Journal Of Neuroimaging[JOURNAL]
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200 papers
Intravenous Contrast-Enhanced MR Myelography in CSF Leakage for the Detection of Spinal CSF Lamellae.
Bendella Z, Haase R, Clauberg R … +5 more , Zülow S, Kindler C, Radbruch A, Paech D, Deike K
J Neuroimaging · 2025 · PMID 40432241 · Full text
BACKGROUND AND PURPOSE: Intracranial hypotension (IH) results from cerebrospinal fluid (CSF) leakage from the dural sac, occurring spontaneously or iatrogenically (e.g., post-lumbar puncture), and may cause a wide range...
BACKGROUND AND PURPOSE: Intracranial hypotension (IH) results from cerebrospinal fluid (CSF) leakage from the dural sac, occurring spontaneously or iatrogenically (e.g., post-lumbar puncture), and may cause a wide range of symptoms with significant functional impairment. Accurate detection of the epidural CSF lamella is key to diagnosis. This study evaluated the diagnostic value of intravenous contrast-enhanced MRI using heavily T2-weighted FLAIR (HT2-FLAIR) spine imaging compared to nonenhanced MR myelography at 3 Tesla. METHODS: Ten consecutive patients with IH symptoms were prospectively examined using HT2-FLAIR imaging of the spine before and up to 3 h after gadolinium-based contrast agent administration, alongside noncontrast MR myelography. Two readers assessed the conspicuity of the CSF lamella on contrast-enhanced HT2-FLAIR (ceHT2-FLAIR) using a score from -2 to +2 and evaluated additional diagnostic benefit. RESULTS: A CSF lamella was seen in eight of 10 patients as a strongly enhancing band on ceHT2-FLAIR. In one case, the lamella was visible exclusively on ceHT2-FLAIR (conspicuity score [CS] = 2, n = 1) and was more conspicuous in three cases (CS = 1, n = 3). Six cases showed equal conspicuity (CS = 0, n = 6). In two cases each, ceHT2-FLAIR either enabled diagnosis or provided supporting information. In six cases, it confirmed diagnosis based on noncontrast imaging. Beyond improved conspicuity, ceHT2-FLAIR helped detect low-flow leaks, optimize axial slice positioning, and assess CSF lamella distribution. CONCLUSIONS: Intravenous ceHT2-FLAIR MRI may be considered as an additional tool in CSF leak evaluation, particularly when used for detecting indirect signs of IH.
Aberrant Spontaneous Low-Frequency Brain Activity in Migraine: A Meta-Analysis of Resting-State fMRI Studies.
Chen Q, Liu Y, Yang X … +2 more , Li B, Liu L
J Neuroimaging · 2025 · PMID 40420335 · Full text
BACKGROUND AND PURPOSE: Resting-state functional MRI has revealed abnormal brain activity in patients with migraine, though findings have been inconsistent. This meta-analysis utilized Seed-based d Mapping to assess vari...
BACKGROUND AND PURPOSE: Resting-state functional MRI has revealed abnormal brain activity in patients with migraine, though findings have been inconsistent. This meta-analysis utilized Seed-based d Mapping to assess variations in amplitude of low-frequency fluctuations (ALFF) and fractional amplitude of low-frequency fluctuations (fALFF). The aim was to identify common brain regions with altered spontaneous brain activity in migraine patients. METHODS: A systematic search was conducted in PubMed, Web of Science, and Embase for studies published up to August 2023, comparing spontaneous low-frequency brain activity between migraine patients and healthy controls (HCs). Jackknife sensitivity, heterogeneity, publication bias, and meta-regression analyses were performed to ensure the robustness and reliability of our findings. RESULTS: Nine studies, including 708 migraine patients and HCs, were included in the analysis. Applying a highly conservative family-wise error rate correction, no significant findings were observed. However, when a less conservative threshold was used, migraine patients exhibited increased ALFF/fALFF in the left anterior thalamus and the corticospinal tract but showed decreased values in the right middle frontal gyrus. Jackknife sensitivity analysis confirmed the reproducibility of these results, while heterogeneity analysis revealed significant variability across studies, likely due to differences in study design and patient populations. CONCLUSIONS: This meta-analysis provides a comprehensive synthesis of neuroimaging evidence, linking migraine to abnormal spontaneous brain activity in regions associated with pain processing and nociceptive emotional modulation. These findings enhance our understanding of migraine pathophysiology and highlight potential targets for neuromodulation therapies, offering new directions for future research and clinical interventions.
Adjunctive Intra-Arterial Thrombolysis Following Endovascular Thrombectomy in Acute Ischemic Stroke: A Meta-Analysis.
Al-Salihi MM, Al-Jebur MS, Saha R … +3 more , Elazim AA, Siddiq F, Qureshi AI
J Neuroimaging · 2025 · PMID 40415217 · Publisher ↗
BACKGROUND AND PURPOSE: Despite significant advances in endovascular thrombectomy (EVT) for acute ischemic stroke (AIS), approximately 30%-40% of patients experience futile recanalization. This meta-analysis aimed to ass...
BACKGROUND AND PURPOSE: Despite significant advances in endovascular thrombectomy (EVT) for acute ischemic stroke (AIS), approximately 30%-40% of patients experience futile recanalization. This meta-analysis aimed to assess the effectiveness and safety of adjunctive intra-arterial thrombolysis (IAT) following EVT in individuals with AIS. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) that compared IAT after EVT with standard care. A literature search was conducted across multiple databases up to March 2025. The primary outcome was excellent functional outcome (modified Rankin Scale [mRS] 0-1) at 90 days, functional independence (mRS 0-2), and mortality rate. Risk ratios (RRs) for dichotomous outcomes and mean differences (MDs) for continuous variables were calculated with 95% confidence intervals. RESULTS: Six RCTs comprising 1971 patients were included. Adjunctive IAT significantly increased excellent functional outcomes at 90 days (RR = 1.24 [1.12-1.39], p < 0.0001), without significant improvement in functional independence (RR = 1.04 [0.96-1.13], p = 0.34). The IAT group exhibited significantly higher EuroQol 5 dimensions scores (MD = 0.08 [0.03-0.13], p = 0.001). Mortality rates were comparable (RR = 1.01 [0.84-1.23], p = 0.89). No significant differences were observed in any intracerebral hemorrhage (RR = 1.15 [1.00-1.33], p = 0.08), symptomatic intracerebral hemorrhage (RR = 1.13 [0.76-1.68], p = 0.53), or systemic bleeding complications. CONCLUSIONS: Adjunctive IAT following EVT significantly enhances excellent functional recovery and health-related quality of life after AIS, without significantly increasing hemorrhagic complications. These findings support the consideration of IAT as a complementary strategy following mechanical thrombectomy in AIS patients who present within 24 h of symptom onset.
Tapping and Task Switching Activation in Individuals With and Without Chronic Ankle Instability: fMRI Pilot Study.
Torp DM, Porter KH, Kosik KB … +3 more , Hoch MC, Song K, Johnson NF
J Neuroimaging · 2025 · PMID 40411262 · Publisher ↗
BACKGROUND AND PURPOSE: Chronic ankle instability (CAI) disrupts mechanoreceptors at the talocrural joint, which requires reliance on other forms of sensory information to maintain normal physical function. Understanding...
BACKGROUND AND PURPOSE: Chronic ankle instability (CAI) disrupts mechanoreceptors at the talocrural joint, which requires reliance on other forms of sensory information to maintain normal physical function. Understanding central nervous system activation patterns in individuals with CAI may lead to the development of interventions aimed at preventing long-term dysfunction. The primary objective of this study was to explore cortical activation patterns between individuals with CAI and uninjured controls during foot tapping and task switching. METHODS: Twenty-six adults (13 CAI) completed a functional MRI protocol. The foot tapping task required participants to tap a response button under their metatarsal heads by plantarflexing their foot in sync with a visual stimulus. The switching task required participants to make a decision about a single stimulus feature (e.g., color or shape) during single and mixed task blocks. Single blocks required attention to either the shape or color of the stimulus, while mixed blocks required participants to switch between features (color and shape). Participants responded to stimuli via a plantarflexion button press. Between and within group voxelwise analyses were then conducted to determine cortical activation patterns. RESULTS: The CAI group demonstrated greater activation in regions of visual processing and sensorimotor integration during foot tapping when compared to the uninjured controls. During task switching, the uninjured group demonstrated more activation in regions of cognitive flexibility, while CAI participants demonstrated more activation in an area of emotional processing. CONCLUSIONS: Individuals with CAI and uninjured controls demonstrate different activation patterns during foot tapping and task switching.
Transcranial Doppler Monitoring of the Wolf Procedure Versus Conventional Ablation to Treat Atrial Fibrillation.
Bardoczi A, Izygon J, Wolf R … +1 more , Garami Z
J Neuroimaging · 2025 · PMID 40405381 · Publisher ↗
BACKGROUND AND PURPOSE: Transfemoral radiofrequency ablation (tfRFA) is the most performed procedure to address atrial fibrillation (AF); however, tfRFA produces thousands of microemboli that can reach major cerebral art...
BACKGROUND AND PURPOSE: Transfemoral radiofrequency ablation (tfRFA) is the most performed procedure to address atrial fibrillation (AF); however, tfRFA produces thousands of microemboli that can reach major cerebral arteries and cause silent ischemic lesions. We measured the microembolization rate during an alternative procedure, the Wolf Procedure (formerly Mini-Maze), to address AF and compared our findings with the literature. METHODS: We used transcranial Doppler monitoring on 10 patients with AF (seven permanent, three paroxysmal) who underwent the Wolf Procedure at Houston Methodist Hospital. Intraoperative emboli, mean flow velocity, and pulsatility index in the middle cerebral artery were monitored and recorded. Standard of care follow-up visits were done at Houston Methodist Hospital. During these visits, the patients' loop recorder and current heart rhythm were analyzed. RESULTS: Overall, we saw an average of 4.7 high-intensity transient signals (HITS) in our 10 patients with a median of 3 HITS (interquartile range = 1-5.25), which is markedly less than the thousands of HITS typically reported in the literature for cases that use tfRFA. In two of the 10 Wolf Procedure cases, zero microembolus was detected. At their last follow-up appointments, nine out of 10 patients were in sinus rhythm. CONCLUSION: The Wolf Procedure is a safe surgical option for AF treatment with a high success rate even after one procedure. The number of emboli during The Wolf Procedure appears to be markedly lower than that during tfRFA, which reduces patient risk for transient ischemic attack, stroke, and silent ischemic brain lesions.
Single- and Multiphase CT Angiography Is Associated With Digital Subtraction Angiography Collateral Score ≥3.
Srinivas T, Lakhani DA, Balar AB … +15 more , Xu R, Moon J, Azzi C, Hyson N, Shahriari M, Wen S, Greene C, Mei J, Maroufi F, Heit JJ, Faizy TD, Albers GW, Salim H, Hoseinyazdi M, Yedavalli VS
J Neuroimaging · 2025 · PMID 40369704 · Publisher ↗
BACKGROUND AND PURPOSE: Collateral status is an important predictor of reperfusion and mortality in patients with large vessel anterior circulation acute ischemic stroke (AIS). We assess the utility of multiphase compute...
BACKGROUND AND PURPOSE: Collateral status is an important predictor of reperfusion and mortality in patients with large vessel anterior circulation acute ischemic stroke (AIS). We assess the utility of multiphase computed tomography angiography (CTA) derived from CT perfusion (CTP) source imaging (dCTA) in determining collateral status compared to the reference standard American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral score on digital subtraction angiography (DSA). METHODS: We retrospectively analyzed AIS patients treated at our institution from January 9, 2017, to January 10, 2023. Inclusion criteria included CTA-confirmed anterior circulation large vessel occlusion, diagnostic CTP, and mechanical thrombectomy with documented DSA collateral score. The modified treatment in cerebral ischemia score was used to assess reperfusion. Logistic regression analyses evaluated associations between demographic and clinical factors, collateral status, ASITN/SIR, and reperfusion status. RESULTS: A total of 311 patients (mean age 67.35 ± 16.37, 57.4% female) were included. Univariate analysis showed that proximal M2 (PM2) occlusion site (odds ratio [OR] 4.45, p < 0.001), Alberta Stroke Program Early CT Score (OR 1.24, p = 0.006), dCTA (OR 3.81, p < 0.001), and CTA Tan (OR 6.05, p < 0.001) were associated with an ASITN score of ≥3, indicating collateral flow. Multivariate regression, adjusted for race, occlusion site, radiologic features, National Institutes of Health stroke score, and premorbid modified Rankin score, found PM2 occlusion site (aOR 5.99, p < 0.001), dCTA (adjusted OR [aOR] 2.24, p = 0.04), and CTA Tan (aOR 3.71, p < 0.01) to be significant predictors of ASITN ≥3. CONCLUSIONS: dCTA is associated with favorable DSA collateral scores and may aid clinical decision-making in AIS patients with large vessel occlusions. Further studies can assess its role in outcome prediction.
T-Dark Rim as a Marker of New and Chronic Active Multiple Sclerosis Lesions: A Serial Study With Frequent 7T MRI.
Marshall M, Aphiwatthanasumet K, Mougin O … +6 more , Stadelmann C, Morgan PS, Dineen RA, Gowland P, Evangelou N, Clarke MA
J Neuroimaging · 2025 · PMID 40361267 · Full text
BACKGROUND AND PURPOSE: Chronic active multiple sclerosis (MS) lesions represent a particularly destructive subset of lesions on pathology. However, their imaging correlates, including paramagnetic rim lesions (PRLs) det...
BACKGROUND AND PURPOSE: Chronic active multiple sclerosis (MS) lesions represent a particularly destructive subset of lesions on pathology. However, their imaging correlates, including paramagnetic rim lesions (PRLs) detected on susceptibility-weighted imaging, lack sensitivity and are difficult to implement in clinical practice. This exploratory, longitudinal study investigates the prevalence and temporal dynamics of a novel imaging marker, T-dark rims, and their relationship with PRLs observed on quantitative susceptibility mapping (QSM). METHODS: Four untreated people with MS underwent 7-Tesla MRI scanning six times over a period of 36 weeks. New and pre-existing lesions were analyzed for the presence and temporal evolution of T-dark and QSM rims. Quantitative T values were derived using B maps, and the relationship between rim status and lesion size was evaluated. RESULTS: Of the 159 baseline lesions, 22 (14%) had T-dark rims, 11 (7%) had QSM rims, and five lesions had both. T-dark and QSM rims showed temporal changes, with T-dark rims preceding new QSM rim appearance in three out of four (75%) lesions. Eleven out of 20 (55%) newly formed lesions had T-dark rims, with a T-dark rim present in all new lesions over 100 mm. Small new lesions lacked discernible rims, but their overall T values aligned with those of larger lesion T-dark rims implying shared pathological processes. CONCLUSIONS: T-dark rims were more common than QSM rims, with greater prevalence in newly formed lesions. We propose they represent edema and inflammation associated with early stages of chronic active lesion formation visible despite, not because of, iron accumulation.
Safety/Efficacy of a Pusher, Thermal Detachment Coil for Ruptured Intracranial Aneurysms: A Multicenter Real-World Study.
Lorenzo A, Gil J, Gallego JI … +6 more , González-Cruz A, Aparici-Robles F, Boscà A, Sagredo A, Comas-Cufí M, Puig J
J Neuroimaging · 2025 · PMID 40346742 · Full text
BACKGROUND AND PURPOSE: Optima coils are a new type of embolic coils with complex and WAVE shape properties and variable degrees of softness. In patients with ruptured intracranial aneurysms, we examined the safety (peri...
BACKGROUND AND PURPOSE: Optima coils are a new type of embolic coils with complex and WAVE shape properties and variable degrees of softness. In patients with ruptured intracranial aneurysms, we examined the safety (periprocedural complications) and efficacy (occlusion rate immediately postprocedure) of the Optima coil. METHODS: We studied 103 consecutive patients with ruptured intracranial aneurysms who were treated exclusively with the Optima coil, without the use of accompanying implanted devices, at five centers in Spain. Endovascular techniques included stand-alone or balloon-assisted coiling. Postprocedural occlusion and periprocedural device-related adverse events were the endpoints. Aneurysm occlusion was graded according to the modified Raymond-Roy Occlusion scale. RESULTS: Of the 103 enrolled patients (70 female; median age 59 years), 59 (57.3%) presented with an IV Fischer Scale grade, and 61 (59.2%) of the ruptured aneurysms were wide-necked. Thirty-eight (36.9%) aneurysms were located in the anterior communicating artery. Simple-coiling and balloon-assisted coiling were performed in 36 (34.9%) and 65 (63.1%) patients, respectively. Raymond-Roy Class I, II, and III were reached in 64 (60.3%), 29 (28.1%), and ten (9.7%) following the procedure. The periprocedural device-related serious adverse event rate was 12 (13.5%), of which eight (7.7%) were due to coil protrusion. Four (3.8%) patients had intraprocedural aneurysm rupture. No early rebleeding or death was reported. CONCLUSION: This analysis suggests that the Optima coil is safe and effective for treating ruptured aneurysms, with satisfactory occlusion rates and low rates of periprocedural device-related serious adverse events.
Aspiration Catheter Design Impacts Combined Approach Mechanical Thrombectomy in Anterior Circulation Large Vessel Stroke.
Puig J, Remollo S, Rodríguez-Caamaño I … +28 more , Castaño C, Comas-Cufí M, Werner M, Dolz G, Blasco J, SanRoman L, Sanchis JM, Aparici-Robles F, González E, Fondevila J, Vega P, Murias E, Jiménez E, Oteros R, López-Frias A, Moreu M, Bashir S, Silva Y, Ripoll E, Martínez-Fernández J, Aguilar Y, Méndez J, Sánchez F, de Paco G, Flores A, Llibre JC, Brinjikji W, ROSSETTI Group
J Neuroimaging · 2025 · PMID 40317995 · Publisher ↗
BACKGROUND AND PURPOSE: Large-bore aspiration catheters (LBACs) are used for thrombectomy in large vessel occlusion (LVO), either as a standalone direct aspiration first-pass technique or combined with a stent retriever...
BACKGROUND AND PURPOSE: Large-bore aspiration catheters (LBACs) are used for thrombectomy in large vessel occlusion (LVO), either as a standalone direct aspiration first-pass technique or combined with a stent retriever (ASR). LBAC design may influence ASR thrombectomy efficacy. We compared the safety and performance of the novel MIVI Q segmental catheter with the well-established SOFIA aspiration device in ASR thrombectomy. METHODS: We analyzed data from the Registry cOmbined vS SinglE Thrombectomy TechnIques registry of consecutive patients with anterior circulation LVO and compared the outcomes of those treated with first-line ASR thrombectomy using Q (Q5 or Q6) or SOFIA (5F or 6F Plus) catheters. Demographic, clinical, angiographic, and clinical outcome data (24-h National Institute of Health Stroke Scale [NIHSS] and modified Rankin Scale score at 3 months) were compared. RESULTS: Of the 853 patients, 155 (18.2%) were treated with MIVI Q and 698 (81.8%) with SOFIA catheters. After adjusting for age, sex, NIHSS score at baseline, tPA use, site occlusion, anesthesia type, and diameter and length of SR, the MIVI Q group was comparable to the SOFIA group in terms of first-pass effect or successful final recanalization and safety. However, the MIVI Q group had a shorter mechanical thrombectomy time (20 [10-45] min vs. 33 [20-51] min; odds ratio [OR] = 7.4, 95% confidence interval [CI]: 1.1-14; p = 0.021) and a lower rate of symptomatic intracerebral hemorrhage (3.3% vs. 8.8%; OR = 3.59, 95% CI: 1.45-10.9; p = 0.011). CONCLUSIONS: In ASR neurothrombectomy, SOFIA aspiration catheters were not superior to MIVI Q in achieving successful and complete first-passage recanalization; however, MIVI Q had shorter procedural times and a lower rate of symptomatic intracranial hemorrhage.
Modified Treatment in Brain Ischemia 2b Stopped or Continued After First-Pass Mechanical Thrombectomy for M1 Occlusions.
García-García JI, Puig J, Chirife Ó … +28 more , Paipa A, Aixut S, Blasco J, Werner M, Comas-Cufí M, Vega P, Murias E, Aparici-Robles F, Morales-Caba L, González E, Labayen I, Romero V, Bravo I, Moreu M, López-Frías A, Remollo S, Rodríguez-Caamaño I, Terceño M, Álvarez-Cienfuegos J, Martínez-Fernández J, Aguilar Y, Méndez JC, Sánchez F, Zamarro J, Cuba V, Castaño M, López-Rueda A, ROSSETTI Group
J Neuroimaging · 2025 · PMID 40285417 · Publisher ↗
BACKGROUND AND PURPOSE: The superiority of achieving modified Treatment in Cerebral Ischemia (mTICI) from multiple passes versus mTICI 2b from a single pass remains uncertain. We aimed to assess whether additional passes...
BACKGROUND AND PURPOSE: The superiority of achieving modified Treatment in Cerebral Ischemia (mTICI) from multiple passes versus mTICI 2b from a single pass remains uncertain. We aimed to assess whether additional passes in M1 occlusion patients with a first-pass mTICI 2b score improved clinical and functional outcomes. METHODS: We analyzed Registry Combined vs. Single Thrombectomy Techniques registry data of consecutive M1-occlusion patients, comparing outcomes of those with mTICI 2b-stopped after the first pass versus continued mechanical thrombectomy (MT) to improve angiographic results (mTICI 2b or mTICI 2c/3). We compared demographic, clinical, angiographic, and clinical outcome data (National Institute of Health Stroke Scale [NIHSS] at 24 h and modified Rankin Scale at 3 months). RESULTS: Patients with first-pass mTICI 2b had lower NIHSS scores at admission, fewer left-side occlusions, and longer last-seen-well times. Endovascular techniques and time from groin puncture to revascularization were similar across groups. Patients with final mTICI 2c/3 had the highest distal embolism rates in a new territory (0% for mTICI2b-stopped vs. 3% for final mTICI2b-continued; 7.7% for final mTICI2c/3; p = 0.02). The groups had similar rates of death, symptomatic intracranial hemorrhage, same-area distal embolism, other MT-related complications, NIHSS at 24 h, NIHSS change from admission to 24 h, and same-territory distal embolism. CONCLUSION: Achieving mTICI 2b after the first pass in M1-occlusion patients proved relevant. These patients had comparable clinical and functional outcomes and a lower risk of new territory distal embolisms compared to those with final mTICI 2c/3 scores.
Clinical Outcomes and Complications of Carotid Artery Stenting With or Without Pre-Stent and Post-Stent Balloon Angioplasty.
Martucci M, Ezzeldin M, Adachi K … +27 more , Delora A, Ezzeldin R, Hassan AE, Siddiq F, Sheriff FG, Kan P, Janjua N, Asif KS, Grandhi R, Alaraj A, Niazi M, Mansour O, Bushnaq S, Tanweer O, Miller S, Bains NK, Colina G, AlMajali M, Edhayan G, Froukh M, Salah WK, Nico E, Ashraf S, Radaideh Y, Quispe-Orozco D, Zaidat O, Hussain MS
J Neuroimaging · 2025 · PMID 40263736 · Publisher ↗
BACKGROUND AND PURPOSE: Carotid artery stenting is a well-established method for treating carotid artery stenosis; however, there are conflicting data on prestenting versus post-stenting balloon angioplasty. Our study ai...
BACKGROUND AND PURPOSE: Carotid artery stenting is a well-established method for treating carotid artery stenosis; however, there are conflicting data on prestenting versus post-stenting balloon angioplasty. Our study aims to understand the risk and safety of pre-stent balloon angioplasty (Pre-SB) and post-stent balloon angioplasty (Post-SB), or both techniques. METHODS: Multicenter retrospective data on angioplasty balloons, stents, complications, and modified Rankin score (mRS) before and after the procedure were collected. Statistical analysis was performed to correlate with complication risks and clinical outcomes. RESULTS: 1,355 patients were enrolled. Post-SB predicted fewer complications (p = 0.035) than Pre-SB or combined Pre-SB and Post-SB. Female sex was a predictor of complications (p = 0.041), while utilization of an embolic protection device predicted fewer complications (p < 0.001). Increasing age (p < 0.001) and smoking (p = 0.027) predicted increased length of stay. Using open-cell stents versus closed-cell stents did not predict follow-up modified rankin score (mRS) or complications, but using open-cell stents did predict a shorter length of stay. Conversely, open-cell stents were more likely to undergo Post-SB (p < 0.001), while closed-cell stents were more likely to undergo Pre-SB (p = 0.002). CONCLUSIONS: Unlike previous literature, our results showed that Post-SB alone was associated with fewer complications compared to either Pre-SB alone or the combination of Pre-SB and Post-SB. Open-cell stents required a higher rate of Post-SB.
Phosphotungstic Acid Staining to Visualize the Vagus Nerve Perineurium Using Micro-CT.
Upadhye AR, Cintron E, Zhang J … +6 more , Coleman J, Kolluru C, Jenkins MW, Wilson D, Pelot NA, Shoffstall AJ
J Neuroimaging · 2025 · PMID 40207700 · Full text
BACKGROUND AND PURPOSE: Peripheral nerve stimulation is approved by the US Food and Drug Administration for treating various disorders, but it is often limited by side effects, highlighting the need for a clear understan...
BACKGROUND AND PURPOSE: Peripheral nerve stimulation is approved by the US Food and Drug Administration for treating various disorders, but it is often limited by side effects, highlighting the need for a clear understanding of fascicular and fiber organization to design selective therapies. Micro-CT imaging of contrast-stained nerves enables the visualization of tissue microstructures, such as the fascicular perineurium and vasculature. In this work, we evaluated phosphotungstic acid (PTA) as a contrast agent and assessed its compatibility with downstream histology. METHODS: Human vagus nerve samples were collected from three embalmed cadavers and subjected to three different staining methods, followed by micro-CT imaging: Lugol's iodine, osmium tetroxide, and PTA. Contrast ratios of adjacent tissue microstructures (perineurium, interfascicular epineurium, and fascicle) were quantified for each stain and compared. We further developed a pipeline to optimize micro-CT scan acquisition parameters based on objective metrics for sharpness, noise, and pixel saturation. The PTA-stained samples underwent subsequent histological processing and staining with hematoxylin and eosin, Masson's trichrome, and immunohistochemistry and were assessed for tissue degradation. RESULTS: PTA enhanced the visualization of perineurium, providing high contrast ratios compared to iodine and osmium tetroxide. Optimized scanning parameters for PTA-stained nerves (55 kV and 109 µA) effectively balanced noise and sharpness. While we found that PTA is generally nondestructive for downstream histology, higher concentrations and longer exposure could alter the optical density of nuclei and affect stain differentiation in special stains. CONCLUSION: PTA serves as a valuable micro-CT contrast agent for nerve imaging, effective in visualizing the perineurium with minimal impact on histological integrity.
Brain Volume Loss After Stereotactic Laser Interstitial Thermal Therapy in Patients With Temporal Lobe Epilepsy.
Müller SJ, Khadhraoui E, Kukhlenko O … +6 more , Schwarzer J, Voges J, Sandalcioglu IE, Behme D, Schmitt F, Büntjen L
J Neuroimaging · 2025 · PMID 40197718 · Full text
BACKGROUND AND PURPOSE: Temporal lobe epilepsy is the most common form of focal epilepsy. MR-guided laser interstitial thermal therapy (LITT) of the amygdalohippocampal complex has become an established therapy option in...
BACKGROUND AND PURPOSE: Temporal lobe epilepsy is the most common form of focal epilepsy. MR-guided laser interstitial thermal therapy (LITT) of the amygdalohippocampal complex has become an established therapy option in case of drug resistance. Long-term anatomic network effects on the brain due to deafferentiation have not yet been evaluated. METHODS: We analyzed brain volumes of 11 patients with temporal lobe epilepsy before and 1-year after hippocampal LITT with FastSurfer segmenting T1-weighted data. Additionally, we performed visual ratings and measurements. RESULTS: A total of 11 patients with temporal lobe epilepsy (7 left-sided, 4 right-sided) were included (5 females); the mean age years (±standard deviation) at surgery was 41.5 (±18.4) years. The mean postoperative defect size was 1427 (±517) mm. Volumetry as well as visual ratings found a progressive volume loss after left-sided surgery in the ipsilateral temporal lobe, the contralateral (right) part of the thalamus, and especially contralateral (right) fusiform cortex. These changes could not be detected for right-sided surgery. CONCLUSION: A (partial) ablation of the left (dominant) hippocampus appears to exert long-term effects on the right thalamus and right-sided temporal cortices. However, we could not observe this effect in the reverse direction. Volumetric studies for larger cohorts should be conducted to investigate these findings.
Parenchymal Hematoma After Endovascular Thrombectomy Is Associated With Pretreatment Basal Ganglia Infarct Volume.
Regenhardt RW, Krieger PP, Bonkhoff AK … +12 more , Schirmer MD, Favilla CG, Tutino VM, Das AS, Dmytriw AA, Gupta R, Rabinov JD, Stapleton CJ, Leslie-Mazwi TM, Patel AB, Lo EH, Rost NS
J Neuroimaging · 2025 · PMID 40150925 · Publisher ↗
BACKGROUND AND PURPOSE: Parenchymal hematomas (PHs) represent an important complication in ischemic stroke after endovascular thrombectomy (EVT), but the risk factors are incompletely understood. Neuroimaging data preint...
BACKGROUND AND PURPOSE: Parenchymal hematomas (PHs) represent an important complication in ischemic stroke after endovascular thrombectomy (EVT), but the risk factors are incompletely understood. Neuroimaging data preintervention, such as infarct topography, may help elucidate predisposing factors and inform more nuanced patient care intra- and postprocedurally. METHODS: Large vessel occlusion patients with pre-EVT MRI were included from a single quaternary center. Diffusion-weighted imaging (DWI) lesions underwent manual segmentation and registration onto a standard brain space for topographical mapping. The presence of PH postintervention was determined. Associations between infarct topography, clinical characteristics, and PH were evaluated. RESULTS: A total of 165 patients (median age: 69; 56% female) were identified. Intravenous alteplase was administered to 52%, 70% achieved thrombolysis in cerebral infarction 2b-3 reperfusion, and 8% had PH postintervention. The preintervention DWI lesions were 48% (38%-60%) white matter, 23% (6%-47%) cortex, and 15% (4%-28%) basal ganglia. Basal ganglia infarct volume was independently associated with PH (adjusted odds ratio = 1.342, 95% confidence interval 1.002-1.797, p = 0.049), accounting for white matter and cortex infarct volume, among other key factors. Basal ganglia infarct volume was associated with susceptibility-weighted imaging vessel sign (beta = 0.233, p = 0.006) and the National Institutes of Health Stroke Scale (beta = 0.220, p = 0.012), controlling for other factors. CONCLUSIONS: Preintervention basal ganglia infarct volume may provide important insights into the risk of PH after intervention. Improved understanding of the biology of basal ganglia infarction and hemorrhagic transformation has implications for the management of patients undergoing EVT and may represent a future therapeutic target for neuroprotective strategies.
Semiautomatic Quantification of Tc-TRODAT-1 SPECT Images in Patients With Idiopathic Parkinson's Disease.
Chan GKW, Chow TK, Ho RWH … +3 more , Leung WCY, Hui YH, Ho WY
J Neuroimaging · 2025 · PMID 40134114 · Publisher ↗
BACKGROUND AND PURPOSE: Tc-TRODAT-1 SPECT imaging is an imaging technique, more commonly used in Asia, to diagnose Parkinson's disease (PD). This study evaluates the use of automated three-dimensional volume-of-interest...
BACKGROUND AND PURPOSE: Tc-TRODAT-1 SPECT imaging is an imaging technique, more commonly used in Asia, to diagnose Parkinson's disease (PD). This study evaluates the use of automated three-dimensional volume-of-interest (VOI) analysis in diagnosing PD. METHODS: Tc-TRODAT-1 SPECT images of 76 patients (50 with PD and 26 without PD) were retrospectively analyzed. The specific binding ratio (SBR) was calculated using an automated program. Multiple linear regression and receiver operating characteristic curve analyses were performed to identify the factors that affect SBR value and determine the optimal cutoff values. RESULTS: Multiple regression analysis revealed disease status as the strongest predictor of SBR values, followed by age and sex. Receiver operating characteristic curve analysis demonstrated good diagnostic performance for the striatum (area under the curve [AUC] = 0.922), putamen (AUC = 0.922), and caudate (AUC = 0.881). Optimal cutoff values were determined for the striatum (0.515; sensitivity 88.5%, specificity 90.0%), putamen (0.445; sensitivity 92.3%, specificity 86.0%), and caudate (0.655; sensitivity 84.6%, specificity 90.0%). CONCLUSIONS: Semiautomatic quantitative analysis of Tc-TRODAT-1 SPECT using automated three-dimensional VOI shows excellent diagnostic performance in differentiating PD from non-Parkinson's cases. Age and sex significantly influence SBR values, suggesting the need for demographic-adjusted cutoff values in clinical practice.
Cladribine Is Associated With Stable Cortical Gray Matter Lesion Burden in Multiple Sclerosis: A 7T MRI Study.
Zurawski J, Tauhid S, Healy BC … +10 more , Chu R, Houtchens MK, Jalkh Y, Khalil S, Quattrucci M, Mateen FJ, Napoli S, Rizvi S, Singhal T, Bakshi R
J Neuroimaging · 2025 · PMID 40103263 · Publisher ↗
BACKGROUND AND PURPOSE: Cladribine, an FDA-approved disease-modifying immunotherapy for multiple sclerosis (MS), penetrates the CSF and mitigates T cells and B cells, and thus may impact the development of cortical gray...
BACKGROUND AND PURPOSE: Cladribine, an FDA-approved disease-modifying immunotherapy for multiple sclerosis (MS), penetrates the CSF and mitigates T cells and B cells, and thus may impact the development of cortical gray matter lesions (CLs) and leptomeningeal enhancement (LME). 7T MRI is a highly sensitive tool for monitoring these outcomes in relapsing-remitting (RR) MS. METHODS: MS subjects (n = 19, age [mean ± standard deviation]: 48.8 ± 10.0 years, 63.1% RRMS, 36.9% secondary progressive MS, Expanded Disability Status Scale [EDSS] score 4.1 ± 2.0) underwent 7T MRI with 0.7-mm voxels within a mean 1.9 months of oral cladribine initiation and ∼1 year later in this real-world study. CLs and LME were quantified by an expert. Wilcoxon signed rank tests and paired t-tests compared baseline to follow-up data. RESULTS: A total of 88.2% of subjects had CLs at baseline (mean 14.1 CLs/patient, range 1-77). No subjects accrued new CLs, and CL volume remained stable (0.33 ± 0.48 mL baseline vs. 0.31 ± 0.46 mL follow-up, p = 0.22). LME was found in 88.9% of subjects at baseline. LME foci number was stable in seven (41.2%), increased in five (29.4%), and decreased in five (29.4%) subjects at follow-up, but overall LME burden was stable (3.1 ± 1.8 vs. 3.2 ± 1.6 foci per subject, p = 1.0). No EDSS or timed 25-foot walk change was noted (both p > 0.35). No subjects had clinical relapses or new T2 or gadolinium-enhancing white matter lesions during the study. CONCLUSION: These observational data suggest that cladribine therapy stabilizes cortical demyelination in MS over the first year of treatment. Overall, LME burden remained stable over 1 year; however, within-subject resolution and accrual were noted.
Functional Alterations in Gray Matter Networks Mediated by White Matter During the Aging Process.
Liu J, Huang M, Hu K … +2 more , Xia N, Linli Z
J Neuroimaging · 2025 · PMID 40103260 · Publisher ↗
BACKGROUND AND PURPOSE: Extensive research has been carried out to investigate changes in various gray matter (GM) regions during the aging process using resting-state functional MRI. However, the impact of aging on the...
BACKGROUND AND PURPOSE: Extensive research has been carried out to investigate changes in various gray matter (GM) regions during the aging process using resting-state functional MRI. However, the impact of aging on the functional connectivity (FC) between white matter (WM) and GM, particularly white matter-gray matter functional connectivity (WM-GM FC), remains largely unknown. This study proposes a novel method for constructing functional networks that integrate both WM and GM. METHODS: By utilizing data from a lifespan cohort of 439 healthy adults, we devised a covariance-based approach to establish a gray matter-white matter-gray matter (GM-WM-GM) mediated network. The FC between GM and WM was quantified using the Johns Hopkins University International Consortium of Brain Mapping-Diffusion Tensor Imaging-81 WM atlas in combination with the Automated Anatomical Labeling atlas. First, the WM-GM FC was calculated via Pearson correlation coefficients between WM and GM regions, followed by the standardization of the resulting matrix. The GM-WM-GM FC was then constructed using the covariance matrix. Furthermore, topological properties were calculated for GM-WM-GM networks. Finally, the age effect of GM-WM-GM and its topology were explored. RESULTS: Our findings reveal a significant age-related decline in intranetwork connectivity and global network efficiency, while internetwork connectivity followed an inverted U-shaped pattern, suggesting functional dedifferentiation in the aging brain. Despite relatively stable local efficiency, the observed reduction in global efficiency indicates a weakening of long-range neural connections. Additionally, a decrease in network modularity further supports this trend. CONCLUSION: These results offer novel insights into the age-associated reorganization of brain networks, enhancing our understanding of the neural mechanisms underlying normal aging.
Intraarterial Thrombolysis as an Adjunct to Thrombectomy in Acute Ischemic Stroke: Current Status and Future Prospects.
Qureshi AI, Al-Salihi MM, Bhatti IA … +12 more , Al-Jebur MS, Abd Elazim A, Ansari SA, Ford DE, Hanley DF, Hassan AE, Lakhani P, Mehr DR, Nguyen TN, Spiotta AM, Powers WJ, Zaidi SF
J Neuroimaging · 2025 · PMID 40095395 · Publisher ↗
BACKGROUND AND PURPOSE: Intraarterial thrombolysis (IAT) has been sporadically used as an adjunct to mechanical thrombectomy (MT) in acute ischemic stroke patients for nearly two decades to improve distal arterial and mi...
BACKGROUND AND PURPOSE: Intraarterial thrombolysis (IAT) has been sporadically used as an adjunct to mechanical thrombectomy (MT) in acute ischemic stroke patients for nearly two decades to improve distal arterial and microvascular perfusion even in patients with near complete or complete recanalization. METHODS: We provide an overall narrative review that includes a systematic review and meta-analysis of two randomized controlled trials (RCTs), Chemical Optimization of Cerebral Embolectomy and Endovascular Recanalization in Patients with Acute Posterior Circulation Arterial Occlusion, to identify current and future implications. Risk ratios (RRs) were calculated from RCTs using a fixed-effects model. We identified 10 ongoing or planned RCTs after a search on clinicaltrials.gov and other sources, of which eight are in China, one in Europe, and one in Australia. RESULTS: A previous meta-analysis of 16 (predominantly observational) studies involving 7572 MT-treated patients had identified 14% higher odds of functional independence (modified Rankin scale [mRS] 0-2) at 90 days in patients treated with IAT. In the current analysis of 321 patients who underwent MT in RCTs, 165 were randomized to IAT and 156 were in the control group. The RR of achieving an mRS score of 0-1 at 90 days postrandomization was higher in patients treated with IAT compared with the control group (absolute increase of 12.87%, RR = 1.39, 95% confidence interval [CI] 1.04-1.86). The rate of symptomatic intracerebral hemorrhage (sICH) within 24 h was slightly higher (absolute increase of 1.64%, RR = 0.95, 95% CI 0.07-13.30) in patients treated with IAT. The ongoing RCTs have sample sizes ranging from 80 to 498 that can identify very large minimal clinically important differences (MCIDs) (13%-20% increase) in primary outcomes, but smaller MCIDs (<10%) that can still result in practice changes with interventions associated with low cost and complexity and are easy to implement, such as IAT, will not be identified. CONCLUSIONS: Observational studies and recent RCTs suggest a potential benefit of IAT in improving functional outcomes among patients post-MT, although the potentially increased risk of sICH, inadequate sample sizes, and lack of data from the United States need to be considered. A large, definitive, and generalizable RCT is required to establish the therapeutic value and safety profile of IAT prior to widespread incorporation into routine practice.
Systematic Review of Radiomics and Artificial Intelligence in Intracranial Aneurysm Management.
Owens MR, Tenhoeve SA, Rawson C … +2 more , Azab M, Karsy M
J Neuroimaging · 2025 · PMID 40095247 · Full text
Intracranial aneurysms, with an annual incidence of 2%-3%, reflect a rare disease associated with significant mortality and morbidity risks when ruptured. Early detection, risk stratification of high-risk subgroups, and...
Intracranial aneurysms, with an annual incidence of 2%-3%, reflect a rare disease associated with significant mortality and morbidity risks when ruptured. Early detection, risk stratification of high-risk subgroups, and prediction of patient outcomes are important to treatment. Radiomics is an emerging field using the quantification of medical imaging to identify parameters beyond traditional radiology interpretation that may offer diagnostic or prognostic significance. The general radiomic workflow involves image normalization and segmentation, feature extraction, feature selection or dimensional reduction, training of a predictive model, and validation of the said model. Artificial intelligence (AI) techniques have shown increasing interest in applications toward vascular pathologies, with some commercially successful software including AiDoc, RapidAI, and Viz.AI, as well as the more recent Viz Aneurysm. We performed a systematic review of 684 articles and identified 84 articles exploring the applications of radiomics and AI in aneurysm treatment. Most studies were published between 2018 and 2024, with over half of articles in 2022 and 2023. Studies included categories such as aneurysm diagnosis (25.0%), rupture risk prediction (50.0%), growth rate prediction (4.8%), hemodynamic assessment (2.4%), clinical outcome prediction (11.9%), and occlusion or stenosis assessment (6.0%). Studies utilized molecular data (2.4%), radiologic data alone (51.2%), clinical data alone (28.6%), and combined radiologic and clinical data (17.9%). These results demonstrate the current status of this emerging and exciting field. An increased pace of innovation in this space is likely with the expansion of clinical applications of radiomics and AI in multiple vascular pathologies.
Arterial Spin Labeling MRI in Alzheimer's Disease: A Systematic Review of Cerebral Perfusion Biomarkers.
Bernetti C, D'Andrea V, Buoso A … +7 more , Barbalace I, Greco F, Pilato F, Calandrelli R, Di Lazzaro V, Zobel BB, Mallio CA
J Neuroimaging · 2025 · PMID 40087957 · Full text
BACKGROUND: Alzheimer's disease (AD) is a leading cause of dementia. Arterial spin labeling (ASL) MRI, particularly at 3 Tesla (3T), offers a noninvasive method to assess cerebral blood flow alterations, which are believ...
BACKGROUND: Alzheimer's disease (AD) is a leading cause of dementia. Arterial spin labeling (ASL) MRI, particularly at 3 Tesla (3T), offers a noninvasive method to assess cerebral blood flow alterations, which are believed to be early indicators of AD. PURPOSE: The purpose of this study is to evaluate the utility of 3T ASL MRI in identifying cerebral perfusion biomarkers for the diagnosis and management of AD, assess its prognostic value, and compare it to other imaging modalities, such as PET. DATA SOURCES: A systematic literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across PubMed, Cochrane Library, and Scopus using keywords related to "ASL," "3T MRI," and "AD." STUDY SELECTION: Studies were included if they used 3T ASL MRI to investigate CBF in AD. Reviews, preclinical studies, case reports, studies lacking 3T ASL MRI, or those focusing on other dementias or mild cognitive impairment without an AD comparison were excluded. Data extracted included study design, sample characteristics, imaging techniques, parameters measured, and outcomes. A qualitative synthesis of findings highlights CBF patterns and biomarkers associated with AD. RESULTS: Findings demonstrated hypoperfusion in the hippocampus, precuneus, and posterior cingulate cortex, distinguishing AD from normal aging and other forms of dementia. CBF patterns are often correlated with the severity and progression of cognitive impairment. ASL MRI at 3T demonstrated diagnostic accuracy comparable to that of PET while being noninvasive and radiation free. CONCLUSION: ASL MRI at 3T could be a valuable tool for the early diagnosis and monitoring of AD. Its noninvasive nature makes it ideal for repeated measures and longitudinal studies. Further research should focus on standardizing protocols and validating their use in larger populations.
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