 70 ± 10 years, 12 women). Of the measured perfusion markers, nGCI had the strongest negative correlation with Fazekas score, total WMH volume, PVS grade, and average total SVD score (<i>r</i> = -0.68, -0.67, -0.54, -0.54, respectively; <i>P</i> < .001) as well as the highest area under the receiver operating characteristics curve (0.95, 95% CI: 0.87-1.0) as a predictor of WMH severity.</p><p><strong>Conclusions: </strong>nGCI, a novel perfusion metric that may capture features of perfusion at the GM-CSF boundary, was strongly correlated with WMH and PVS severity. Further, longitudinal studies are required to determine the potential role of nGCI as a predictive marker of SVD progression.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1345-1352"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287438","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":"Sodium MRI in Pediatric Brain Tumors.","authors":"Aashim Bhatia, Cassie Kline, Peter J Madsen, Michael J Fisher, Fernando E Boada, Timothy P L Roberts","doi":"10.3174/ajnr.A8642","DOIUrl":"10.3174/ajnr.A8642","url":null,"abstract":"<p><p>Direct sodium MRI (²³Na-MRI) derives its signal from spin-manipulation of the ²³Na nucleus itself and not the more conventional and familiar ¹H-MRI. Although present at much lower concentrations in the human body than the ¹H nuclei in the water molecule H₂O, advances in coil design and pulse sequence development have enabled the feasibility of human in vivo ²³Na-MRI. Additionally, ²³Na-MRI has the potential to offer nuanced physiologic insights not available to conventional MRI; this feature forms the basis of interest in its development and optimism for its novel clinical utility. ²³Na-MRI has the potential to be a useful noninvasive imaging technique to assess biochemical and physiologic cellular changes in tissues, eg, cell integrity and tissue viability. Pathologically, the concentration of total sodium is elevated in tumors relative to normal counterparts due to increased intracellular sodium and/or an increased proportion of extracellular space (reflecting changes in cell morphology and anomalies of homeostasis). Here we review the technological advancements with improved pulse sequences and reconstruction methods that counter the inherent challenges of measuring sodium concentrations in the pediatric brain (in particular, its short-tissue T2 value) and present detailed imaging approaches to quantifying sodium concentrations in the pediatric brain that can be assessed in various CNS pathologies, with the focus on pediatric brain tumors.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1309-1317"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334625","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":"Location-Specific Net Water Uptake and Malignant Cerebral Edema in Acute Anterior Circulation Occlusion Ischemic Stroke.","authors":"XiaoQing Cheng, Bing Tian, LiJun Huang, Xi Shen, AnYu Liao, ChangSheng Zhou, Quan Hui Liu, HuiMin Pang, JinJing Tang, BaiYan Luo, Xia Tian, YuXi Hou, LuGuang Chen, Qian Chen, WuSheng Zhu, ChengWei Shao, XinDao Yin, GuangMing Lu","doi":"10.3174/ajnr.A8659","DOIUrl":"10.3174/ajnr.A8659","url":null,"abstract":"<p><strong>Background and purpose: </strong>Early identification of malignant cerebral edema (MCE) in patients with acute ischemic stroke is crucial for timely interventions. We aimed to identify regions critically associated with MCE using the ASPECTS to evaluate the association between location-specific net water uptake (NWU) and MCE.</p><p><strong>Materials and methods: </strong>This multicenter, retrospective cohort study included patients with acute ischemic stroke following large anterior circulation occlusion. The ASPECTS was determined by RAPID ASPECTS software. ASPECTS-NWU and Region-NWU were calculated automatically by comparing the Hounsfield unit values in the ischemic and contralateral regions. Critical ASPECTS MCE regions and Region-NWU were evaluated by multivariate logistic regression and the areas under the receiver operating characteristic curves (AUCs).</p><p><strong>Results: </strong>The study included 513 patients. Multivariate analysis showed that the ASPECTS insula (OR = 2.49; 95% CI, 1.44-4.31) and M5 (OR = 1.59; 95% CI, 1.11-3.41) regions were significantly associated with MCE. After adjustment, only the insula (OR = 2.34; 95% CI, 1.23-4.45) was independently associated with MCE. Univariable receiver operating characteristic curve analysis found AUCs for Insula-NWU (AUC, 0.70; 95% CI, 0.65-0.76) and ASPECTS-NWU (AUC, 0.64; 95% CI, 0.58-0.70). The Insula-NWU had better diagnostic power than ASPECTS-NWU (DeLong test; <i>P</i> = .01). A multivariate regression model that combined the NIHSS, ASPECTS, insula involvement, and Insula-NWU had good discriminatory power (AUC = 0.80; 95% CI, 0.74-0.86) and better diagnostic power than Insula-NWU (DeLong test; <i>P</i> < .01).</p><p><strong>Conclusions: </strong>The insula region is critical for MCE, and Insula-NWU has better prediction efficacy than ASPECTS-NWU. This method does not rely on advanced imaging, facilitating rapid assessment in emergencies.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1329-1335"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017622","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":"Prevalence and Characteristics of Microspurs in Patients with Spontaneous Intracranial Hypotension Compared with the General Population.","authors":"Danial Nasiri, Levin Häni, Johannes Goldberg, Thomas Petutschnigg, Tomas Dobrocky, Ralph T Schär, Christoph Schankin, Andreas Raabe, Jürgen Beck, Eike Immo Piechowiak, Christopher Marvin Jesse","doi":"10.3174/ajnr.A8644","DOIUrl":"10.3174/ajnr.A8644","url":null,"abstract":"<p><strong>Background and purpose: </strong>In patients diagnosed with spontaneous intracranial hypotension (SIH), microspurs are considered the culprit lesion in most ventral dural leaks (type I). The imaging characteristics of discogenic spurs, and their prevalence in the general population has not been reported in the literature.</p><p><strong>Materials and methods: </strong>This observational case-control study was conducted comparing the prevalence and characteristics of discogenic microspurs between patients with SIH with a type I leak treated at a tertiary hospital between 2013 and 2023 and an age- and sex-matched cohort of trauma patients.</p><p><strong>Results: </strong>Each group consisted of 85 patients (mean age 51.6 ± 11.9 years), 74% (58/85 patients) were women. The prevalence of discogenic microspurs in the control group and SIH group was 31.8% and 90.6%, respectively. The mean length of the culprit microspur responsible for a dural leak was larger compared with the mean length of all coincidental microspurs from both the SIH and the control group not causing a dural leak (2.6 mm versus 1.6 mm, <i>P</i> < .001). Our multivariate logistic regression revealed that an increasing length of a microspur (OR, 1.942, CI 1.35-2.80, <i>P</i> < .001) and a narrower diameter of the spinal canal (OR, 0.85, CI 0.76-0.96, <i>P</i> = .008) were predictive for a dural tear.</p><p><strong>Conclusions: </strong>A discogenic microspur is a common incidental finding and may be found in almost one-third of the general population. The length of the culprit microspur and the diameter of the spinal canal are distinct morphologic characteristics for type I associated CSF leaks.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1486-1492"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960165","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":"Safety and Effectiveness of a Novel Integrated Angiography System for Continuous Guidance and Flushing in Diagnostic Cerebral Catheter Angiography: A Randomized Controlled Trial.","authors":"Boseong Kwon, Jong-Tae Yoon, Yun Hyeok Choi, Soo Jeong, Byung Jun Kim, Joon Ho Choi, Sun Moon Hwang, Deok Hee Lee, Yunsun Song","doi":"10.3174/ajnr.A8700","DOIUrl":"10.3174/ajnr.A8700","url":null,"abstract":"<p><strong>Background and purpose: </strong>The guided angiography system, an integrated angiography system, enables continuous guidance and flushing during diagnostic procedures. A guidewire provides guidance by remaining inside the catheter during contrast injection into tortuous vessels. While its feasibility was demonstrated in a retrospective study, this randomized controlled trial aims to evaluate its safety and effectiveness.</p><p><strong>Materials and methods: </strong>This single-center, single-blind, randomized controlled trial was conducted from September 2021 to June 2022. Patients with unruptured intracranial aneurysms were enrolled and randomly assigned to either the guided or the conventional group. Primary outcomes were procedural time and serious adverse events. Secondary outcomes included catheterization success, adverse events, fluoroscopy time, fluoroscopy dose, and image quality.</p><p><strong>Results: </strong>A total of 200 participants (mean age, 59 [SD, 10 years], 71% women) were randomized into the guided (<i>n</i> = 100) and the conventional (<i>n</i> = 100) groups. The guided group demonstrated shorter procedural times compared with the conventional group (18.3 [SD, 9.2] versus 21.3 [SD, 8.1] minutes, <i>P</i> < .001). There were no serious adverse events in either group, and adverse events were similar. Catheterization success rates were similar between the guided and conventional groups (93.9% versus 96.8%, <i>P</i> = .226). However, the guided angiography system backed up more catheterization failures from the conventional angiography system, but not vice versa (57.1% versus 11.1%, <i>P</i> = .003). Among catheterization successes, the guided group achieved shorter fluoroscopy time (7.0 versus 7.7 minutes, <i>P</i> = .033) and lower fluoroscopy dose (466.8 versus 566.5 μGy·m², <i>P</i> = .015). Regarding imaging quality, clinical acceptability was comparable between the guided and conventional groups (95.3% versus 95.5%, <i>P</i> = .781).</p><p><strong>Conclusions: </strong>The guided angiography system offers a simple and effective alternative for diagnostic cerebral conventional angiography, with reduced radiation exposure and a favorable safety profile.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1395-1402"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425809","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":"Photon-counting detector CT of the brain reduces variability of Hounsfield units and has a mean offset compared with energy-integrating detector CT.","authors":"Thomas Stein, Friederike Lang, Stephan Rau, Marco Reisert, Maximilian F Russe, Till Schürmann, Anna Fink, Elias Kellner, Jakob Weiss, Fabian Bamberg, Horst Urbach, Alexander Rau","doi":"10.3174/ajnr.A8910","DOIUrl":"https://doi.org/10.3174/ajnr.A8910","url":null,"abstract":"<p><strong>Background and purpose: </strong>Distinguishing gray matter (GM) from white matter (WM) is essential for CT of the brain. The recently established photon-counting detector CT (PCD-CT) technology employs a novel detection technique that might allow more precise measurement of tissue attenuation for an improved delineation of attenuation values (Hounsfield units - HU) and improved image quality in comparison with energy-integrating detector CT (EID-CT). To investigate this, we compared HU, GM vs. WM contrast, and image noise using automated deep learning-based brain segmentations.</p><p><strong>Materials and methods: </strong>We retrospectively included patients who received either PCD-CT or EID-CT and did not display a cerebral pathology. A deep learning-based segmentation of the GM and WM was used to extract HU. From this, the gray-to-white ratio and contrast-to-noise ratio were calculated.</p><p><strong>Results: </strong>We included 329 patients with EID-CT (mean age 59.8 ± 20.2 years) and 180 with PCD-CT (mean age 64.7 ± 16.5 years). GM and WM showed significantly lower HU in PCD-CT (GM: 40.4 ± 2.2 HU; WM: 33.4 ± 1.5 HU) compared to EID-CT (GM: 45.1 ± 1.6 HU; WM: 37.4 ± 1.6 HU, p < .001). Standard deviations of HU were also lower in PCD-CT (GM and WM both p < .001) and contrast-tonoise ratio was significantly higher in PCD-CT compared to EID-CT (p < .001). Gray-to-white matter ratios were not significantly different across both modalities (p > .99). In an age-matched subset (n = 157 patients from both cohorts), all findings were replicated.</p><p><strong>Conclusions: </strong>This comprehensive comparison of HU in cerebral gray and white matter revealed substantially reduced image noise and an average offset with lower HU in PCD-CT while the ratio between GM and WM remained constant. The potential need to adapt windowing presets based on this finding should be investigated in future studies.</p><p><strong>Abbreviations: </strong>CNR = Contrast-to-Noise Ratio; CTDIvol = Volume Computed Tomography Dose Index; EID = Energy-Integrating Detector; GWR = Gray-to-White Matter Ratio; HU = Hounsfield Units; PCD = Photon-Counting Detector; ROI = Region of Interest; VMI = Virtual Monoenergetic Images.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546528","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":"Effect of SARS-CoV-2 Infection on Endovascular Thrombectomy Outcomes-Data from the Florida Stroke Registry.","authors":"Hayes B Fountain, Ian Ramsay, Ruijie Yin, Ahmed Abdelsalam, Michael Silva, David Z Rose, Angus Jameson, Ying Hao, Ayham Alkhachroum, Carolina M Gutierrez, Victor J Del Brutto, Robert M Starke, Tanja Rundek, Hannah Gardener, Jose G Romano, Negar Asdaghi","doi":"10.3174/ajnr.A8673","DOIUrl":"10.3174/ajnr.A8673","url":null,"abstract":"<p><strong>Background and purpose: </strong>Endovascular thrombectomy outcomes are impacted by changes in stroke systems of care. During the pandemic, SARS-CoV-2 positive status had major implications on hospital arrival and treatment models of non-COVID-related hospital admissions. Using the Florida Stroke Registry, we compared the rates of in-hospital death and discharge outcomes of patients treated with endovascular thrombectomy who tested positive for SARS-CoV-2 infection during their hospitalization.</p><p><strong>Materials and methods: </strong>Data from Get with the Guidelines-Stroke hospitals participating in the Florida Stroke Registry during the COVID pandemic from March 2020 to December 2022 were reviewed to identify endovascular thrombectomy patients with coding for SARS-CoV-2 testing during their hospital stay. Associations between SARS-CoV-2 status and favorable endovascular thrombectomy outcomes of mRS (0-2) at discharge, discharge to home or rehabilitation center, symptomatic intracerebral hemorrhage, in-hospital mortality, and independent ambulation at discharge were examined by using multivariate logistic regression modeling adjusting for demographics, vascular risk factors, and clinical characteristics. Temporal analyses were used to compare outcomes across the study period.</p><p><strong>Results: </strong>A total of 8184 patients underwent endovascular thrombectomy (median age 71.1 years, women 49.7%, mean NIHSS 14). Of these, 180 (2.20%) were SARS-CoV-2 positive. Compared with SARS-CoV-2 negative endovascular thrombectomy patients, those who tested positive were younger, more frequently men, but with comparable stroke severity at presentation. In multivariable analysis, adjusting for baseline differences and confounding variables, there was a 33% lower likelihood of being discharged to home/inpatient rehab (OR = 0.67, 95% CI: 0.49-0.93), 65% higher odds of in-hospital death (OR = 1.65, 95% CI: 1.06-2.58), as well as a 91% less chance of having a high mRS (>2) at discharge (OR = 0.15, 95% CI: 0.04-0.60) for patients with positive SARS-CoV-2 infection. However, a similar risk of symptomatic intracerebral hemorrhage was present compared with SARS-CoV-2 negative patients (OR = 0.97, 95% CI: 0.50-1.88). Temporal analysis of SARS-CoV-2 positive patients showed no significant differences.</p><p><strong>Conclusions: </strong>In this large multicenter stroke registry, despite comparable clinical presentation and treatment timelines, SARS-CoV2 positive status negatively impacted thrombectomy outcomes.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1374-1378"},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054205","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}