J Neuroimaging [JOURNAL]
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200 papers
Continuous transcranial ultrasound in large vessel stroke: Image guidance for high-intensity focused sonothrombolysis.
Beaudoin AM, Pelletier J, Cayer C … +8 more , Sirois MP, Lemieux M, Masson P, Quaegebeur N, Battista MC, Lemaire-Paquette S, Lapointe-Garant MP, Moreau F
J Neuroimaging · 2024 · PMID 39462840 · Publisher ↗
BACKGROUND AND PURPOSE: Sonothrombolysis is a potential adjunctive therapy for large vessel occlusion (LVO) stroke. Bedside ultrasound image-guided high-intensity focused ultrasound (HIFU) therapy could deliver higher en...
BACKGROUND AND PURPOSE: Sonothrombolysis is a potential adjunctive therapy for large vessel occlusion (LVO) stroke. Bedside ultrasound image-guided high-intensity focused ultrasound (HIFU) therapy could deliver higher energy therapeutic ultrasound to the thrombus with higher precision than what was previously accomplished in human trials. The aim is to test the feasibility of diagnostic transcranial contrast-enhanced ultrasound (CEUS) to image the occlusion site and continuously maintain the guidance image on-target for a sufficient exposure time for HIFU to be effective during LVO stroke evaluation and treatment. METHODS: This prospective, single center, observational cohort study included adult patients, presenting within 6 hours of stroke symptom onset, with LVO identified on computed tomography angiography (CTA). A hand-held CEUS imaging study was initiated following CTA and lasted up to 30 minutes. The primary outcome is the proportion of patients where a guidance CEUS image of the occlusion was achieved. RESULTS: A CEUS image of the occluded artery was obtained in 32/35 of the included patients. The median total imaging time was 23 minutes (interquartile range 15-30). Patients undergoing thrombectomy had a lower total imaging time (17 vs. 29.5 minutes, p = .002). When imaging was successful, on-target image was maintained for only 58% (standard deviation 23.8%) of total imaging time. No complications related to CEUS were observed. CONCLUSIONS: This feasibility study explored the use of diagnostic transcranial CEUS for continuous imaging of occlusion sites in LVO strokes. Challenges in maintaining target image during HIFU were identified, highlighting the need for technical advances for clinical application.
A novel method to detect carotid artery in-stent restenosis.
Luo Y, Gu G, Li Y … +9 more , Zheng B, Ren F, Wang J, Chen C, Chen Z, Zhang Y, Zhao B, Yang J, Wang J
J Neuroimaging · 2024 · PMID 39462837 · Publisher ↗
BACKGROUND AND PURPOSE: Carotid artery stenosis is a major risk factor for ischemic stroke. Despite carotid artery stenting, in-stent restenosis (ISR) remains challenging. Pigs serve as an ideal ISR model. This study aim...
BACKGROUND AND PURPOSE: Carotid artery stenosis is a major risk factor for ischemic stroke. Despite carotid artery stenting, in-stent restenosis (ISR) remains challenging. Pigs serve as an ideal ISR model. This study aims to establish a novel porcine model of carotid ISR using open-loop and closed-loop stents and to assess ISR with optical coherence tomography (OCT) and histopathology, comparing incidence and vascular response between stent types. METHODS: Twelve adult male Bama miniature pigs underwent carotid stenting with either open-loop or closed-loop stents. The animals received antiplatelet therapy pre- and postimplantation. Postimplantation evaluations at 90 days included carotid digital subtraction angiography (DSA), OCT, histopathological examination, and electron microscopy. RESULTS: Both stent types showed ISR as detected by OCT and DSA. OCT revealed comparable neointimal proliferation within stent struts for both types, with no significant differences in stent, lumen, and neointimal dimensions. Histopathological analysis and electron microscopy provided insights into tissue responses and healing processes following stent implantation. No significant difference in ISR incidence was found between the stent types based on a χ test (p = .110). OCT and hematoxylin-eosin staining exhibit the highest consistency in evaluating neointimal area. CONCLUSIONS: The novel porcine ISR model demonstrated similar ISR outcomes for open-loop and closed-loop stents. OCT proved to be a highly consistent and valuable tool for evaluating stent and arterial conditions, comparable to histopathological findings. However, due to a small sample size, the validity of these preliminary findings requires further investigation to be confirmed.
Multicenter validation of automated detection of paramagnetic rim lesions on brain MRI in multiple sclerosis.
Chen L, Ren Z, Clark KA … +26 more , Lou C, Liu F, Cao Q, Manning AR, Martin ML, Luskin E, O'Donnell CM, Azevedo CJ, Calabresi PA, Freeman L, Henry RG, Longbrake EE, Oh J, Papinutto N, Bilello M, Song JW, Kaisey M, Sicotte NL, Reich DS, Solomon AJ, Ontaneda D, Sati P, Absinta M, Schindler MK, Shinohara RT, NAIMS Cooperative
J Neuroimaging · 2024 · PMID 39410780 · Full text
BACKGROUND AND PURPOSE: Paramagnetic rim lesions (PRLs) are an MRI biomarker of chronic inflammation in people with multiple sclerosis (MS). PRLs may aid in the diagnosis and prognosis of MS. However, manual identificati...
BACKGROUND AND PURPOSE: Paramagnetic rim lesions (PRLs) are an MRI biomarker of chronic inflammation in people with multiple sclerosis (MS). PRLs may aid in the diagnosis and prognosis of MS. However, manual identification of PRLs is time-consuming and prone to poor interrater reliability. To address these challenges, the Automated Paramagnetic Rim Lesion (APRL) algorithm was developed to automate PRL detection. The primary objective of this study is to evaluate the accuracy of APRL for detecting PRLs in a multicenter setting. METHODS: We applied APRL to a multicenter dataset, which included 3-Tesla MRI acquired in 92 participants (43 with MS, 14 with clinically isolated syndrome [CIS]/radiologically isolated syndrome [RIS], 35 without RIS/CIS/MS). Subsequently, we assessed APRL's performance by comparing its results with manual PRL assessments carried out by a team of trained raters. RESULTS: Among the 92 participants, expert raters identified 5637 white matter lesions and 148 PRLs. The automated segmentation method successfully captured 115 (78%) of the manually identified PRLs. Within these 115 identified lesions, APRL differentiated between manually identified PRLs and non-PRLs with an area under the curve (AUC) of .73 (95% confidence interval [CI]: [.68, .78]). At the subject level, the count of APRL-identified PRLs predicted MS diagnosis with an AUC of .69 (95% CI: [.57, .81]). CONCLUSION: Our study demonstrated APRL's capability to differentiate between PRLs and lesions without paramagnetic rims in a multicenter study. Automated identification of PRLs offers greater efficiency over manual identification and could facilitate large-scale assessments of PRLs in clinical trials.
Neuromuscular ultrasound for the differential diagnosis of radial tunnel syndrome and lateral epicondylitis.
Kerasnoudis A, Venouziou A, Vasiliadis AV
J Neuroimaging · 2024 · PMID 39397287 · Publisher ↗
BACKGROUND AND PURPOSE: Lateral elbow pain is quite common in everyday life. Lateral epicondylitis and radial tunnel syndrome are the most common causes of lateral elbow pain. The aim of this study was to evaluate the se...
BACKGROUND AND PURPOSE: Lateral elbow pain is quite common in everyday life. Lateral epicondylitis and radial tunnel syndrome are the most common causes of lateral elbow pain. The aim of this study was to evaluate the sensitivity and specificity of neuromuscular ultrasound examination in the diagnosis of lateral epicondylitis versus radial tunnel syndrome. METHODS: This was a prospective double-blinded pilot study of 68 elbows in 34 patients with lateral elbow pain. Patients underwent clinical examination and standardized neuromuscular ultrasound evaluation in the first 15 days after the initiation of symptoms. Statistical significance was set at p < .001. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. RESULTS: Sixty-eight radial nerves were examined in 34 healthy controls (16 males; mean age 48.1 ± 8.2 years). Pain with palpation over the radial tunnel was found in 25 of 48 elbows (52.1%) compared to the pain over the lateral epicondyle found in 10 of 48 elbows (20.8%). Τhe sensitivity of palpation in differentiating radial tunnel syndrome from lateral epicondylitis was 75.7%, while the specificity was 50% (PPV 71.4%, NPV 51.5%). The sensitivity of neuromuscular ultrasound in differentiating radial tunnel syndrome from lateral epicondylitis was 92.6%, while the specificity was 80% (PPV 92.6%, NPV 80.0%). In most of the patients (25/31), fibrous bands anterior to the radio-capitellar joint were responsible for the nerve entrapment. CONCLUSIONS: The present study highlights the importance of the neuromuscular ultrasound's diagnostic role in differentiating radial tunnel syndrome from lateral epicondylitis in the clinical scenario of lateral elbow pain.
Deep learning from head CT scans to predict elevated intracranial pressure.
Sato R, Akiyama Y, Mikami T … +7 more , Yamaoka A, Kamada C, Sakashita K, Takahashi Y, Kimura Y, Komatsu K, Mikuni N
J Neuroimaging · 2024 · PMID 39387348 · Publisher ↗
BACKGROUND AND PURPOSE: Elevated intracranial pressure (ICP) resulting from severe head injury or stroke poses a risk of secondary brain injury that requires neurosurgical intervention. However, currently available nonin...
BACKGROUND AND PURPOSE: Elevated intracranial pressure (ICP) resulting from severe head injury or stroke poses a risk of secondary brain injury that requires neurosurgical intervention. However, currently available noninvasive monitoring techniques for predicting ICP are not sufficiently advanced. We aimed to develop a minimally invasive ICP prediction model using simple CT images to prevent secondary brain injury caused by elevated ICP. METHODS: We used the following three methods to determine the presence or absence of elevated ICP using midbrain-level CT images: (1) a deep learning model created using the Python (PY) programming language; (2) a model based on cistern narrowing and scaling of brainstem deformities and presence of hydrocephalus, analyzed using the statistical tool Prediction One (PO); and (3) identification of ICP by senior residents (SRs). We compared the accuracy of the validation and test data using fivefold cross-validation and visualized or quantified the areas of interest in the models. RESULTS: The accuracy of the validation data for the PY, PO, and SR methods was 83.68% (83.42%-85.13%), 85.71% (73.81%-88.10%), and 66.67% (55.96%-72.62%), respectively. Significant differences in accuracy were observed between the PY and SR methods. Test data accuracy was 77.27% (70.45%-77.2%), 84.09% (75.00%-85.23%), and 61.36% (56.82%-68.18%), respectively. CONCLUSIONS: Overall, the outcomes suggest that these newly developed models may be valuable tools for the rapid and accurate detection of elevated ICP in clinical practice. These models can easily be applied to other sites, as a single CT image at the midbrain level can provide a highly accurate diagnosis.
Quantification of porcine lower thoracic spinal cord morphology with intact dura mater using high-resolution μCT.
Chin J, Settell ML, Brucker-Hahn MK … +11 more , Lust D, Zhang J, Upadhye AR, Knudsen B, Deshmukh A, Ludwig KA, Lavrov IA, Crofton AR, Lempka SF, Zhang M, Shoffstall AJ
J Neuroimaging · 2024 · PMID 39390716 · Full text
BACKGROUND AND PURPOSE: Spinal cord stimulation (SCS) is approved by the Food and Drug Administration for treating chronic intractable pain in the back, trunk, or limbs through stimulation of the dorsal column. Numerous...
BACKGROUND AND PURPOSE: Spinal cord stimulation (SCS) is approved by the Food and Drug Administration for treating chronic intractable pain in the back, trunk, or limbs through stimulation of the dorsal column. Numerous studies have used swine as an analog of the human spinal cord to better understand SCS and further improve its efficacy. We performed high-resolution imaging of the porcine spinal cord with intact dura mater using micro-computed tomography (μCT) to construct detailed 3-dimensional (3D) visualizations of the spinal cord and characterize the morphology of the dorsal and ventral rootlets. METHODS: We obtained spinal cords from Yorkshire/Landrace crossbred swine (N = 7), stained samples with osmium tetroxide, and performed μCT imaging of the T12-T15 levels at isotropic voxel resolutions ranging from 3.3 to 50 μm. We measured the anatomical morphology using the 3D volumes and compared our results to measurements previously collected from swine and human spinal cords via microdissection techniques in prior literature. RESULTS: While the porcine thoracic-lumbar spinal cord is a popular model for SCS, we highlight multiple notable differences compared to previously published T8-T12 human measurements including rootlet counts (porcine dorsal/ventral: 12.2 ± 2.6, 26.6 ± 3.4; human dorsal/ventral: 5.3 ± 1.3, 4.4 ± 2.4), rootlet angles (porcine ventral-rostral: 161 ± 1°, ventral-caudal: 155 ± 6°, dorsal-rostral: 148 ± 9°, dorsal-caudal: 142 ± 6°; human ventral-rostral: 170 ± 3°, ventral-caudal: 22 ± 10°, dorsal-rostral: 171 ± 3°, dorsal-caudal: 15 ± 7°), and the presence and count of dorsal rootlet bundles. CONCLUSIONS: Detailed measurements and highlighted differences between human and porcine spinal cords can inform variations in modeling and electrophysiological experiments between the two species. In contrast to other approaches for measuring the spinal cord and rootlet morphology, our method keeps the dura intact, reducing potential artifacts from dissection.
Slowly expanding lesions are associated with disease activity and gray matter loss in relapse-onset multiple sclerosis.
Yokote H, Miyazaki Y, Fujimori J … +6 more , Nishida Y, Toru S, Niino M, Nakashima I, Miura Y, Yokota T
J Neuroimaging · 2024 · PMID 39390692 · Publisher ↗
BACKGROUND AND PURPOSE: Slowly expanding lesions (SELs) have been proposed as novel MRI markers of chronic active lesions in multiple sclerosis (MS). However, the mechanism through which SELs affect brain volume loss in...
BACKGROUND AND PURPOSE: Slowly expanding lesions (SELs) have been proposed as novel MRI markers of chronic active lesions in multiple sclerosis (MS). However, the mechanism through which SELs affect brain volume loss in patients with MS remains unknown. Additionally, the prevalence and significance of SELs in Asian patients with MS remain unclear. This study aimed to investigate the association between SELs and no evidence of disease activity (NEDA)-3 status as well as brain volume loss in Japanese patients. METHODS: A total of 99 patients with relapse-onset MS were retrospectively evaluated. SELs were identified on brain MRI based on local deformation when consecutive scans were registered longitudinally. We developed a logistic regression model and generalized linear mixed models (GLMMs) to evaluate the association between the number of SELs and disease activity and changes in brain volume. RESULTS: During the observation period (2.0 ± 0.22 years), 35 patients developed at least one SEL. Multivariable logistic regression analysis showed that ≥2 SELs were associated with 0.2 times the risk of achieving a NEDA-3 status. GLMMs revealed that the number of SELs was negatively associated with volume changes in the cortex (p = .00169) and subcortical gray matter (p = .00964) after correction for multiple comparisons. CONCLUSION: SELs were identified in Japanese patients with MS during the 2-year observation period. The number of SELs is associated with disease activity and brain volume loss, suggesting that the number of SELs could be a biomarker of disease activity in MS.
A simplified approach to define cervical vertebral levels in spinal cord MRI studies.
Papinutto N, Perretti I, Mallott J … +7 more , Cheng S, Cooper T, Gomez R, Stern WA, Pichiecchio A, Caverzasi E, Henry RG
J Neuroimaging · 2024 · PMID 39370554 · Full text
BACKGROUND AND PURPOSE: Spinal cord (SC) cross-sectional areas (CSAs) assessed with MRI have proven to be extremely valuable imaging markers in several diseases. Among the challenges is the delineation of vertebral level...
BACKGROUND AND PURPOSE: Spinal cord (SC) cross-sectional areas (CSAs) assessed with MRI have proven to be extremely valuable imaging markers in several diseases. Among the challenges is the delineation of vertebral levels to determine level-dependent changes in cord atrophy. With this study, we aimed to (1) test the hypothesis that there is proportionality in the position of the first six intervertebral discs and the length of the upper portion of the SC and (2) show that a proportionality approach can simplify the CSA assessment across vertebrae offering good reliability. METHODS: Forty-six volunteers underwent standard T2-weighted and T1-weighted cervical SC MRI acquisitions. The distance between the obex and the intervertebral discs (from C2-C3 to T1-T2) was measured on the T2-weighted acquisitions of the entire cohort. In a test-retest experiment on 12 subjects, the % disc position values were used to define vertebral levels, and a comparison was performed with manual vertebrae assignment in terms of mean CSA and its coefficient of variation. RESULTS: The mean upper cord length for the cohort was 144.0 ± 13.1 mm. The discs' level % position in the upper cord was found to be fairly consistent, with standard deviations of 0.8%-1.7%. The mean vertebral CSA obtained with the proportionality method was substantially equivalent to the manual approach in terms of mean CSA values and test-retest reliability. CONCLUSIONS: With this study, we propose a proportionality method for the assignment of cervical SC vertebral levels that can simplify the processing of MRI datasets in the context of CSA measurements.
Intracerebral hemorrhage risk after adjunct intraarterial thrombolysis in thrombectomy-treated acute ischemic stroke.
Qureshi AI, Huang Y, Bhatti IA … +15 more , Gomez CR, Hanley DF, Ford DE, Hassan AE, Nguyen TN, Spiotta AM, Veznedaroglu E, Budzik RF, Gupta R, Nogueira RG, Krajina A, Bartolini B, English J, Baxter B, Liebeskind DS
J Neuroimaging · 2024 · PMID 39307964 · Publisher ↗
BACKGROUND AND PURPOSE: Intraarterial thrombolysis as an adjunct to mechanical thrombectomy is increasingly being considered to enhance reperfusion in acute ischemic stroke patients. Intraarterial thrombolysis may increa...
BACKGROUND AND PURPOSE: Intraarterial thrombolysis as an adjunct to mechanical thrombectomy is increasingly being considered to enhance reperfusion in acute ischemic stroke patients. Intraarterial thrombolysis may increase the risk of post-thrombectomy intracerebral hemorrhage (ICH) in certain patient subgroups. METHODS: We analyzed acute ischemic stroke patients treated with mechanical thrombectomy in a multicenter registry. The occurrence of any (asymptomatic and symptomatic) post-thrombectomy ICH was ascertained using standard definition requiring serial neurological examinations and computed tomographic scans acquired within 48 hours of the thrombectomy. We determined the risk of ICH in subgroups defined by clinical characteristics and the use of intravenous (IV) thrombolysis. RESULTS: A total of 146 (7.5%) patients received intraarterial thrombolysis among 1953 acute ischemic stroke patients who underwent mechanical thrombectomy. The proportion of patients who developed any ICH was 26 (17.8%) and 510 (28.2%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p = .006). The proportion of patients who developed symptomatic ICH was 4 (2.7%) and 30 (1.7%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p = .34). Among patients who received IV thrombolysis (n = 1042), the proportion of patients who developed any ICH was 9 (16.7%) and 294 (30.7%) among patients who were and were not treated with intraarterial thrombolysis, respectively (p = .028). The risk was not different in strata defined by age, gender, location of occlusion, preprocedure National Institutes of Health Stroke Scale score, time interval between symptom onset and thrombectomy, Alberta Stroke Program Early CT Score, systolic blood pressure, and serum glucose concentrations. CONCLUSIONS: In patients undergoing mechanical thrombectomy, the risk of any ICH and symptomatic ICH was not increased with intraarterial thrombolysis, including in those who had already received IV thrombolytics.
Human performance in predicting enhancement quality of gliomas using gadolinium-free MRI sequences.
Azizova A, Wamelink IJHG, Prysiazhniuk Y … +5 more , Cakmak M, Kaya E, Petr J, Barkhof F, Keil VC
J Neuroimaging · 2024 · PMID 39300683 · Publisher ↗
BACKGROUND AND PURPOSE: To develop and test a decision tree for predicting contrast enhancement quality and shape using precontrast magnetic resonance imaging (MRI) sequences in a large adult-type diffuse glioma cohort....
BACKGROUND AND PURPOSE: To develop and test a decision tree for predicting contrast enhancement quality and shape using precontrast magnetic resonance imaging (MRI) sequences in a large adult-type diffuse glioma cohort. METHODS: Preoperative MRI scans (development/optimization/test sets: n = 31/38/303, male = 17/22/189, mean age = 52/59/56.7 years, high-grade glioma = 22/33/249) were retrospectively evaluated, including pre- and postcontrast T1-weighted, T2-weighted, fluid-attenuated inversion recovery, and diffusion-weighted imaging sequences. Enhancement prediction decision tree (EPDT) was developed using development and optimization sets, incorporating four imaging features: necrosis, diffusion restriction, T2 inhomogeneity, and nonenhancing tumor margins. EPDT accuracy was assessed on a test set by three raters of variable experience. True enhancement features (gold standard) were evaluated using pre- and postcontrast T1-weighted images. Statistical analysis used confusion matrices, Cohen's/Fleiss' kappa, and Kendall's W. Significance threshold was p < .05. RESULTS: Raters 1, 2, and 3 achieved overall accuracies of .86 (95% confidence interval [CI]: .81-.90), .89 (95% CI: .85-.92), and .92 (95% CI: .89-.95), respectively, in predicting enhancement quality (marked, mild, or no enhancement). Regarding shape, defined as the thickness of enhancing margin (solid, rim, or no enhancement), accuracies were .84 (95% CI: .79-.88), .88 (95% CI: .84-.92), and .89 (95% CI: .85-.92). Intrarater intergroup agreement comparing predicted and true enhancement features consistently reached substantial levels (≥.68 [95% CI: .61-.75]). Interrater comparison showed at least moderate agreement (group: ≥.42 [95% CI: .36-.48], pairwise: ≥.61 [95% CI: .50-.72]). Among the imaging features in the EPDT, necrosis assessment displayed the highest intra- and interrater consistency (≥.80 [95% CI: .73-.88]). CONCLUSION: The proposed EPDT has high accuracy in predicting enhancement patterns of gliomas irrespective of rater experience.
Periaqueductal gray connectivity in spinal cord injury-induced neuropathic pain.
Shoraka O, Syed M, Mandloi S … +10 more , Thalheimer S, Kashani SN, Heller JE, Mohamed FB, Sharan AD, Talekar KS, Matias CM, Harrop JS, Krisa L, Alizadeh M
J Neuroimaging · 2024 · PMID 39252511 · Full text
BACKGROUND AND PURPOSE: Neuropathic pain (NP) is a debilitating condition following spinal cord injury (SCI). The role of periaqueductal gray (PAG) in NP development following SCI remains underexplored. Using resting-sta...
BACKGROUND AND PURPOSE: Neuropathic pain (NP) is a debilitating condition following spinal cord injury (SCI). The role of periaqueductal gray (PAG) in NP development following SCI remains underexplored. Using resting-state functional MRI (rsfMRI), our study aimed to demonstrate the alterations in functional connectivity (FC) of PAG in NP following SCI. METHODS: Ten SCI patients (SCI + NP, n = 7, and SCI - NP, n = 3), alongside 10 healthy controls (HCs), were enrolled. rsfMRI was conducted followed by seed-to-voxel analysis using PAG as the seed region and then group-based analysis comprising three groups (SCI + NP, SCI - NP, and HC). Age and gender were considered as confounding variables. RESULTS: Compared to HCs, SCI + NP demonstrated decreased FC between PAG and right insula, right frontal orbital cortex, right pallidum, dorsal raphe nucleus (DRN), red nuclei (RN), substantia nigra (SN), and ventral posterolateral (VPL) thalamic nuclei. Compared to SCI - NP, SCI + NP demonstrated increased FC between PAG and posterior cingulate cortex (PCC), hippocampus, cerebellar vermis lobules IV and V, and thalamic structures (posterior and lateral pulvinar, the mediodorsal nuclei, and the ventral lateral nuclei). Additionally, decreased FC between the PAG and VPL, geniculate bodies, intralaminar nuclei of thalamus, DRN, RN, SN, and prefrontal cortex was observed in this comparison. CONCLUSIONS: Altered FC between PAG and right anterior insula, VPL, DRN, RN, SN, cerebellar vermis lobules IV and V, frontal cortex, and PCC was associated with NP sequelae of SCI. Additionally, SCI was independently associated with decreased FC between PAG and right posterior insula, cerebellar lobules IV and V, and cerebellar vermis lobules III, IV, and V.
Alterations in functional brain connectivity associated with developmental dyscalculia.
Mateu-Estivill R, Adan A, Grau S … +4 more , Rifà-Ros X, Caldú X, Bargalló N, Serra-Grabulosa JM
J Neuroimaging · 2024 · PMID 39238165 · Publisher ↗
BACKGROUND AND PURPOSE: In recent years, there has been a growing interest in the study of resting neural networks in different neurological and mental disorders. While previous studies suggest that the default mode netw...
BACKGROUND AND PURPOSE: In recent years, there has been a growing interest in the study of resting neural networks in different neurological and mental disorders. While previous studies suggest that the default mode network (DMN) may be altered in dyscalculia, the study of resting-state networks in the development of numerical skills, especially in children with developmental dyscalculia (DD), is scarce and relatively recent. Based on this, this study examines differences in resting-state functional connectivity (rs-FC) data of children with DD using functional connectivity multivariate pattern analysis (fc-MVPA), a data-driven methodology that summarizes properties of the entire connectome. METHODS: We performed fc-MVPA on resting-state images of a sample composed of a group of children with DD (n = 19, 8.06 ± 0.87 years) and an age- and sex-matched control group of typically developing children (n = 23, 7.76 ± 0.46 years). RESULTS: Analysis of fc-MVPA showed significant differences between group connectivity profiles in two clusters allocated in both the right and left medial temporal gyrus. Post hoc effect size results revealed a decreased rs-FC between each temporal pole and the DMN in children with DD and an increased rs-FC between each temporal pole and the sensorimotor network. CONCLUSIONS: Our results suggest an aberrant information flow between resting-state networks in children with DD, demonstrating the importance of these networks for arithmetic development.
Perfusion imaging predicts short-term clinical outcome in isolated posterior cerebral artery occlusion stroke.
Salim HA, Huang S, Lakhani DA … +22 more , Mei J, Balar A, Musmar B, Adeeb N, Hoseinyazdi M, Luna L, Deng F, Hyson NZ, Bahouth M, Dmytriw AA, Guenego A, Albers's GW, Lu H, Urrutia VC, Nael K, Marsh EB, Hillis AE, Llinas R, Wintermark M, Heit JJ, Faizy TD, Yedavalli V
J Neuroimaging · 2024 · PMID 39223766 · Publisher ↗
BACKGROUND AND PURPOSE: Ischemic strokes due to isolated posterior cerebral artery (PCA) occlusions represent 5% of all strokes but have significant impacts on patients' quality of life, primarily due to visual deficits...
BACKGROUND AND PURPOSE: Ischemic strokes due to isolated posterior cerebral artery (PCA) occlusions represent 5% of all strokes but have significant impacts on patients' quality of life, primarily due to visual deficits and thalamic involvement. Current guidelines for acute PCA occlusion management are sparse, and the prognostic value of perfusion imaging parameters remains underexplored. METHODS: We conducted a retrospective analysis of 32 patients with isolated PCA occlusions treated at Johns Hopkins Medical Institutions between January 2017 and March 2023. Patients underwent pretreatment perfusion imaging, with perfusion parameters analyzed using RAPID software. The primary outcome was short-term clinical outcome as measured by the National Institutes of Health Stroke Scale (NIHSS) at discharge. RESULTS: The median age of the cohort was 70 years, with 34% female and 66% male. Significant correlations were found between NIHSS at discharge and various perfusion parameters, including time-to-maximum (Tmax) >6 seconds (ρ = .55, p = .004), Tmax >8 seconds (ρ = .59, p = .002), Tmax >10 seconds (ρ = .6, p = .001), mismatch volume (ρ = .51, p = .008), and cerebral blood volume (CBV) < 34% (ρ = .59, p = .002). CONCLUSIONS: Tmax and CBV volumes significantly correlated with discharge NIHSS with marginal superiority of Tmax >10 seconds and CBV <42% volumes. These findings suggest that CT and MR perfusion imaging can play a crucial role in the acute management of PCA strokes, though larger, standardized studies are needed to validate these results and refine imaging thresholds specific to posterior circulation infarcts.
Prevalence, trends, and outcomes of cerebral infarction in patients with aneurysmal subarachnoid hemorrhage in the USA.
Qureshi AI, Bhatti IA, Gillani SA … +6 more , Beall J, Cassarly CN, Gajewski B, Martin RH, Suarez JI, Kwok CS
J Neuroimaging · 2024 · PMID 39223763 · Publisher ↗
BACKGROUND AND PURPOSE: Cerebral infarction remains an important cause of death or disability in patients with aneurysmal subarachnoid hemorrhage (SAH). The prevalence, trends, and outcomes of cerebral infarction in pati...
BACKGROUND AND PURPOSE: Cerebral infarction remains an important cause of death or disability in patients with aneurysmal subarachnoid hemorrhage (SAH). The prevalence, trends, and outcomes of cerebral infarction in patients with aneurysmal SAH at a national level are not known. METHODS: We identified the proportion of patients who develop cerebral infarction (ascertained using validated methodology) among patients with aneurysmal SAH and annual trends using the Nationwide Inpatient Sample (NIS) from 2016 to 2021. We analyzed the effect of cerebral infarction on in-hospital mortality, routine discharge without palliative care (based on discharge disposition), poor outcome defined by the NIS SAH outcome measure, and length and costs of hospitalization after adjusting for potential confounders. RESULTS: A total of 35,305 (53.6%) patients developed cerebral infarction among 65,840 patients with aneurysmal SAH over a 6-year period. There was a trend toward an increase in the proportion of patients who developed cerebral infarction from 51.5% in 2016 to 56.1% in 2021 (p trend p<.001). Routine discharge was significantly lower (30.5% vs. 37.8%, odds ratio [OR] 0.82, 95% confidence interval [CI] 0.75-0.89, p<.001), and poor outcome defined by NIS-SAH outcome measure was significantly higher among patients with cerebral infarction compared with those without cerebral infarction (67.4% vs. 59.3%, OR 1.29, 95% CI 1.18-1.40, p<.001). There was no difference in in-hospital mortality (13.0% vs. 13.6%, OR 0.94, 95% CI 0.85-1.05, p = .30). The length of stay (median 18 days [interquartile range [IQR] 13-25] vs. 14 days [IQR 9-20]), coefficient 3.04, 95% CI 2.44-3.52 and hospitalization cost (median $96,823 vs. $71,311, coefficient 22,320, 95% CI 20,053-24,587) were significantly higher among patients who developed cerebral infarction compared with those who did not develop cerebral infarction. CONCLUSIONS: Cerebral infarction was seen in 54% of the patients with a trend toward an increase in the affected proportion of patients with aneurysmal SAH. Patients with cerebral infarction had higher rates of adverse outcomes and required higher resources during hospitalization.
Reliability of quantitative magnetic susceptibility imaging metrics for cerebral cortex and major subcortical structures.
Pirozzi MA, Canna A, Nardo FD … +4 more , Sansone M, Trojsi F, Cirillo M, Esposito F
J Neuroimaging · 2024 · PMID 39210534 · Publisher ↗
BACKGROUND AND PURPOSE: Susceptibility estimates derived from quantitative susceptibility mapping (QSM) images for the cerebral cortex and major subcortical structures are variably reported in brain magnetic resonance im...
BACKGROUND AND PURPOSE: Susceptibility estimates derived from quantitative susceptibility mapping (QSM) images for the cerebral cortex and major subcortical structures are variably reported in brain magnetic resonance imaging (MRI) studies, as average of all ( ), absolute ( ), or positive- ( ) and negative-only ( ) susceptibility values using a region of interest (ROI) approach. This pilot study presents a reliability analysis of currently used ROI-QSM metrics and an alternative ROI-based approach to obtain voxel-weighted ROI-QSM metrics ( and ). METHODS: Ten healthy subjects underwent repeated (test-retest) 3-dimensional multi-echo gradient-echo (3DMEGE) 3 Tesla MRI measurements. Complex-valued 3DMEGE images were acquired and reconstructed with slice thicknesses of 1 and 2 mm (3DMEGE1, 3DMEGE2) along with 3DT1-weighted isometric (voxel 1 mm) images for independent registration and ROI segmentation. Agreement, consistency, and reproducibility of ROI-QSM metrics were assessed through Bland-Altman analysis, intraclass correlation coefficient, and interscan and intersubject coefficient of variation (CoV). RESULTS: All ROI-QSM metrics exhibited good to excellent consistency and test-retest agreement with no proportional bias. Interscan CoV was higher for in comparison to the other metrics where it was below 15%, in both 3DMEGE1 and 3DMEGE2 datasets. Intersubject CoV for and exceeded 50% in all ROIs. CONCLUSIONS: Among the evaluated ROI-QSM metrics, and estimates were less reliable, whereas separating positive and negative values (using ) improved the reproducibility within, and the comparability between, subjects, even when reducing the slice thickness. These preliminary findings may offer valuable insights toward standardizing ROI-QSM metrics across different patient cohorts and imaging settings in future clinical MRI studies.
Dynamic degree centrality in stroke-induced Broca's aphasia varies based on first language: A functional MRI study.
Linazi G, Li S, Qu M … +1 more , Xi Y
J Neuroimaging · 2024 · PMID 39175169 · Publisher ↗
BACKGROUND AND PURPOSE: This study sought to explore dynamic degree centrality (DC) variability in particular regions of the brain in patients with poststroke Broca aphasia (BA) using a resting-state functional magnetic...
BACKGROUND AND PURPOSE: This study sought to explore dynamic degree centrality (DC) variability in particular regions of the brain in patients with poststroke Broca aphasia (BA) using a resting-state functional magnetic resonance imaging (rs-fMRI) approach, comparing differences between Uyghur and Chinese BA patients. METHODS: This study investigated two factors, language and BA status, and divided patients into four groups: Uyghur aphasia patients (UA), Uyghur normal control subjects (UN), Chinese aphasia patients (CA), and Chinese normal subjects (CN) who underwent rs-fMRI analysis. Two-way analysis of variance (ANOVA) was used to calculate the comprehensive differences in dynamic DC among these four groups. Correlations between DC and language behavior were assessed with partial correlation analyses. RESULTS: Two-way ANOVA revealed comparable results for the results of pairwise comparisons of dynamic DC variability among the four groups in the right middle frontal gyrus/orbital part (ORBmid.R), right superior frontal gyrus/dorsolateral, and right precuneus (PCUN.R), with results as follows: UA < UN, CA > CN, UA < CA, and UN > CN (p < .05, with the exception of the p-values for UA and UN in superior frontal gyrus/dorsolateral). In contrast, the opposite results were observed for the right calcarine fissure and surrounding cortex (CAL.R, p < .05). CONCLUSION: The observed enhancement of dynamic DC variability in ORBmid.R and PCUN.R among Chinese BA patients and in CAL.R in Uyghur BA patients may be attributable to language network restructuring. Overall, these results suggest that BA patients who use different language families may exhibit differences in the network mechanisms that characterize observed impairments of language function.
Serum glial fibrillary acidic protein as a marker of brain MRI metrics in multiple sclerosis: A scoping review.
Marini N, Lesack N, Alizadeh S … +4 more , Kani A, Kitchin V, Vavasour IM, Laule C
J Neuroimaging · 2024 · PMID 39175168 · Publisher ↗
BACKGROUND AND PURPOSE: Magnetic resonance imaging (MRI) is heavily relied upon for the diagnosis and monitoring of multiple sclerosis (MS), a chronic, demyelinating disease of the central nervous system. Serum biomarker...
BACKGROUND AND PURPOSE: Magnetic resonance imaging (MRI) is heavily relied upon for the diagnosis and monitoring of multiple sclerosis (MS), a chronic, demyelinating disease of the central nervous system. Serum biomarkers may serve as an accessible tool for increasing sensitivity, improving accessibility, corroborating symptoms, and providing additional data to guide clinical management. This scoping review investigates the current understanding of how the serum biomarker glial fibrillary acidic protein (sGFAP) relates to brain MRI metrics. METHODS: We adhered to the Joanna Briggs Institute methodology for scoping reviews and the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The databases Medline (Ovid), Embase (Ovid), CINAHL (Ebsco), and Web of Science (University of British Columbia institutional access) were searched on August 24, 2023 using a combination of medical subject headings and keyword terms for the topic of serum biomarkers in MS. RESULTS: A total of 9880 articles were retrieved in total of which 6271 unique titles and abstracts were screened. Twelve of the 259 resultant papers contained sGFAP data and proceeded to extraction. It was found that lesion MRI metrics generally had a positive relationship with sGFAP, while gray matter and white matter metrics, including normal-appearing white matter, were related negatively or not at all. CONCLUSIONS: These results highlight that while sGFAP may not be specific for MS, it may have utility for increasing sensitivity in postdiagnosis monitoring of MS progression.
Contrast-free visualization of distal trigeminal nerve segments using MR neurography.
Sahu S, Hellwig D, Morrison Z … +2 more , Hughes J, Sadleir RJ
J Neuroimaging · 2024 · PMID 39175143 · Publisher ↗
BACKGROUND AND PURPOSE: The 3-dimensional cranial nerve imaging (CRANI) sequence may assist visualization of anatomical details of extraforaminal cranial nerves and aid in clinical diagnosis and preoperative planning. In...
BACKGROUND AND PURPOSE: The 3-dimensional cranial nerve imaging (CRANI) sequence may assist visualization of anatomical details of extraforaminal cranial nerves and aid in clinical diagnosis and preoperative planning. In this study, we investigated the feasibility of using a combined CRANI and magnetization-prepared rapid-acquisition gradient-echo (MPRAGE) imaging protocol to comprehensively identify trigeminal nerve projections. METHOD: We evaluated the detection of distal regions of three branches of the ophthalmic nerve (V1), three branches of the maxillary nerve (V2), and five branches of the mandibular nerve (V3) in seven healthy adult subjects, with and without contrast injection. Nerve branches were rated on a 5-point scale by three observers. Interobserver reliability was studied using weighted kappa statistics and percentage agreement. RESULTS: Among V1 and V2 branches, the frontal nerve and infraorbital nerve were most successfully identified (average rating of 3.9, agreement >80%) in precontrast MPRAGE images. In V3 branches, lingual and inferior alveolar nerves were most successfully identified (average rating of 3.9, agreement >80%) in precontrast CRANI images, with an excellent average rating. In all cases except one, interobserver reliability was rated good to excellent. The buccal nerve was the only branch with a low average interobserver rating. Gadolinium contrast did not improve nerve segment visualization in our study. This may relate to the specific anatomic regions assessed, gadolinium dose, postcontrast image timing, and lack of pathology. CONCLUSION: A combined CRANI and MPRAGE protocol can be combined to visualize distal branches of V1, V2, and V3 and has potential for clinical use.
Mapping stroke outcomes: A review of brain connectivity atlases.
Karnadipa T, Chong B, Shim V … +3 more , Fernandez J, Lin DJ, Wang A
J Neuroimaging · 2024 · PMID 39133035 · Publisher ↗
The brain connectivity-based atlas is a promising tool for understanding neural communication pathways in the brain, gaining relevance in predicting personalized outcomes for various brain pathologies. This critical revi...
The brain connectivity-based atlas is a promising tool for understanding neural communication pathways in the brain, gaining relevance in predicting personalized outcomes for various brain pathologies. This critical review examines the robustness of the brain connectivity-based atlas for predicting post-stroke outcomes. A comprehensive literature search was conducted from 2012 to May 2023 across PubMed, Scopus, EMBASE, EBSCOhost, and Medline databases. Twenty-one studies were screened, and through analysis of these studies, we identified 18 brain connectivity atlases employed by the studies for lesion analysis in their predictions. The brain atlases were assessed for study cohorts, connectivity measures, identified brain regions, atlas applications, and limitations. Based on the analysis of these studies, most atlases were based on diffusion tensor imaging and resting-state functional magnetic resonance imaging (MRI). Studies predicting post-stroke functional outcomes relied on the atlases for multivariate lesion analysis and region of interest identification, often employing atlases derived from young, healthy populations. Current brain connectivity-based atlases for stroke applications lack standardized methods to define and map brain connectivity across atlases and cover sensorimotor functional connectivity to a limited extent. In conclusion, this review highlights the need to develop more comprehensive, robust, and adaptable brain connectivity-based atlases specifically tailored to post-stroke populations.
Intracranial meningioma: A review of recent and emerging data on the utility of preoperative imaging for management.
Beutler BD, Lee J, Edminster S … +9 more , Rajagopalan P, Clifford TG, Maw J, Zada G, Mathew AJ, Hurth KM, Artrip D, Miller AT, Assadsangabi R
J Neuroimaging · 2024 · PMID 39113129 · Publisher ↗
Meningiomas are the most common neoplasms of the central nervous system, accounting for approximately 40% of all brain tumors. Surgical resection represents the mainstay of management for symptomatic lesions. Preoperativ...
Meningiomas are the most common neoplasms of the central nervous system, accounting for approximately 40% of all brain tumors. Surgical resection represents the mainstay of management for symptomatic lesions. Preoperative planning is largely informed by neuroimaging, which allows for evaluation of anatomy, degree of parenchymal invasion, and extent of peritumoral edema. Recent advances in imaging technology have expanded the purview of neuroradiologists, who play an increasingly important role in meningioma diagnosis and management. Tumor vascularity can now be determined using arterial spin labeling and dynamic susceptibility contrast-enhanced sequences, allowing the neurosurgeon or neurointerventionalist to assess patient candidacy for preoperative embolization. Meningioma consistency can be inferred based on signal intensity; emerging machine learning technologies may soon allow radiologists to predict consistency long before the patient enters the operating room. Perfusion imaging coupled with magnetic resonance spectroscopy can be used to distinguish meningiomas from malignant meningioma mimics. In this comprehensive review, we describe key features of meningiomas that can be established through neuroimaging, including size, location, vascularity, consistency, and, in some cases, histologic grade. We also summarize the role of advanced imaging techniques, including magnetic resonance perfusion and spectroscopy, for the preoperative evaluation of meningiomas. In addition, we describe the potential impact of emerging technologies, such as artificial intelligence and machine learning, on meningioma diagnosis and management. A strong foundation of knowledge in the latest meningioma imaging techniques will allow the neuroradiologist to help optimize preoperative planning and improve patient outcomes.
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