AJNR. American journal of neuroradiology最新文献

{"title":"Effects of psilocybin on mouse brain microstructure.","authors":"Paloma C Frautschi, Ajay P Singh, Nicholas A Stowe, Sean M Grady, Zarmeen Zahid, Matthew I Banks, John-Paul J Yu","doi":"10.3174/ajnr.A8634","DOIUrl":"https://doi.org/10.3174/ajnr.A8634","url":null,"abstract":"<p><strong>Background and purpose: </strong>There is surging interest in the therapeutic potential of psychedelic compounds like psilocybin in the treatment of psychiatric illnesses like major depressive disorder (MDD). Recent studies point to the rapid antidepressant effect of psilocybin; however, the biological mechanisms underlying these differences remain unknown. This study determines the feasibility of using diffusion MRI to characterize and define the potential spatiotemporal microstructural differences in the brain following psilocybin treatment in C57BL/6J male mice.</p><p><strong>Materials and methods: </strong>11-15 week-old C57BL/6J male mice were randomized to receive psilocybin, 6F-DET (6-fluoro-N,Ndiethyltryptamine), or saline and <i>ex vivo</i> imaged 24h (n=18) and 72h (n=18) post treatment. A one-way ANOVA with multiple comparison testing (Bonferroni correction) assessed diffusion metric differences (tractography, DTI, NODDI) between the three groups and was performed in the following regions of interest: amygdala, striatum, hippocampus, thalamus, primary visual cortex area, frontal association cortex, and medial prefrontal cortex at 24h and 72h post drug administration.</p><p><strong>Results: </strong>Psilocybin treated mice demonstrated structural connectivity differences at 72h in the frontal association cortex (compared to saline, mean tract length increases, p=0.03). Psilocybin also induced microstructural differences at 24h post-injection in the primary visual cortex (compared to saline, MD increases, p=0.02) and 72h post-injection in the striatum (compared to saline; MD increases, p= 0.02, NDI decreases, p=0.02) and hippocampus (compared to saline; MD increases, p=0.04, NDI decreases, p=0.02).</p><p><strong>Conclusions: </strong>Diffusion microstructure imaging and white matter tractography are sensitive methods to detect and characterize the neural substrates and microstructural differences accompanying psilocybin treatment. These findings suggest the potential role for diffusion microstructure imaging to quantify the bioeffects of psychedelics like psilocybin on the brain, monitor treatment response, and identify salient clinical endpoints in an emerging therapeutic option for patients with MDD.</p><p><strong>Abbreviations: </strong>dMRI= diffusion-weighted MRI; 6F-DET= 6-fluoro-N,N-diethyltryptamine; NODDI= neurite orientation dispersion and density imaging; DTI= diffusion tensor imaging; NDI= neurite density index; ODI= orientation dispersion index; FA= fractional anisotropy; MD= mean diffusivity; MTL= mean tract length; mPFC= medial prefrontal cortex.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069676","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":"Posterior fossa ring-enhancing lesions in the adult immunocompetent host: illustrative cases, systematic review, and proposed diagnostic algorithm.","authors":"Elisabeth Van Boxstael, Alexia de Hennin, Eric Vigneul, Pasquale Scoppettuolo, Souraya El Sankari, Anna Paola Bocchio, Serena Borrelli, Valentina Lolli, Vincent van Pesch, Sofia Maldonado Slootjes, Patrice Finet, Àlex Rovira, Daniel S Reich, Pietro Maggi","doi":"10.3174/ajnr.A8677","DOIUrl":"https://doi.org/10.3174/ajnr.A8677","url":null,"abstract":"<p><strong>Purpose: </strong>Posterior fossa ring-enhancing lesions (PFREL) in the adult immunocompetent hosts pose a diagnostic challenge. We aimed to evaluate the spectrum of PFREL etiologies and propose a diagnostic algorithm.</p><p><strong>Methods: </strong>This study involved a retrospective analysis of PFREL cases from our institution (January 2023 to April 2024) and a systematic literature review conducted using Embase and PubMed databases following the PRISMA 2020 guidelines. Clinical and radiological features from these cases formed the basis of a diagnostic algorithm, which was further refined via an additional comprehensive literature review, and finally validated on an independent set of PFREL cases.</p><p><strong>Results: </strong>The systematic review (467 studies, 56 selected after inclusion/exclusion criteria) revealed that PFREL etiology was infectious in 52%, tumoral in 38% and inflammatory in 2% of cases. At initial presentation, mean age was 48 years and 36% of patients had multiple PFREL. Headache was the most common symptom (46%). Among those with reported outcomes, 36% showed complete resolution of symptoms, 29% showed improvement with residual symptoms, and 16% died. The diagnostic algorithm was created from a total of 116 PFREL cases (10 from our institutional series, 56 from the systematic literature review and 50 supplementary cases found in the literature) and included 29 possible PFREL etiologies. In the validation set (16 patients), the algorithm provided the correct diagnosis in each case.</p><p><strong>Conclusion: </strong>PFREL in immunocompetent adults encompass a broad differential diagnosis. Our algorithm integrates clinical and radiologic data to assist in identifying the underlying cause of PFREL, potentially reducing the need for neurosurgical biopsy. This approach aims to enhance diagnostic accuracy, leading to better treatment decisions and improved patient outcomes.</p><p><strong>Abbreviations: </strong>ADEM = acute disseminated encephalomyelitis; CLL = chronic lymphocytic leukemia; CSF = cerebrospinal fluid; DLBCL: diffuse large B cell lymphoma; FLAIR = fluid attenuated inversion recovery; MeSH = medical subject headings; MRI = magnetic resonance imaging; NIHSS = National Institutes of Health Stroke Scale; NMOSD = neuromyelitis optic spectrum disorder; PFREL = posterior fossa ring enhancing lesion; PRISMA = Preferred Reporting Items for Systematic reviews and Meta-Analyses; SUV max = maximum standardized uptake value.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069970","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":"Advanced Imaging of Type 2 Spinal CSF Leaks with Ultrahigh-Resolution Cone-Beam CT Myelography.","authors":"Niklas Lützen, Charlotte Zander, Jürgen Beck, Florian Volz, Katharina Wolf, Amir El Rahal, Horst Urbach","doi":"10.3174/ajnr.A8675","DOIUrl":"https://doi.org/10.3174/ajnr.A8675","url":null,"abstract":"<p><p>Type 2 CSF leaks are spinal lateral dural tears, causing spontaneous intracranial hypotension (SIH). They may be visualized with digital subtraction myelography (DSM), cone-beam CT (CBCT) myelography, energy-integrating detector or photon-counting CT myelography. A recently introduced ultrahigh-resolution cone-beam CT (UHR-CBCT) myelography has shown beneficial visualization of CSF-venous fistula, another cause of SIH. However, the use of this technique has not yet been reported in imaging of type 2 leaks. In this technical report, we describe first experiences and highlight the advantages of UHR-CBCT for visualizing type 2 leaks in SIH.ABBREVIATIONS: SIH=Spontaneous intracranial hypotension, DSM=Digital subtraction myelography, CBCT=Cone-beam CT, UHRCBCT=Ultrahigh-resolution cone-beam CT.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069501","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":"Endovascular Treatment for Tentorial Dural Arteriovenous Fistulas: A Retrospective Single-Center Study.","authors":"Guanghao Zhang, Miao Pang, Zhe Li, Chenghao Shang, Yuhang Zhang, Qi Zhang, Qinghai Huang, Yi Xu, Guoli Duan, Qiang Li, Jianmin Liu","doi":"10.3174/ajnr.A8676","DOIUrl":"https://doi.org/10.3174/ajnr.A8676","url":null,"abstract":"<p><strong>Background and purpose: </strong>Current evidence suggests that tentorial dural arteriovenous fistulas with endovascular treatment offer a high rate of occlusion and reduced procedural risks. Here we report the clinical and angiographic outcomes in patients with tentorial dural arteriovenous fistulas who underwent endovascular treatment as first-line treatment.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on 83 patients with tentorial dural arteriovenous fistulas treated at our center from April 2009 to November 2023 using endovascular treatment. Patient demographics, clinical presentation, angiographic, treatment results, and follow-up outcomes were registered. Univariable and multivariable logistic regression were performed to identify onset of intracranial hemorrhage predictors, procedure-related complications predictors and predictors of poor functional outcome.</p><p><strong>Results: </strong>Eighty-three patients underwent endovascular treatment as first-line treatment. Most patients (80.7%) were symptomatic and a total of 25 patients (30.1%) presented with intracranial hemorrhage. Presence of deep venous drainage and midline location was associated with a lower incidence of intracranial hemorrhage. Middle meningeal artery (57.8%, 48/83) and pial artery (15.7%, 13/83) were the most frequently used access routes for embolization. A total of 74 (89.1%) TDAVFs were completely occluded after the last EVT session immediately. Complications occurred in 11 patients (13.3%). Six-month angiographic follow-up was performed in 68 patients (81.8%), and 91.2% (62/68) tentorial dural arteriovenous fistulas were occluded. At clinical follow-up (100%, 83/83), good functional outcome (mRS 0-2) was documented in 74 (89.1%) patients. Logistic regression analysis identified baseline mRS 3-5 as the most significant independent predictor of poor functional outcome. Subgroup analysis showed no statistically significant differences in baseline characteristics, angiographic and clinical results between patients treated with targeted pial artery embolization and non-targeted pial artery embolization.</p><p><strong>Conclusions: </strong>Endovascular treatment is a safe and effective primary modality for managing tentorial dural arteriovenous fistulas, achieving high rates of complete angiographic occlusion and favorable functional outcomes. Transarterial embolization, predominantly via middle meningeal artery, was the mainstay of treatment. In patients with pial arterial feeders, omitting aggressive embolization did not compromise efficacy or increase complications.</p><p><strong>Abbreviations: </strong>DAVF = dural arteriovenous fistula; TDAVF = tentorial dural arteriovenous fistula; EVT = endovascular treatment; TAE = transarterial embolization; TVE = transvenous embolization; MMA = middle meningeal artery.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069613","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-CoV2 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":"https://doi.org/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-CoV2 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-CoV2 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-CoV2 testing during their hospital stay. Associations between SARS-CoV2 status and favorable endovascular thrombectomy outcomes of mRS (0-2) at discharge, discharge to home or rehabilitation centre, symptomatic intracerebral hemorrhage, in-hospital mortality, and independent ambulation at discharge were examined 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 8,184 patients underwent endovascular thrombectomy (median age 71.1 years, female 50%, mean NIHSS 14), of these, 180 (2.2%) were SARS-CoV2 positive. Compared to SARS-CoV2 negative endovascular thrombectomy patients, those who tested positive were younger, more frequently male, 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 85% less chance of having a high mRS (>2) at discharge (OR=0.15, 95% CI=(0.04-0.60)) for patients with positive SARS-CoV2 infection. However, a similar risk of symptomatic intracerebral hemorrhage was present compared to SARS-CoV2 negative patients (OR=0.97, 95% CI=(0.501.88)). Temporal analysis of SARS-CoV2 positive patients showed no significant differences.</p><p><strong>Conclusions: </strong>In this large multicenter stroke registry, despite comparable clinical presentation and in-hospital treatment timelines, SARS-CoV2 positive status negatively impacted thrombectomy outcomes.</p><p><strong>Abbreviations: </strong>AIS = acute ischemic stroke; LVO = large vessel occlusion; EVT = endovascular thrombectomy; FSR = Florida Stroke Registry; sICH = symptomatic intracerebral hemorrhage.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","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}

{"title":"Cracking the Code of Calcification: How Presence and Burden among Intracranial Arteries Influence Stroke Incidence and Recurrence.","authors":"Matteo Conte, Mohammed O Alalfi, Riccardo Cau, Roberta Scicolone, Seemant Chaturvedi, Renu Virmani, Gianluca De Rubeis, Daniel Bos, Luca Saba","doi":"10.3174/ajnr.A8668","DOIUrl":"https://doi.org/10.3174/ajnr.A8668","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Intracranial atherosclerosis accounts for about 8% of all strokes in Western societies but the influence of arterial calcification on plaque instability is a topic on ongoing debate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Explore the association between the presence and burden of calcium in atherosclerotic plaques among intracranial arteries with the risk of clinical or silent stroke events through a systematic review and meta-analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;Adhering to PRISMA guidelines, studies from PubMed and Embase were analyzed up to May 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study selection: &lt;/strong&gt;Adult populations undergoing CT/CTA scans for symptomatic and asymptomatic atherosclerosis among intracranial vessels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data analysis: &lt;/strong&gt;Statistical analyses were performed to identify the impact of calcium presence and relative burden on stroke incidence or recurrence. Risk of bias was evaluated with QUADAS-2 criteria while GRADE system was used to assess quality of evidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data synthesis: &lt;/strong&gt;The study synthesized data from 8 longitudinal studies, creating two different models: Calcium presence (heterogeneity: Q 9.19; I&lt;sup&gt;2&lt;/sup&gt; 42.61%) and calcium burden (heterogeneity: Q 6.01; I&lt;sup&gt;2&lt;/sup&gt; 0.01%). As for calcium presence and stroke events, 6839 patients were considered, and two statistical models were made. Our analysis established a significant association between the presence of calcium and stroke events. [OR= 1.54, 95% CI 1.06, 2.24, p=0.001]. A subsequent effect size analysis showed a similar correlation's strength [OR = 1.56, 95% CI 1.11, 2.19, p = 0.001]. As for calcium burden and stroke events, 4885 patients were considered with effect size analysis establishing a positive correlation [OR = 1.31, 95% CI, 1.17, 1.46, p =&lt; 0.001). A decrease in correlation strength was found between calcium presence [OR = 1.56] and burden [OR = 1.31] with stroke events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Despite strict exclusion criteria, heterogeneity across studies and between different statistical models of the present study persisted. Valuable data loss among excluded studies could have affected the findings of this meta-analysis. Unified calcium scoring pattern and individual arterial segment analysis was not widely adopted by included literature.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our meta-analysis showed a weak, yet present association between presence and burden of calcification among intracranial arterial vessels and clinical or silent stroke events. Considering the high prevalence of intracranial calcification in the general population, widespread intracranial calcium assessment for stroke prediction has currently poor evidence. Investigation on specific intracranial vessels or exploration of newer calcium patterns could be essential to enhance the predictive accuracy of calcification in stroke incidence or recurrence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Abbreviations: &lt;/strong&gt;IAC = Intracranial ","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043904","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":"Proximal protection devices for carotid artery stenting - A benchtop assessment of flow reversal performance.","authors":"Jiahui Li, Esref A Bayraktar, Cem Bilgin, Yang Liu, Yigit C Senol, Jonathan Cortese, Ramanathan Kadirvel, Waleed Brinjikji, David F Kallmes","doi":"10.3174/ajnr.A8664","DOIUrl":"https://doi.org/10.3174/ajnr.A8664","url":null,"abstract":"<p><strong>Background and purpose: </strong>Proximal protection devices, such as TransCarotid Artery Revascularization (TCAR, SilkRoad Medical, Sunnyvale), aim to yield better outcomes in carotid artery stenting (CAS) than distal protection devices by preventing plaque embolization to the brain. However, transfemoral catheters may not fully reverse flow from the external carotid artery (ECA) to the internal carotid artery (ICA). We assess a new balloon-sheath device, Femoral Flow Reversal Access for Carotid Artery Stenting (FFRACAS), for this purpose.</p><p><strong>Materials and methods: </strong>The FFRACAS prototype (ID = 0.117\"; L=80cm) was compared to TCAR (ID=0.104\", L=30cm) and MoMa (Medtronic, Minneapolis; ID=0.083\", L=90cm) in a pulsatile flow model with blood simulant at 800mL/min. MoMa was used according to labeled instructions, with both CCA and ECA balloon inflation, without CCA-femoral vein shunt placement, and in an off-label fashion with single balloon occlusion in the CCA and shunt. Flow rates of the ICA, ECA, and shunt, when applicable, were monitored during CAS stages: CCA flow arrest, shunt activation, and stent delivery. Experiments were conducted under two ECA inflow conditions (-10 and -20 mL/min). Statistical comparison of ICA flow rates was conducted using ANOVA and Tukey's post-hoc tests.</p><p><strong>Results: </strong>MoMa's on-label use maintained retrograde ICA flow (-0.3 mL/min) throughout CAS. Upon shunt activation, TCAR and FFRACAS reversed ICA flow similarly under low ECA inflow (ICA=-5.10 mL/min vs. -4.83 mL/min; p=0.349), but neither achieved ICA flow reversal under high ECA inflow or during stent delivery. MoMa off-label use failed to reverse ICA flow.</p><p><strong>Conclusions: </strong>FFRACAS presents a potential alternative to TCAR, achieving similar degrees of flow reversal from a transfemoral approach to that achieved with the transcarotid approach. The MoMa system reliably prevents anterograde flow in ICA during CAS.</p><p><strong>Abbreviations: </strong>CAS = Carotid Artery Stenting; TCAR = Transcarotid Arterial Revascularization; CCA = Common Carotid Artery; ICA = Internal Carotid Artery; ECA = External Carotid Artery; VA = Vertebral Artery; FFRACAS = Femoral Flow Reversal Access for Carotid Artery Stenting; ID = Inner Diameter; OD = Outer Diameter.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025887","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":"https://doi.org/10.3174/ajnr.A8665","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and purpose: &lt;/strong&gt;Differentiating Parkinson's Disease (PD) from Atypical Parkinsonism Syndrome (APS), including Multiple System Atrophy (MSA) and Progressive Supranuclear Palsy (PSP), is challenging, and there is no gold standard. Integrating quantitative susceptibility mapping (QSM) and morphometry can help differentiate PD from APS and improve the internal diagnosis of APS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;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 regions of interest (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 magnetic resonance Parkinson's disease index (MRPI), the midbrain area-pons area ratio (M/P), and the ratio of 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 diagnosis between PD and APS and between diseases within APS. The diagnostic value was assessed using the area under the curve (AUC), sensitivity, and specificity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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 two 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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;QSM and morphometry will improve the differential diagnosis between PD and APS, as well as improve the internal diagnosis of APS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Abbreviations: &lt;/strong&gt;PD = Parkinson's Disease; MSA = Multiple System Atrophy; MSA-P = Multiple System Atrophy parkinsonian subtype; MSA-C = Multiple System Atrophy cerebellar subtype; PSP =Progressive Supranuclear Palsy; QSM = quantitative susceptibility mapping; Pu = Putamen; GP = Globus Pallidus; RN = Red Nucleus; MRPI = magnetic resonance parkinsonism index","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-21","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":"Location-specific net water uptake and malignant cerebral edema in acute anterior circulation occlusion ischemic stroke.","authors":"Xiao Qing Cheng, Bing Tian, Li Jun Huang, Xi Shen, An Yu Liao, Chang Sheng Zhou, Quan Hui Liu, Hui Min Pang, Jin Jing Tang, Bai Yan Luo, Xia Tian, Yu Xi Hou, Lu Guang Chen, Qian Chen, Wu Sheng Zhu, Cheng Wei Shao, Xin Dao Yin, Guang Ming Lu","doi":"10.3174/ajnr.A8659","DOIUrl":"https://doi.org/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 Alberta Stroke Program Early Computed Tomography Score (ASPECTS) to evaluate the association between location-specific-net water uptake (NWU) and MCE.</p><p><strong>Materials and methods: </strong>This multicentre, 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 units 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 ROC 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; P=0.01). 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; P<0.01).</p><p><strong>Conclusions: </strong>Brief statement directed to the stated purpose or hypothesis; no references should be cited.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><p><strong>Abbreviations: </strong>ASPECTS = the Alberta Stroke Program Early Computed Tomography Score; AUC= the areas under the receiver operating characteristic curve; CT=computed tomography; CTP=CT perfusion; HU = hounsfield unit; MCE = malignant cerebral edema; NCCT=non-contrast Computed Tomography; NWU = net water uptake; ROC = receiver operating characteristic curve.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","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":"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":"https://doi.org/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 using a deep neural network trained on 7T data, applied to T2-weighted turbo spin echo imaging. Raw k-space data from 30 consecutive clinical 7T brain MRI patients was reconstructed 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 (p<0.001), 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.ABBREVIATIONS: CNR = contrast-to-noise ratio; DL = deep learning; GRAPPA = GeneRalized Autocalibrating Partially Parallel Acquisitions; IQR = interquartile range; MNI = Montreal Neurological Institute; SD = standard deviation.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-20","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}