AJNR. American journal of neuroradiology最新文献

{"title":"Cognitive Control Network and Language Reorganization in Patients with Brain Tumors.","authors":"Luca Pasquini, Antonio Napolitano, Leonardo Spitoni, Maurizio Schmid, Francesco Dellepiane, Mehrnaz Jenabi, Kyung Peck, Andrei Holodny","doi":"10.3174/ajnr.A8638","DOIUrl":"10.3174/ajnr.A8638","url":null,"abstract":"<p><strong>Background and purpose: </strong>The interaction between language and other cognitive networks in patients harboring brain tumors is poorly understood. We studied the modification of the cognitive control network (CCN) induced by brain tumors and its participation in language reorganization. We hypothesized that patients with brain tumors and reorganized language would show a modification of the CCN compared with patients who remain left dominant.</p><p><strong>Materials and methods: </strong>Patients were selected with the criteria: newly diagnosed, pathologically-confirmed left-hemispheric tumor; single lesions; right-handedness; task-based and resting-state fMRI; no artifacts. Age-matched healthy controls (HC) were recruited from open-source databases. Language laterality was calculated by using task-based fMRI. We obtained the CCN through ad hoc independent component analysis on resting-state fMRI. Differences in CCN between patients and HC were characterized by cosine similarity (CS) and earth mover's distance (EMD). Changes related to language reorganization and patients' speech were assessed with the <i>t</i> test (<i>P</i> < .05). Results were corrected for multiple comparisons.</p><p><strong>Results: </strong>One hundred forty-two right-handed patients (35 low-grade and 88 high-grade gliomas; 19 metastases) and 184 HC were included. Two independent components of the CCN were obtained. The <i>t</i> test confirmed significant effects of lateralization on the CCN (<i>P</i> = .004). Modification of CCN was associated with fewer speech deficits 1 week after surgery (<i>P</i> = .005).</p><p><strong>Conclusions: </strong>This study provides evidence that modifications of CCN occur in the setting of language reorganization. Patients exhibiting these modifications perform better at speech evaluation after surgery, suggesting a role of cognitive control in compensating for speech deficits when language reorganizes.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1238-1248"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901073","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":"Contrast-Enhanced CISS/FIESTA Imaging for Increased Conspicuity of Pituitary Microadenomas in Cushing Disease.","authors":"Ian T Mark, Jamie Van Gompel, Maria Peris Celda, Eric Stinson, Irina Bancos, Lucinda Gruber, Jason Little, Derek R Johnson, Steven A Messina","doi":"10.3174/ajnr.A8596","DOIUrl":"10.3174/ajnr.A8596","url":null,"abstract":"<p><strong>Background and purpose: </strong>Pituitary microadenomas can be challenging to see on MRI, particularly when they are small. The detection of microadenomas commonly relies on contrast-enhanced sequences, highlighting the adenoma that demonstrates hypoenhancement relative to the native pituitary gland on T1-weighted sequences. Detecting adenomas in patients with Cushing disease is crucial because surgery is the standard of care treatment. Accurate preoperative lesion localization is directly associated with improved outcomes. The purpose of our study was to determine the utility of contrast-enhanced CISS/FIESTA with cycling (FIESTA-C) for identifying pituitary microadenomas in patients with Cushing disease.</p><p><strong>Materials and methods: </strong>This cross-sectional study retrospectively reviewed pituitary MR images in patients with Cushing disease who had postcontrast CISS/FIESTA-C. Images were evaluated for lesion conspicuity (well-defined margins), as well as the signal intensity (SI) of the adenoma and native pituitary gland. The normalized SI difference was calculated by subtracting the lesion SI from the pituitary SI and dividing by the pituitary SI. Patient age, sex, and diagnosis based on intraoperative findings, pathology results, and postoperative adrenal insufficiency were recorded.</p><p><strong>Results: </strong>Seventeen patients (15 women) were included in this study. Sixteen (94%) adenomas were discrete on CISS/FIESTA-C compared with 11 (65%) on T1-weighted imaging. The mean adenoma normalized SI difference with CISS/FIESTA-C was 0.512 (SD, 0.12), relative to 0.242 (SD, 0.15) on T1-weighted imaging (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>In comparison with MR T1-weighted images, contrast-enhanced CISS/FIESTA-C imaging detects a higher number of pituitary microadenomas with superior conspicuity. Because up to 50% of patients with Cushing disease present without a pituitary lesion detected on MRI, postcontrast CISS/FIESTA-C may be especially valuable as an additional sequence in this population.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1255-1259"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689925","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":"7T MRI as a Powerful Tool to Detect Small- and Medium-Size Vessel CNS Vasculitis.","authors":"Angelika Hoffmann, William Almiri, Pasquale Mordasini, Alexandrine Bähler, David J Seiffge, Martina B Göldlin, Eugen Jäger, Ioan-Paul Muresan, Lisa Christ, Mirjam R Heldner, Roland Wiest, Piotr Radojewski","doi":"10.3174/ajnr.A8627","DOIUrl":"10.3174/ajnr.A8627","url":null,"abstract":"<p><p>Imaging can help to diagnose CNS vasculitis. Yet so far, no imaging studies of CNS vasculitis at 7T are available. We share our experience of vessel wall imaging (VWI) at 7T in patients with suspected vasculitis. All included patients (<i>n</i>=45) underwent a clinically approved 7T MRI comprising high-resolution arterial TOF angiography as well as high-resolution VWI with T1 sampling perfection with application-optimized contrast using different flip angle evolution (SPACE) and T1 SE acquired pre- and postcontrast. Twenty-three patients showed negative and 22 patients showed positive VWI at 7T. Ten of 22 7T VWI-positive cases were suggestive of vasculitis with 9 patients showing VWI of large- and medium-size vessels and 1 patient VWI of small vessels. Small-vessel vasculitis was only depicted with 7T VWI, but not 3T VWI. Our work demonstrates that diagnosing CNS vasculitis, especially small-vessel vasculitis, is feasible at 7T and highlights the potential of high-field VWI encouraging further studies in this field.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1283-1286"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856947","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":"Normal Facial Nerve Enhancement on Volumetric Interpolated Breath-Hold Examination MRI Sequence.","authors":"Nanjiba Nawaz, Amit B Desai, Alok A Bhatt","doi":"10.3174/ajnr.A8592","DOIUrl":"10.3174/ajnr.A8592","url":null,"abstract":"<p><strong>Background and purpose: </strong>Enhancement of the facial nerve can be seen on MRI due to its rich arteriovenous plexus. Classically, enhancement of the facial nerve beyond the geniculate ganglion has been described as a normal finding, while enhancement of the canalicular and labyrinthine segments is considered abnormal. We hypothesize facial nerve enhancement of the canalicular and labyrinthine segments is a normal finding on the postcontrast T1-weighted, fat-saturated volumetric interpolated breath-hold examination (VIBE) sequence on both 1.5T and 3T MRI scanners.</p><p><strong>Materials and methods: </strong>Fifty patients without facial nerve symptoms undergoing MRI by using the internal auditory canal protocol were identified at our institution, 25 cases on a 1.5T scanner and 25 cases on a 3T scanner; a total of 100 facial nerves. Presence or absence of enhancement of the facial nerve segments on the postcontrast T1-weighted, fat-saturated VIBE sequence were independently analyzed by 2 neuroradiologists.</p><p><strong>Results: </strong>On 1.5T, of 50 facial nerves evaluated, percentage of nerves with enhancement at each segment was as follows: 80% canalicular, 92% labyrinthine, 100% tympanic, 100% mastoid, and 80% intraparotid. On 3T, of 50 facial nerves evaluated, percentage of nerves with enhancement at each segment was as follows: 60% canalicular, 84% labyrinthine, 98% tympanic, 100% mastoid, and 93% intraparotid.</p><p><strong>Conclusions: </strong>Enhancement of the canalicular and labyrinthine segments of the facial nerve is a normal finding on the postcontrast, T1-weighted, fat-saturated VIBE sequence. Careful attention to clinical history and asymmetry should be considered before calling abnormality of the facial nerve.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1268-1271"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694078","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":"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":"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 biologic 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>Eleven- to 15-week-old C57BL/6J male mice were randomly assigned to receive psilocybin, 6-fluoro-N, N-diethyltryptamine, or saline and ex vivo imaged 24 hours (<i>n</i>=18) and 72 hours (<i>n</i>=18) posttreatment. A 1-way ANOVA with multiple comparison testing (Bonferroni correction) assessed diffusion metric differences (tractography, DTI, neurite orientation dispersion and density imaging) between the 3 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 24 hours and 72 hours postdrug administration.</p><p><strong>Results: </strong>Psilocybin-treated mice demonstrated structural connectivity differences at 72 hours in the frontal association cortex (compared with saline, mean tract length increases, <i>P</i> = .03). Psilocybin also induced microstructural differences at 24 hours postinjection in the primary visual cortex (compared with saline, mean diffusivity [MD] increases, <i>P</i> = .02) and 72 hours postinjection in the striatum (compared with saline; MD increases, <i>P</i> = .02, neurite density index [NDI] decreases, <i>P</i> = .02) and hippocampus (compared with saline; MD increases, <i>P</i> = .04, NDI decreases, <i>P</i> = .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 end points in an emerging therapeutic option for patients with MDD.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1216-1222"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069676","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":"Gender Differences in Medicare Practice and Payment of Neuroradiologists.","authors":"Ajay Malhotra, Chris Lee, Mihir Khunte, Dheeman Futela, Raj Moily, Seyedmehdi Payabvash, Dheeraj Gandhi, Max Wintermark","doi":"10.3174/ajnr.A8633","DOIUrl":"10.3174/ajnr.A8633","url":null,"abstract":"<p><strong>Background and purpose: </strong>Female neuroradiologists in clinical practice are outnumbered by their male counterparts. However, it is unknown whether there are differences in practice patterns and Medicare billing and payment between female and male neuroradiologists. Our aim was to compare representation, practice range, clinical productivity, and Medicare payments for female and male neuroradiologists.</p><p><strong>Materials and methods: </strong>A retrospective cross-sectional study of Medicare provider and service data was conducted. Male and female neuroradiologists who received Medicare payments from 2017 to 2021 and the services rendered were analyzed. Primary outcome was gender representation, mean payments received from Medicare, charges submitted, and codes billed. <i>T</i> tests and Mann-Whitney <i>U</i> tests were used to determine differences in payment and practice volume between male and female radiologists.</p><p><strong>Results: </strong>From 2017 to 2021, there were a total of 2701 neuroradiologists, of whom 526 (19.5%) were female, with a higher proportion of women in academic than nonacademic neuroradiology practice (23.3% versus 15.6%, respectively). On average, female neuroradiologists charged less (mean, standard error [SE], $642,489 [$14,756] versus $738,416 [$7800]; <i>P</i> < .001) and were paid less by Medicare (mean [SE], $92,834 [$1877] versus $113,495 [$1044]; <i>P</i> < .001) compared with their male counterparts. By contrast, female neuroradiologists had a higher payment-per-service ratio (mean [SE], 0.232 [0.001] versus 0.208 [0.0003]; <i>P</i> < .001). Women billed fewer median total services (1802; interquartile range [IQR], 925-4726] versus 2461 [IQR, 1268-5781]; <i>P</i> < .001), served fewer median beneficiaries (1232 [IQR, 705-1963] versus 1697 [IQR, 990-2682]; <i>P</i> < .001), and billed fewer median unique codes (19 [IQR, 13-26] versus 23 [IQR, 17-33]; <i>P</i> < .001). Temporal analysis of data across the 5-year study period showed that men consistently received higher payments than women, though the difference in mean Medicare charge (<i>P</i> = .03), mean Medicare payment (<i>P</i> = .04), and median number of services provided (<i>P</i> = .04) between the 2 cohorts is decreasing.</p><p><strong>Conclusions: </strong>Female neuroradiologists were underrepresented, charged less, and received less overall payment compared with their male counterparts. Female neuroradiologists provided a smaller range and number of services, and a greater proportion of female neuroradiologists billed for higher-paying services. Further studies are needed to assess differences in part-time work and subspecialty representation to determine their impact.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":"46 6","pages":"1093-1099"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217831","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":"Role of Hypoperfusion Intensity Ratio in Vessel Occlusions: A Review on Safety and Clinical Outcomes.","authors":"Sana Rehman, Arsalan Nadeem, Arbab Burhan Uddin Kasi, Ali Husnain, Summaiyya Waseem, Sohail Kumar, Syed Muhammad Owais, Nasreen Banu, Dhairya A Lakhani, Hamza A Salim, Risheng Xu, Vaibhav S Vagal, Yasmin N Aziz, Argye E Hillis, Victor C Urrutia, Rafael H Llinas, Elisabeth B Marsh, Richard Leigh, Hanzhang Lu, Adam A Dmytriw, Adrien Guenego, Gregory W Albers, Jeremy J Heit, Tobias D Faizy, Vivek S Yedavalli","doi":"10.3174/ajnr.A8557","DOIUrl":"10.3174/ajnr.A8557","url":null,"abstract":"<p><p>The hypoperfusion intensity ratio (HIR) is a quantitative metric used in vascular occlusion imaging to evaluate the extent of brain tissue at risk due to hypoperfusion. Defined as the ratio of tissue volume with a time-to-maximum (Tmax) of >10 seconds to that of >6 seconds, HIR assists in differentiating between the salvageable penumbra and the irreversibly injured core infarct. This review explores the role of HIR in assessing clinical outcomes and guiding treatment strategies, including mechanical thrombectomy and thrombolytic therapy, for patients with large-vessel occlusions (LVOs). Evidence suggests that higher HIR values are associated with worse clinical outcomes, indicating more severe tissue damage and reduced potential for salvage through reperfusion. Additionally, HIR demonstrates predictive accuracy regarding infarct growth, collateral flow, and the risk of reperfusion hemorrhage. It has shown superiority over traditional metrics, such as core infarct volume, in predicting functional outcomes. HIR offers valuable insights for risk stratification and treatment planning in patients with LVOs and distal medium vessel occlusions. Incorporating HIR into clinical practice enhances patient care by improving decision-making processes, promoting timely interventions, and optimizing postintervention management to minimize complications and improve recovery outcomes.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1069-1081"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549479","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":"Delta Wave MRI: fMRI of Electrophysiologic Activity.","authors":"Jeffrey I Berman, Luke Bloy, Shana Ward, Timothy P L Roberts","doi":"10.3174/ajnr.A8618","DOIUrl":"10.3174/ajnr.A8618","url":null,"abstract":"<p><p>We propose a novel application of MR encephalography (MREG) to detect the frequency spectrum of endogenous slow oscillatory brain activity (delta, <4 Hz). MREG offers faster image acquisition than conventional fMRI and superior spatial localization than electroencephalography/magnetoencephalography. MREG was acquired at a 0.1-second temporal resolution in a healthy adult during interleaved wakefulness and sleep to demonstrate its capability for detecting delta-band power changes associated with sleep, previously demonstrated by electroencephalography. For each voxel, the brain activity of MREG signal was used to compute a spectrogram and a whole-brain image of delta-band spectral power. The delta-band power was observed to increase during sleep compared with the awake states using measures from MREG voxelwise spectrograms and sequential whole-brain spatial maps of slow-wave power. This work introduces an MR technique for measuring brain slow-wave activity that is sensitive to changes in the magnitude and frequency of brain activity in sleep.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1203-1207"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803689","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":"Comprehensive Analysis of Neurologic Complications following Transradial Cerebral Angiography.","authors":"Hoon Kim, Hyeong Jin Lee, Seon Woong Choi, Sunghan Kim, Seong-Rim Kim, Ik Seong Park","doi":"10.3174/ajnr.A8625","DOIUrl":"10.3174/ajnr.A8625","url":null,"abstract":"<p><strong>Background and purpose: </strong>Transradial access (TRA) for cerebral angiography has become more popular due to fewer complications and greater patient comfort compared with transfemoral access. However, the frequency and nature of neurologic complications linked to TRA remain unclear. This study aimed to determine the incidence of symptomatic neurologic complications after transradial cerebral angiography, identify risk factors, and characterize clinical and imaging features of these complications.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed 1679 consecutive cases of transradial cerebral angiography from a single institution between January 2018 and December 2020. Neurologic complications were defined as any symptomatic changes confirmed by DWI revealing ischemic lesions. A case-control matching method was used to enhance the reliability of the results. Clinical, procedural, and anatomic factors were examined for predictors of neurologic complications.</p><p><strong>Results: </strong>Neurologic complications occurred in 1.0% (<i>n</i> = 19) of cases, with 85% occurring within 6 hours postprocedure. No significant predictors of neurologic complications could be identified among the clinical, procedural, or anatomic factors assessed. Overall, 58% of patients experienced transient or reversible complications. Patients with permanent symptoms had mild to moderate disability (mRS scores of 1 or 2), with no severe disability (mRS score ≥3). DWI commonly showed multifocal cortical or subcortical ischemic patterns, typically affecting the right middle cerebral artery territory or multiple territories, suggesting embolic mechanisms as a potential cause.</p><p><strong>Conclusions: </strong>Neurologic complications following transradial cerebral angiography were rare but occurred early in the postprocedural period. The observed ischemic patterns, particularly the right-sided predominance, suggest embolic mechanisms as a potential cause. However, further large-scale, multicenter prospective studies are essential to identify risk factors more clearly and enhance patient safety in this increasingly utilized transradial approach.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1166-1172"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856910","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":"Diagnostic Confidence of Contrast-Enhanced T1-Weighted MRI for the Detection of Brain Metastases: 3D FSE versus 3D GRE-Based Sequences.","authors":"Maria Gule-Monroe, Nathan Chasen, James P Long, Vinodh A Kumar, Komal Shah, Melissa Chen, Jason Stafford, Caroline Chung, Max Wintermark, Ping Hou, Ekta Sura, Chenyang Wang, Jeffrey Weinberg, Ho-Ling Liu","doi":"10.3174/ajnr.A8590","DOIUrl":"10.3174/ajnr.A8590","url":null,"abstract":"<p><strong>Background and purpose: </strong>This retrospective study evaluated the utility of contrast-enhanced T1-weighted 3D fast spin-echo-based sampling perfection with application-optimized contrasts by using different flip angle evolutions (SPACE) sequences for brain metastasis detection on 3T MRI compared with a gradient-recalled echo-based 3D FLASH sequence.</p><p><strong>Materials and methods: </strong>We identified all patients at a single institution who underwent SPACE and 3D FLASH sequences as part of a practice quality-improvement project. Their medical records were retrospectively reviewed. Five certified neuroradiologists reviewed the images, with at least 2 weeks' separation between scoring sequences for the same patient. We evaluated the following parameters: number of metastatic lesions, number of indeterminate lesions, lesion margin, contrast-to-noise ratio (CNR), extent of image artifacts, and overall image quality. The CNR was also quantified for solidly enhancing lesions of >1 cm.</p><p><strong>Results: </strong>We identified 220 patients who underwent SPACE and 3D FLASH sequences (the order of the sequences was equally distributed). Of these, 79 had brain metastases on imaging, and 7 were excluded; thus, 72 patients were included in the study. Twenty patients were scored by 2 radiologists. Of the 92 evaluations, SPACE detected more lesions than 3D FLASH in 35, while 3D FLASH detected more lesions in 10. More indeterminate lesions were seen on 3D FLASH (<i>n</i> = 27) than on SPACE (<i>n</i> = 9). For the lesion margin, CNR, and overall image quality on a Likert scale, SPACE performed significantly better than 3D FLASH, with fewer image artifacts (<i>P</i> < .00001). Higher quantitative CNRs were found on SPACE than on 3D FLASH images, though this result was not statistically significant (median = 22.9 versus 15.5, respectively, <i>P</i> = .134). There was a high interreader lesion detection concordance with the Krippendorf α ordinals at 0.962 for SPACE, 0.870 for 3D FLASH, and 0.918 for the 2 sequences combined.</p><p><strong>Conclusions: </strong>Compared with 3D FLASH, the SPACE sequence detected more metastatic lesions and was rated higher for image quality, lesion margin, and CNR, with fewer artifacts. Importantly, the SPACE sequence resulted in increased reader confidence, with fewer indeterminate lesions detected.</p>","PeriodicalId":93863,"journal":{"name":"AJNR. American journal of neuroradiology","volume":" ","pages":"1231-1237"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12152807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689927","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}