AJNR. American journal of neuroradiology最新文献

{"title":"Quantification of Collateral Supply with Local-AIF Dynamic Susceptibility Contrast MRI Predicts Infarct Growth.","authors":"Mira M Liu, Niloufar Saadat, Steven P Roth, Marek A Niekrasz, Mihai Giurcanu, Timothy J Carroll, Gregory A Christoforidis","doi":"10.3174/ajnr.A8441","DOIUrl":"10.3174/ajnr.A8441","url":null,"abstract":"<p><strong>Background and purpose: </strong>In ischemic stroke, leptomeningeal collaterals can provide delayed and dispersed compensatory blood flow to tissue-at-risk despite an occlusion and can impact treatment response and infarct growth. The purpose of this work is to test the hypothesis that inclusion of this delayed and dispersed flow with an appropriately calculated Local Arterial Input Function (Local-AIF) is needed to quantify the degree of collateral blood supply in tissue distal to an occlusion.</p><p><strong>Materials and methods: </strong>Seven experiments were conducted in a pre-clinical middle cerebral artery occlusion model. Dynamic susceptibility contrast MRI was imaged and post-processed to yield quantitative cerebral blood flow (qCBF) maps with both a traditionally chosen single arterial input function applied globally to the whole brain (i.e. \"Global-AIF\") and a delay and dispersion corrected AIF (i.e. \"Local-AIF\") that is sensitive to retrograde flow. Leptomeningeal collateral arterial recruitment was quantified with a pial collateral score from x-ray angiograms, and infarct growth calculated from serially acquired diffusion weighted MRI scans.</p><p><strong>Results: </strong>The degree of collateralization at x-ray correlated more strongly with qCBF using the Local-AIF in the ischemic penumbra (R²=0.81) than traditionally chosen Global-AIF (R²=0.05). qCBF using a Local-AIF was negatively correlated (less infarct progression as perfusion increased) with infarct growth (R² = 0.79) more strongly than a Global-AIF (R²=0.02).</p><p><strong>Conclusions: </strong>In acute stroke, qCBF calculated with a Local-AIF is more accurate for assessing tissue status and collateral supply than traditionally chosen Global-AIFs. These findings support use of a Local-AIF that corrects for delayed and dispersed retrograde flow in determining quantitative tissue perfusion with collateral supply in occlusive disease.</p><p><strong>Abbreviations: </strong>MRI = magnetic resonance imaging; DSC = dynamic susceptibility contrast; PCS = pial collateral score; MCAO = middle cerebral artery occlusion; MCA = middle cerebral artery; AIF = arterial input function; rCBF = relative cerebral blood flow; qCBF = quantitative cerebral blood flow.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972428","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":"Inter-and intrarater agreement of Computed Tomographic brain calcification scoring in Primary Familial Brain Calcification.","authors":"Birgitta M G Snijders, Huiberdina L Koek, Mike J L Peters, Willem P T M Mali, Michelle M van Beek, Merel J C Betman, Nienke M S Golüke, Tijl Kruyswijk, Stéphanie V de Lange, Bouke D W T Lith, Ruth M Pekelharing, Marvin J Roos, Dirk R Rutgers, Simone M Uniken Venema, Wouter R Verberne, Marielle H Emmelot-Vonk, Pim A de Jong","doi":"10.3174/ajnr.A8446","DOIUrl":"https://doi.org/10.3174/ajnr.A8446","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Total Calcification Score (TCS) is a visual rating scale to measure Primary Familial Brain Calcification (PFBC) related calcification severity on Computed Tomography (CT). We investigated the inter-and intrarater agreement of a modified TCS.</p><p><strong>Materials and methods: </strong>Patients aged ≥18 years with PFBC or Fahr's syndrome who visited the outpatient clinic of a Dutch academic hospital were included. The TCS was modified, for example by adding hippocampal calcification, and ranged from 0 to 95 points. Fifteen raters evaluated all CTs, of whom three evaluated the CTs twice. Their Entrustable Professional Activity (EPA) level ranged from II (medical student) to V (neuroradiologist). Agreement was assessed using the intraclass correlation coefficient (ICC) for the total score. Kendall's W and weighted Cohen's Kappa were used to determine the inter- and intrarater agreement for individual locations, respectively.</p><p><strong>Results: </strong>Forty patients were included (mean age 60 years, 53% female). The median modified TCS was 34 (range 4-76). For all EPA levels, the interrater agreement of the modified TCS was excellent (ICC=0.97 (95% CI 0.95-0.98)). Kendall's W's were good to excellent for commonly affected locations, but poor to moderate for less commonly affected locations for raters with lower levels of expertise. The intrarater agreement of the modified TCS was excellent. Kappa's of most locations were substantial to almost perfect.</p><p><strong>Conclusions: </strong>The modified TCS can be used with excellent reproducibility of the overall amount of brain calcifications and with limited training, although for some individual calcification locations more expertise is needed.</p><p><strong>Abbreviations: </strong>CI, Confidence Interval; CT, Computed Tomography; EPA, Entrustable Professional Activity; IBGC, Idiopathic Basal Ganglia Calcification; ICC, Intraclass Correlation Coefficient; IQR, Interquartile Range; PFBC, Primary Familial Brain Calcification; SD, Standard Deviation, TCS, Total Calcification Score; UMCU, University Medical Center Utrecht.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972427","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":"Impact of Patient Head Posture on Lens Radiation Exposure During Cerebral Angiography.","authors":"Su Jeong Yang, Jong-Tae Yoon, Jae-Chan Ryu, Byung Jun Kim, Mi Hyeon Kim, Boseong Kwon, Deok Hee Lee, Yunsun Song","doi":"10.3174/ajnr.A8447","DOIUrl":"https://doi.org/10.3174/ajnr.A8447","url":null,"abstract":"<p><strong>Background and purpose: </strong>Cerebral angiography remains crucial for detailed characterization and preoperative assessments for intracranial aneurysm. Despite its diagnostic importance, cerebral angiography poses challenges due to its invasiveness, the risk of neurological complications, and radiation exposure. To investigate the impact of head posture on lens radiation exposure during cerebral angiography, this study focused on the correlation between radiation doses to the eye lens, head flexion angles, and head size.</p><p><strong>Materials and methods: </strong>A retrospective analysis was performed on 20 patients who underwent cerebral angiography for unruptured intracranial aneurysms between October and November 2022. Radiation doses to the lens, which were measured in a prior prospective study using photoluminescent glass dosimeters, were analyzed alongside head flexion angles, anteroposterior (AP) head diameters, and kerma-area product (KAP) to evaluate their correlation with lens radiation exposure. The lateral radiation source is located on the left side of the patients.</p><p><strong>Results: </strong>The cohort consisted of 20 patients (60% female, mean age: 62.3 ± 9.9 years). The radiation dose to the left eye (the eye closer to the x-ray source) was 2.8 times higher than that to the right eye (9.18 ± 3.31 mGy vs. 3.3 ± 0.60 mGy, P < 0.001). A strong positive correlation was observed between the left eye lens dose and head flexion angle (R = 0.815, P < 0.001). While the AP head diameter significantly correlated with the flexion angle, it showed no significant correlation with lens dose. The KAP was inversely correlated with both the left lens dose (R = -0.597, P = 0.005) and the flexion angle (R = -0.689, P < 0.001).</p><p><strong>Conclusions: </strong>Our findings underscore the significant impact of head posture on lens radiation exposure during cerebral angiography. Adjusting head positioning may provide a practical approach to reduce radiation exposure to the lens. Furthermore, it is worth noting that the left lens received more radiation than the right, likely due to the X-ray source being on the left side of the patient.</p><p><strong>Abbreviations: </strong>AP = anteroposterior; KAP = kerma-area product, PLD = photoluminescent glass dosimeter.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914812","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":"Combinations of Clinical Factors, CT Signs, Radiomics for Differentiating High-density Areas After Mechanical Thrombectomy in Patients with Acute Ischemic Stroke.","authors":"Duchang Zhai, Yuanyuan Wu, Manman Cui, Yan Liu, Xiuzhi Zhou, Dongliang Hu, Yuancheng Wang, Shenghong Ju, Guohua Fan, Wu Cai","doi":"10.3174/ajnr.A8434","DOIUrl":"https://doi.org/10.3174/ajnr.A8434","url":null,"abstract":"<p><strong>Background and purpose: </strong>Clinically, hemorrhagic transformation (HT) after mechanical thrombectomy (MT) is a common complication. This study is aim to investigate the value of clinical factors, CT signs, and radiomics in the differential diagnosis of high-density areas (HDAs) in the brain after MT in patients with acute ischemic stroke with large vessel occlusion (AIS-LVO).</p><p><strong>Materials and methods: </strong>A total of 156 eligible patients with AIS-LVO in Center Ⅰ from December 2015 to June 2023 were retrospectively enrolled and randomly divided into training (n=109) and internal validation (n=47) sets at a ratio of 7:3. The data of 63 patients in Center Ⅱ were collected as an external validation set. According to the diagnostic criteria, the patients in the three datasets were divided into a HT group and a non-HT group. The clinical and imaging data from Centers Ⅰ and Ⅱ were used to construct a clinical factor and CT-sign model, a radiomic model and a combined model by logistic regression (LR). Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic efficacy of each model in the three datasets.</p><p><strong>Results: </strong>Clinical blood glucose (Glu) and the maximum cross-sectional area (Area_max) on CT were associated with the nature of the HDA according to multivariate LR analyses (<i>P</i> < 0.05). Among the three models, the combined model had the highest diagnostic efficiency, with area under the curve (AUC) values of 0.895, 0.882, and 0.820 in the three datasets, which were significantly greater than the AUC values of the radiomic model (0.887, 0.898, 0.798) and clinical factor and CT sign model (0.831, 0.744, 0.684).</p><p><strong>Conclusions: </strong>The combined model based on radiomics had the best performance, indicating that radiomic features can be used as imaging biomarkers to aid in the clinical judgment of the nature of HDA after MT.</p><p><strong>Abbreviations: </strong>HDA =high-density area; HT =hemorrhagic transformation; MT =mechanical thrombectomy; AIS-LVO =acute ischemic stroke with large vessel occlusion; LR =logistic regression; AUC =area under the curve; ICE =iodine contrast extravasation; DECT =dual energy CT; IOM =iodine overlay map; VNC =virtual noncontrast; Glu =glucose; LASSO =least absolute shrinkage and selection operator; ICC =intraclass correlation coefficient; ROC =receiver operating characteristic; DCA =decision curve analysis.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914799","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":"Facet Injections, Prior Authorization, and the Future of Image-Guided Spinal Pain Management.","authors":"John C Benson","doi":"10.3174/ajnr.A8371","DOIUrl":"10.3174/ajnr.A8371","url":null,"abstract":"","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11383416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536143","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":"Low-Field Portable MR Imaging to Evaluate Ventricular Volumes: A Single-Center Retrospective Study.","authors":"Vivek Velagapudi, Nathan S Artz, Johnston K Fite, Sherwin S Chan, Adam G Rouse","doi":"10.3174/ajnr.A8269","DOIUrl":"10.3174/ajnr.A8269","url":null,"abstract":"<p><p>This study assesses the efficacy of low-field portable MR imaging in measuring ventricular volumes in the pediatric population in the hospital setting. We compared portable and standard of care MR images from the same patient. The estimated ventricular volumes had excellent agreement with a mean bias of 2.06% by Bland-Altman analysis and a correlation of 0.99. From this initial data set, our results suggest that low-field, portable MR imaging is a promising technique for imaging and quantifying ventricular volumes.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11383396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141536144","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":"Individual Structural Covariance Network Predicts Long-Term Motor Improvement in Parkinson Disease with Subthalamic Nucleus Deep Brain Stimulation.","authors":"Yu Diao, Hutao Xie, Yanwen Wang, Baotian Zhao, Anchao Yang, Jianguo Zhang","doi":"10.3174/ajnr.A8245","DOIUrl":"10.3174/ajnr.A8245","url":null,"abstract":"<p><strong>Background and purpose: </strong>The efficacy of long-term chronic subthalamic nucleus deep brain stimulation (STN-DBS) in treating Parkinson disease (PD) exhibits substantial variability among individuals. The preoperative identification of suitable deep brain stimulation (DBS) candidates through predictive means becomes crucial. Our study aims to investigate the predictive value of characterizing individualized structural covariance networks for long-term efficacy of DBS, offering patients a precise and cost-effective preoperative screening tool.</p><p><strong>Materials and methods: </strong>We included 138 patients with PD and 40 healthy controls. We developed individualized structural covariance networks from T1-weighted images utilizing network template perturbation, and computed the networks' topological characteristics. Patients were categorized according to their long-term motor improvement following STN-DBS. Intergroup analyses were conducted on individual network edges and topological indices, alongside correlation analyses with long-term outcomes for the entire patient cohort. Finally, machine learning algorithms were employed for regression and classification to predict post-DBS motor improvement.</p><p><strong>Results: </strong>Among the patients with PD, 6 edges (left middle frontal and left caudate nucleus, right olfactory and right insula, left superior medial frontal gyrus and right insula, right middle frontal and left paracentral lobule, right middle frontal and cerebellum, left lobule VIIb of the cerebellum and the vermis of the cerebellum) exhibited significant results in intergroup comparisons and correlation analyses. Increased degree centrality and local efficiency of the cerebellum, parahippocampal gyrus, and postcentral gyrus were associated with DBS improvement. A regression model constructed from these 6 edges revealed a significant correlation between predicted and observed changes in the unified PD rating scale (<i>R</i> = 0.671, <i>P </i>< .001) and receiver operating characteristic analysis demonstrated an area under the curve of 0.802, effectively distinguishing between patients with good and moderate improvement post-DBS.</p><p><strong>Conclusions: </strong>Our findings reveal the link between individual structural covariance network fingerprints in patients with PD and long-term motor outcome following STN-DBS. Additionally, binary and continuous cerebellum-basal ganglia-frontal structural covariance network edges have emerged as potential predictive biomarkers for DBS motor outcome.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11383399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140112357","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":"Usefulness of Olfactory Bulb Measurement in 3D-FIESTA in Differentiating Parkinson Disease from Atypical Parkinsonism.","authors":"Satoru Ide, Yu Murakami, Koichiro Futatsuya, Kenta Anai, Yuta Yoshimatsu, Satoshi Fukumitsu, Jun Tsukamoto, Tomoyo Hashimoto, Hiroaki Adachi, Issei Ueda, Shingo Kakeda, Takatoshi Aoki","doi":"10.3174/ajnr.A8275","DOIUrl":"10.3174/ajnr.A8275","url":null,"abstract":"<p><strong>Background and purpose: </strong>Parkinson disease is a prevalent disease, with olfactory dysfunction recognized as an early nonmotor manifestation. It is sometimes difficult to differentiate Parkinson disease from atypical parkinsonism using conventional MR imaging and motor symptoms. It is also known that olfactory loss occurs to a lesser extent or is absent in atypical parkinsonism. To the best of our knowledge, no study has examined olfactory bulb changes to differentiate Parkinson disease from atypical parkinsonism, even in an early diagnosis, and its association with conventional MR imaging findings. Hence, we aimed to assess the utility of olfactory bulb measurements in differentiating Parkinson disease from atypical parkinsonism even in the early stage.</p><p><strong>Materials and methods: </strong>In this retrospective study, we enrolled 108 patients with Parkinson disease, 13 with corticobasal syndrome, 15 with multiple system atrophy, and 17 with progressive supranuclear palsy who developed parkinsonism. Thirty-nine age-matched healthy subjects served as controls. All subjects underwent conventional MR imaging and 3D FIESTA for olfactory bulb measurements using manual ROI quantification of the cross-sectional olfactory bulb area using the coronal plane. Bilateral olfactory bulb measurements were averaged. For group comparisons, we used the Welch <i>t</i> test, and we assessed diagnostic accuracy using receiver operating characteristic analysis.</p><p><strong>Results: </strong>Patients with Parkinson disease had a mean olfactory bulb area of 4.2 (SD, 1.0 mm²), significantly smaller than in age-matched healthy subjects (6.6 [SD, 1.7 mm²], <i>P </i>< .001), and those with corticobasal syndrome (5.4 [SD, 1.2 mm²], <i>P </i>< .001), multiple system atrophy (6.5 [SD, 1.2 mm²], <i>P </i>< .001), and progressive supranuclear palsy (5.4 [SD, 1.2 mm²], <i>P </i>< .001). The receiver operating characteristic analysis for the olfactory bulb area measurements showed good diagnostic performance in differentiating Parkinson disease from atypical parkinsonism, with an area under the curve of 0.87, an optimal cutoff value of 5.1 mm², and a false-positive rate of 18%. When we compared within 2 years of symptom onset, the olfactory bulb in Parkinson disease (4.2 [SD, 1.1 mm²]) remained significantly smaller than in atypical parkinsonism (versus corticobasal syndrome (6.1 [SD, 0.7 mm²]), <i>P </i>< .001; multiple system atrophy (6.3 [SD, 1.4 mm²]), <i>P </i>< .001; and progressive supranuclear palsy (5.2 [1.3 mm²], <i>P </i>= .003, respectively).</p><p><strong>Conclusions: </strong>3D FIESTA-based olfactory bulb measurement holds promise for distinguishing Parkinson disease from atypical parkinsonism, especially in the early stage.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11383392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141319236","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":"Occult Amyloid-β-Related Angiitis: Neuroimaging Findings at 1.5T, 3T, and 7T MRI.","authors":"Can Özütemiz, Haitham M Hussein, Salman Ikramuddin, H Brent Clark, Andreas Charidimou, Christopher Streib","doi":"10.3174/ajnr.A8264","DOIUrl":"10.3174/ajnr.A8264","url":null,"abstract":"<p><p>Cerebral amyloid angiopathy (CAA) is a progressive neurodegenerative small vessel disease that is associated with intracranial hemorrhage and cognitive impairment in the elderly. The clinical and radiographic presentations have many overlapping features with vascular cognitive impairment, hemorrhagic stroke, and Alzheimer disease (AD). Amyloid-β-related angiitis (ABRA) is a form of primary CNS vasculitis linked to CAA, with the development of spontaneous autoimmune inflammation against amyloid in the vessel wall with resultant vasculitis. The diagnosis of ABRA and CAA is important. ABRA is often fatal if untreated and requires prompt immunosuppression. Important medical therapies such as anticoagulation and antiamyloid agents for AD are contraindicated in CAA. Here, we present a biopsy-proved case of ABRA with underlying occult CAA. Initial 1.5T and 3T MR imaging did not suggest CAA per the Boston Criteria 2.0. ABRA was not included in the differential diagnosis due to the lack of any CAA-related findings on conventional MR imaging. However, a follow-up 7T MR imaging revealed extensive cortical/subcortical cerebral microbleeds, cortical superficial siderosis, and intragyral hemorrhage in extensive detail throughout the supratentorial brain regions, which radiologically supported the diagnosis of ABRA in the setting of CAA. This case suggests an increased utility of high-field MR imaging to detect occult hemorrhagic neuroimaging findings with the potential to both diagnose more patients with CAA and diagnose them earlier.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11383424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473319","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":"Deposition of Gadolinium in the Central and Peripheral Nervous Systems and Its Effects on Sensory, Cognitive, and Athletic Implications after Multiple Injections of Gadolinium-Based Contrast Agents in Rats.","authors":"Xiang Yao, Jingyi Hu, Guangsong Wang, Xiaoning Lin, Jin Sun, Guijiang Dong, Junlong Kang, Wei Feng, Bowen Xie, Yanlin Huang, Xinhua Tian, E Chen","doi":"10.3174/ajnr.A8295","DOIUrl":"10.3174/ajnr.A8295","url":null,"abstract":"<p><strong>Background and purpose: </strong>After repeat administration of gadolinium-based contrast agents (GBCAs), the association between gadolinium retention in the central and peripheral nervous systems and the main manifestations of myelopathy and progressive neurologic symptoms remains unclear. We investigated the effects of the repeat administration of GBCAs on gadolinium retention in the central and peripheral nervous systems and the sensory, cognitive, and athletic implications.</p><p><strong>Materials and methods: </strong>Forty-eight male Wistar rats (6 weeks of age) were randomly divided into 4 experimental groups (12 rats in each group): the gadodiamide group (linear and nonionic GBCAs), the gadopentetate dimeglumine group (linear and ionic GBCAs), the gadoterate meglumine group (macrocyclic and ionic GBCAs), and the control group (0.9% saline solution). The brains of the rats were scanned using 9.4T MRI. Sensory behavioral tests were performed to assess the effect of GBCAs on pain sensitivity function. Gadolinium deposition in the brain, spinal cord, and peripheral nerves was determined by inductively coupled plasma mass-spectrometry. Transmission electron microscopy was used to observe the microscopic distribution of gadolinium after deposition in the spinal cord. The histopathologic features in the spinal cord were analyzed by H&E staining, Nissl staining, glial fibrillary acidic protein staining, and neuron-specific enolase staining after administration of GBCAs.</p><p><strong>Results: </strong>All GBCAs resulted in gadolinium deposition in the central and peripheral nerve tissues, with the highest deposition in the sciatic nerve tissue (mean, 62.86 [SD, 12.56] nmol/g). Decreased muscle power, impairment of spatial cognitive function power, and pain hypersensitivity to thermal and mechanical stimuli were observed after exposure to gadodiamide. At the spinal cord, transmission electron microscopy found that the region of gadolinium depositions had a spheric structure similar to \"sea urchins\" and was mainly located near the vascular basement membrane.</p><p><strong>Conclusions: </strong>Multiple injections of GBCAs caused gadolinium deposition in the brain, spinal cord, and peripheral nerves, especially in the spinal cords of the gadodiamide group. Gadodiamide led to pain hypersensitivity and decreased muscle power and cognitive ability. For the patients who are hypersensitive to pain and need multiple MRI examinations, we recommend using macrocyclic GBCAs and the lowest dose possible.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11383410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592390","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}