Livja Mertiri, John T. Freiling, Nilesh K. Desai, Stephen F. Kralik, Thierry A. G. M. Huisman
Neurotuberculosis is defined as a tuberculous infection of the meninges, brain parenchyma, vessels, cranial and spinal nerves, spinal cord, skull, and spine that can occur either in a localized or in a diffuse form.
It is a heterogeneous disease characterized by many imaging appearances and it has been defined as “the great mimicker” due to similarities with many other conditions.
The diagnosis of central nervous system (CNS) tuberculosis (TB) is based on clinical presentation, neuroimaging findings, laboratory and microbiological findings, and comprehensive evaluation of the response to anti-TB drug treatment.
However, the absence of specific symptoms, the wide spectrum of neurological manifestations, the myriad of imaging findings, possible inconclusive laboratory results, and the paradoxical reaction to treatment make the diagnosis often challenging and difficult, potentially delaying adequate treatment with possible devastating short-term and long-term neurologic sequelae.
Familiarity with the imaging characteristics helps in accurate diagnosis and may prevent or limit significantly morbidity and mortality. The goal of this review is to provide a comprehensive up-to-date overview of the conventional and advanced imaging features of CNS TB for radiologists, neuroradiologists, and pediatric radiologists. We discuss the most typical neurotuberculosis imaging findings and their differential diagnosis in children and adults with the goal to provide a global overview of this entity.
{"title":"Pediatric and adult meningeal, parenchymal, and spinal tuberculosis: A neuroimaging review","authors":"Livja Mertiri, John T. Freiling, Nilesh K. Desai, Stephen F. Kralik, Thierry A. G. M. Huisman","doi":"10.1111/jon.13177","DOIUrl":"10.1111/jon.13177","url":null,"abstract":"<p>Neurotuberculosis is defined as a tuberculous infection of the meninges, brain parenchyma, vessels, cranial and spinal nerves, spinal cord, skull, and spine that can occur either in a localized or in a diffuse form.</p><p>It is a heterogeneous disease characterized by many imaging appearances and it has been defined as “the great mimicker” due to similarities with many other conditions.</p><p>The diagnosis of central nervous system (CNS) tuberculosis (TB) is based on clinical presentation, neuroimaging findings, laboratory and microbiological findings, and comprehensive evaluation of the response to anti-TB drug treatment.</p><p>However, the absence of specific symptoms, the wide spectrum of neurological manifestations, the myriad of imaging findings, possible inconclusive laboratory results, and the paradoxical reaction to treatment make the diagnosis often challenging and difficult, potentially delaying adequate treatment with possible devastating short-term and long-term neurologic sequelae.</p><p>Familiarity with the imaging characteristics helps in accurate diagnosis and may prevent or limit significantly morbidity and mortality. The goal of this review is to provide a comprehensive up-to-date overview of the conventional and advanced imaging features of CNS TB for radiologists, neuroradiologists, and pediatric radiologists. We discuss the most typical neurotuberculosis imaging findings and their differential diagnosis in children and adults with the goal to provide a global overview of this entity.</p>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"34 2","pages":"179-194"},"PeriodicalIF":2.4,"publicationDate":"2023-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138680453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dhairya A. Lakhani, Aneri B. Balar, Manisha Koneru, Meisam Hoseinyazdi, Nathan Hyson, Andrew Cho, Cynthia Greene, Risheng Xu, Licia Luna, Justin Caplan, Adam Dmytriw, Adrien Guenego, Max Wintermark, Fernando Gonzalez, Victor Urrutia, Judy Huang, Kambiz Nael, Ansaar T. Rai, Gregory W. Albers, Jeremy J. Heit, Vivek Yedavalli
Background and Purpose
Acute ischemic stroke due to large vessel occlusion (AIS-LVO) is a major cause of functional dependence. Collateral status (CS) is an important determinant of functional outcomes. Pretreatment CT perfusion (CTP) parameters serve as reliable surrogates of CS. Penumbra Salvage Index (PSI) is another parameter predictive of functional outcomes in AIS-LVO. The aim of this study is to assess the relationship of pretreatment CTP parameters with PSI.
Methods
In this prospectively collected, retrospectively reviewed multicenter analysis, inclusion criteria were as follows: (1) CT angiography confirmed middle cerebral artery (MCA) M1-segment and proximal M2-segment occlusion from 9/1/2017 to 9/22/2022; (2) diagnostic CTP; and (3) available diagnostic Magnetic resonance Imaging (MRI) diffusion-weighted images. Pearson correlation analysis was performed to assess the association between cerebral blood volume (CBV) index and hypoperfusion intensity ratio (HIR) with PSI. p value ≤.05 was considered statistically significant.
Results
In total, 131 patients (n = 86, M1 and n = 45, proximal M2 occlusion) met our inclusion criteria. CBV index showed a modest positive correlation with PSI (r = 0.34, p<.001) in patients with proximal MCA occlusion. Similar trends were noted in subgroup analysis of patients with M1 occlusion, and proximal M2 occlusion. Whereas, HIR did not have a strong trend or correlation with PSI.
Conclusion
CBV index correlates with PSI, whereas HIR does not. Future studies are needed to expand our understanding of the adjunct role of CBV index with other similar pretreatment CTP-based markers in clinical evaluation and decision-making in patients with MCA occlusion.
{"title":"Pretreatment CT perfusion collateral parameters correlate with penumbra salvage in middle cerebral artery occlusion","authors":"Dhairya A. Lakhani, Aneri B. Balar, Manisha Koneru, Meisam Hoseinyazdi, Nathan Hyson, Andrew Cho, Cynthia Greene, Risheng Xu, Licia Luna, Justin Caplan, Adam Dmytriw, Adrien Guenego, Max Wintermark, Fernando Gonzalez, Victor Urrutia, Judy Huang, Kambiz Nael, Ansaar T. Rai, Gregory W. Albers, Jeremy J. Heit, Vivek Yedavalli","doi":"10.1111/jon.13178","DOIUrl":"10.1111/jon.13178","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Acute ischemic stroke due to large vessel occlusion (AIS-LVO) is a major cause of functional dependence. Collateral status (CS) is an important determinant of functional outcomes. Pretreatment CT perfusion (CTP) parameters serve as reliable surrogates of CS. Penumbra Salvage Index (PSI) is another parameter predictive of functional outcomes in AIS-LVO. The aim of this study is to assess the relationship of pretreatment CTP parameters with PSI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospectively collected, retrospectively reviewed multicenter analysis, inclusion criteria were as follows: (1) CT angiography confirmed middle cerebral artery (MCA) M1-segment and proximal M2-segment occlusion from 9/1/2017 to 9/22/2022; (2) diagnostic CTP; and (3) available diagnostic Magnetic resonance Imaging (MRI) diffusion-weighted images. Pearson correlation analysis was performed to assess the association between cerebral blood volume (CBV) index and hypoperfusion intensity ratio (HIR) with PSI. <i>p</i> value ≤.05 was considered statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 131 patients (<i>n</i> = 86, M1 and <i>n</i> = 45, proximal M2 occlusion) met our inclusion criteria. CBV index showed a modest positive correlation with PSI (<i>r</i> = 0.34, <i>p</i><.001) in patients with proximal MCA occlusion. Similar trends were noted in subgroup analysis of patients with M1 occlusion, and proximal M2 occlusion. Whereas, HIR did not have a strong trend or correlation with PSI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CBV index correlates with PSI, whereas HIR does not. Future studies are needed to expand our understanding of the adjunct role of CBV index with other similar pretreatment CTP-based markers in clinical evaluation and decision-making in patients with MCA occlusion.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"34 1","pages":"44-49"},"PeriodicalIF":2.4,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.13178","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138498634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Margareta A. Clarke, Rachael Cheek, Habeeb F. Kazimuddin, Bryan Hernandez, Reece Clarke, Colin D. McKnight, Joy Derwenskus, James Eaton, Rebecca Irlmeier, Fei Ye, Kristin P. O'Grady, Baxter Rogers, Seth A. Smith, Francesca Bagnato
Background and Purpose
Paramagnetic rims and the central vein sign (CVS) are proposed imaging markers of multiple sclerosis (MS) lesions. Using 7 tesla magnetic resonance imaging, we aimed to: (1) characterize the appearance of paramagnetic rim lesions (PRLs); (2) assess whether PRLs and the CVS are associated with higher levels of MS pathology; and (3) compare the characteristics between subjects with and without PRLs in early MS.
Methods
Prospective study of 32 treatment-naïve subjects around the time of diagnosis who were assessed for the presence of PRLs and the CVS. Comparisons of lesion volume and macromolecular pool size ratio (PSR) index, a proxy of myelin integrity, between PRLs and non-PRLs, and CVS-positive and CVS-negative lesions were carried out. Differences in clinical/demographic characteristics between patients with PRLs and those without were tested.
Results
Fifteen subjects had ≥1 PRL for a total of 36 PRLs, of which two-thirds had a full rim. PRLs predicted a larger lesion size and decreased PSR signal. Lesion volume and presence of cervical spine lesions were significantly different between subjects with PRLs and those without, although neither remained significant after adjusting for multiple comparisons. One hundred and eighty-one lesions with CVS were identified with no differences between CVS-positive and CVS-negative lesions in volume (p = .27) and PSR values (p = .62).
Conclusions
PRLs, but not CVS-positive lesions, are larger and have lower myelin integrity. Our findings indicate that PRLs are associated with higher levels of lesion-specific pathology prior to the start of disease-modifying therapy.
{"title":"Paramagnetic rim lesions and the central vein sign: Characterizing multiple sclerosis imaging markers","authors":"Margareta A. Clarke, Rachael Cheek, Habeeb F. Kazimuddin, Bryan Hernandez, Reece Clarke, Colin D. McKnight, Joy Derwenskus, James Eaton, Rebecca Irlmeier, Fei Ye, Kristin P. O'Grady, Baxter Rogers, Seth A. Smith, Francesca Bagnato","doi":"10.1111/jon.13173","DOIUrl":"10.1111/jon.13173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Paramagnetic rims and the central vein sign (CVS) are proposed imaging markers of multiple sclerosis (MS) lesions. Using 7 tesla magnetic resonance imaging, we aimed to: (1) characterize the appearance of paramagnetic rim lesions (PRLs); (2) assess whether PRLs and the CVS are associated with higher levels of MS pathology; and (3) compare the characteristics between subjects with and without PRLs in early MS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Prospective study of 32 treatment-naïve subjects around the time of diagnosis who were assessed for the presence of PRLs and the CVS. Comparisons of lesion volume and macromolecular pool size ratio (PSR) index, a proxy of myelin integrity, between PRLs and non-PRLs, and CVS-positive and CVS-negative lesions were carried out. Differences in clinical/demographic characteristics between patients with PRLs and those without were tested.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen subjects had ≥1 PRL for a total of 36 PRLs, of which two-thirds had a full rim. PRLs predicted a larger lesion size and decreased PSR signal. Lesion volume and presence of cervical spine lesions were significantly different between subjects with PRLs and those without, although neither remained significant after adjusting for multiple comparisons. One hundred and eighty-one lesions with CVS were identified with no differences between CVS-positive and CVS-negative lesions in volume (<i>p</i> = .27) and PSR values (<i>p</i> = .62).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PRLs, but not CVS-positive lesions, are larger and have lower myelin integrity. Our findings indicate that PRLs are associated with higher levels of lesion-specific pathology prior to the start of disease-modifying therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"34 1","pages":"86-94"},"PeriodicalIF":2.4,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.13173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138451616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Amin, Oun Al-iedani, Rodney A. Lea, Fabienne Brilot, Vicki E. Maltby, Jeannette Lechner-Scott
Background and Purpose
Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a relapsing demyelinating condition. There are several cross-sectional studies showing evidence of brain atrophy in people with MOGAD (pwMOGAD), but longitudinal brain volumetric assessment is still an unmet need. Current recommendations do not include monitoring with MRI and assume distinct attacks. Evidence of ongoing axon loss will have diagnostic and therapeutic implications. In this study, we assessed brain volume changes in pwMOGAD over a mean follow-up period of 2 years and compared this to changes in people with multiple sclerosis (pwMS).
Methods
This is a retrospective single-center study over a 7-year period from 2014 to 2021. MRI brain scans at the time of diagnosis and follow-up in remission were collected from 14 Caucasian pwMOGAD, confirmed by serum myelin oligodendrocyte glycoprotein immunoglobulin G antibody presence, detected by live cell-based assays. Total brain volume (TBV), white matter (WM), gray matter (GM), and demyelinating lesion volumes were assessed automatically using the Statistical Parametric Mapping and FMRIB automated segmentation tools. MRI brain scans at diagnosis and follow-up on remission were collected from 32-matched pwMS for comparison. Statistical analysis was done using analysis of variance.
Results
There is evidence of TBV loss, affecting particularly GM, over an approximately 2-year follow-up period in pwMOGAD (p < .05), comparable to pwMS. WM and lesion volume change over the same period were not statistically significant (p > .1).
Conclusion
We found evidence of loss of GM and TBV over time in pwMOGAD, similar to pwMS, although the WM and lesion volumes were unchanged.
{"title":"A longitudinal analysis of brain volume changes in myelin oligodendrocyte glycoprotein antibody-associated disease","authors":"Mohammad Amin, Oun Al-iedani, Rodney A. Lea, Fabienne Brilot, Vicki E. Maltby, Jeannette Lechner-Scott","doi":"10.1111/jon.13175","DOIUrl":"10.1111/jon.13175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a relapsing demyelinating condition. There are several cross-sectional studies showing evidence of brain atrophy in people with MOGAD (pwMOGAD), but longitudinal brain volumetric assessment is still an unmet need. Current recommendations do not include monitoring with MRI and assume distinct attacks. Evidence of ongoing axon loss will have diagnostic and therapeutic implications. In this study, we assessed brain volume changes in pwMOGAD over a mean follow-up period of 2 years and compared this to changes in people with multiple sclerosis (pwMS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a retrospective single-center study over a 7-year period from 2014 to 2021. MRI brain scans at the time of diagnosis and follow-up in remission were collected from 14 Caucasian pwMOGAD, confirmed by serum myelin oligodendrocyte glycoprotein immunoglobulin G antibody presence, detected by live cell-based assays. Total brain volume (TBV), white matter (WM), gray matter (GM), and demyelinating lesion volumes were assessed automatically using the Statistical Parametric Mapping and FMRIB automated segmentation tools. MRI brain scans at diagnosis and follow-up on remission were collected from 32-matched pwMS for comparison. Statistical analysis was done using analysis of variance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There is evidence of TBV loss, affecting particularly GM, over an approximately 2-year follow-up period in pwMOGAD (<i>p</i> < .05), comparable to pwMS. WM and lesion volume change over the same period were not statistically significant (<i>p</i> > .1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found evidence of loss of GM and TBV over time in pwMOGAD, similar to pwMS, although the WM and lesion volumes were unchanged.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"34 1","pages":"78-85"},"PeriodicalIF":2.4,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.13175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138451614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Parenchymal hematoma is a dreaded complication of mechanical thrombectomy after acute ischemic stroke. This study evaluated whether blood-brain barrier permeability measurements based on CT perfusion could be used as predictors of parenchymal hematoma after successful recanalization and compared the predictive value of various permeability parameters in patients with acute ischemic stroke.
Methods
We enrolled 53 patients with acute ischemic stroke who underwent mechanical thrombectomy and achieved successful recanalization. Each patient underwent CT, CT angiography, and CT perfusion imaging before treatment. We used relative volume transfer constant (rKtrans) values, relative permeability–surface area product (rP·S), and relative extraction fraction (rE) to evaluate preoperative blood-brain barrier permeability in the delayed perfusion area.
Results
Overall, 22 patients (37.7%) developed hemorrhagic transformation after surgery, including 10 patients (16.9%) with hemorrhagic infarction and 11 patients (20.8%) with parenchymal hematoma. The rP·S, rKtrans, and rE of the hypoperfusion area in the parenchymal hematoma group were significantly higher than those in the hemorrhagic infarction and no-hemorrhage transformation groups (p < .01). We found that rE and rP·S were superior to rKtrans in predicting parenchymal hematoma transformation after thrombectomy (P·S area under the curve [AUC] .844 vs. rKtrans AUC .753, z = 2.064, p = .039; rE AUC .907 vs. rKtrans AUC .753, z = 2.399, p = .017).
Conclusions
Patients with parenchymal hematoma after mechanical thrombectomy had higher blood-brain barrier permeability in hypoperfusion areas. Among blood-brain barrier permeability measurement parameters, rP·S and rE showed better accuracy for parenchymal hematoma prediction.
背景与目的:脑实质血肿是急性缺血性脑卒中机械取栓术中一种可怕的并发症。本研究评估了基于CT灌注的血脑屏障通透性测量是否可以作为脑实质血肿再通成功后的预测指标，并比较了各种通透性参数在急性缺血性脑卒中患者中的预测价值。方法:我们招募了53例急性缺血性脑卒中患者，他们接受了机械取栓术并成功地实现了再通。治疗前均行CT、CT血管造影、CT灌注成像。我们使用相对体积传递常数(rKtrans)值、相对透性-表面积积(rP·S)和相对提取分数(rE)来评估延迟灌注区术前血脑屏障透性。结果:术后发生出血转化22例(37.7%)，其中出血性梗死10例(16.9%)，实质血肿11例(20.8%)。脑实质血肿组低灌注区rP·S、rKtrans、rE均显著高于出血性梗死组和无出血转化组(p trans预测取栓后脑实质血肿转化的曲线下p·S面积[AUC] .844 vs. rKtrans AUC .753, z = 2.064, p = 0.039;rE AUC为0.907,rKtrans AUC为0.753,z = 2.399, p = 0.017)。结论:机械取栓后脑实质血肿患者在低灌注区具有较高的血脑屏障通透性。在血脑屏障通透性测量参数中，rP·S和rE对脑实质血肿的预测精度较高。
{"title":"Blood-brain barrier permeability by CT perfusion predicts parenchymal hematoma after recanalization with thrombectomy","authors":"Xinyi Chen, Jie Xu, Shunyuan Guo, Sheng Zhang, Huiyuan Wang, Panpan Shen, Yafei Shang, Mingming Tan, Yu Geng","doi":"10.1111/jon.13172","DOIUrl":"10.1111/jon.13172","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Parenchymal hematoma is a dreaded complication of mechanical thrombectomy after acute ischemic stroke. This study evaluated whether blood-brain barrier permeability measurements based on CT perfusion could be used as predictors of parenchymal hematoma after successful recanalization and compared the predictive value of various permeability parameters in patients with acute ischemic stroke.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 53 patients with acute ischemic stroke who underwent mechanical thrombectomy and achieved successful recanalization. Each patient underwent CT, CT angiography, and CT perfusion imaging before treatment. We used relative volume transfer constant (r<i>K</i><sub>trans</sub>) values, relative permeability–surface area product (r<i>P</i>·<i>S</i>), and relative extraction fraction (r<i>E</i>) to evaluate preoperative blood-brain barrier permeability in the delayed perfusion area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 22 patients (37.7%) developed hemorrhagic transformation after surgery, including 10 patients (16.9%) with hemorrhagic infarction and 11 patients (20.8%) with parenchymal hematoma. The r<i>P</i>·<i>S</i>, r<i>K</i><sub>trans</sub>, and r<i>E</i> of the hypoperfusion area in the parenchymal hematoma group were significantly higher than those in the hemorrhagic infarction and no-hemorrhage transformation groups (<i>p</i> < .01). We found that r<i>E</i> and r<i>P</i>·<i>S</i> were superior to r<i>K</i><sub>trans</sub> in predicting parenchymal hematoma transformation after thrombectomy (<i>P</i>·<i>S</i> area under the curve [AUC] .844 vs. r<i>K</i><sub>trans</sub> AUC .753, <i>z</i> = 2.064, <i>p</i> = .039; r<i>E</i> AUC .907 vs. r<i>K</i><sub>trans</sub> AUC .753, <i>z</i> = 2.399, <i>p</i> = .017).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with parenchymal hematoma after mechanical thrombectomy had higher blood-brain barrier permeability in hypoperfusion areas. Among blood-brain barrier permeability measurement parameters, r<i>P</i>·<i>S</i> and r<i>E</i> showed better accuracy for parenchymal hematoma prediction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"34 2","pages":"241-248"},"PeriodicalIF":2.4,"publicationDate":"2023-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138451615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Many studies have shown that exposure to life events can have a negative impact on mental health. Life events like the death of a spouse or the birth of a child pose a challenge and require temporal or permanent adjustments. Meta-analyses on brain stress responses found bilateral anterior insula activation in response to acute stress. Fear conditioning is assumed a crucial mechanism for the development of anxiety disorders associated with increased activation in the bilateral amygdala. Empirical evidence is lacking regarding the relationship of exposure to recent life events and past childhood adversity with neural processing during fear conditioning.
Methods
In the present study, we analyzed data from 103 young, healthy participants. Multiple linear regressions were performed on functional magnetic resonance imaging activation during fear conditioning with the Life Events Scale for Students and the Childhood Trauma questionnaire included as covariates in two separate models.
Results
We found a positive relationship between the number of life events in the last year and left amygdala activation to the conditioned stimulus. A second finding was a positive relationship between childhood adversity and right anterior insula response to the unconditioned stimulus.
Conclusions
Many studies have shown increased amygdala activity after stressful life events. In addition, the anterior insula is activated during acute stress. The present study points to stressor-induced increased salience processing during fear conditioning. We suggest that this could be a potential mechanism for resilience versus mental illness.
{"title":"The impact of past childhood adversity and recent life events on neural responses during fear conditioning","authors":"Miriam Kampa, Rudolf Stark, Tim Klucken","doi":"10.1111/jon.13174","DOIUrl":"10.1111/jon.13174","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and purpose</h3>\u0000 \u0000 <p>Many studies have shown that exposure to life events can have a negative impact on mental health. Life events like the death of a spouse or the birth of a child pose a challenge and require temporal or permanent adjustments. Meta-analyses on brain stress responses found bilateral anterior insula activation in response to acute stress. Fear conditioning is assumed a crucial mechanism for the development of anxiety disorders associated with increased activation in the bilateral amygdala. Empirical evidence is lacking regarding the relationship of exposure to recent life events and past childhood adversity with neural processing during fear conditioning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the present study, we analyzed data from 103 young, healthy participants. Multiple linear regressions were performed on functional magnetic resonance imaging activation during fear conditioning with the Life Events Scale for Students and the Childhood Trauma questionnaire included as covariates in two separate models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found a positive relationship between the number of life events in the last year and left amygdala activation to the conditioned stimulus. A second finding was a positive relationship between childhood adversity and right anterior insula response to the unconditioned stimulus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Many studies have shown increased amygdala activity after stressful life events. In addition, the anterior insula is activated during acute stress. The present study points to stressor-induced increased salience processing during fear conditioning. We suggest that this could be a potential mechanism for resilience versus mental illness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"34 2","pages":"217-223"},"PeriodicalIF":2.4,"publicationDate":"2023-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.13174","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138444972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This work investigates verbal memory functional MRI (fMRI) versus language fMRI in terms of lateralization, and assesses the validity of performing word recognition during the functional scan.
Methods
Thirty patients with a diagnosis of epilepsy underwent verbal memory, visuospatial memory, and language fMRI. We used word encoding, word recognition, image encoding, and image recognition memory tasks, and semantic description, reading comprehension, and listening comprehension language tasks. We used three common lateralization metrics: network spatial distribution, maximum statistical value, and laterality index (LI).
Results
Lateralization of signal spatial distribution resulted in poor similarity between verbal memory and language fMRI tasks. Signal maximum lateralization showed significant (>.8) but not perfect (1) similarity. Word encoding LI showed significant correlation only with listening comprehension LI (p = .016). Word recognition LI was significantly correlated with expressive language semantic description LI (p = .024) and receptive language reading and listening comprehension LIs (p = .015 and p = .019, respectively). There was no correlation between LIs of the visuospatial tasks and LIs of the language tasks.
Conclusions
Our results support the association between language and verbal memory lateralization, optimally determined by LI quantification, and the introduction of quantitative means for language fMRI interpretation in clinical settings where verbal memory lateralization is imperative.
{"title":"Concordance of verbal memory and language fMRI lateralization in people with epilepsy","authors":"Vasileios Kokkinos, Ioannis Seimenis","doi":"10.1111/jon.13171","DOIUrl":"10.1111/jon.13171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>This work investigates verbal memory functional MRI (fMRI) versus language fMRI in terms of lateralization, and assesses the validity of performing word recognition during the functional scan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty patients with a diagnosis of epilepsy underwent verbal memory, visuospatial memory, and language fMRI. We used word encoding, word recognition, image encoding, and image recognition memory tasks, and semantic description, reading comprehension, and listening comprehension language tasks. We used three common lateralization metrics: network spatial distribution, maximum statistical value, and laterality index (LI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Lateralization of signal spatial distribution resulted in poor similarity between verbal memory and language fMRI tasks. Signal maximum lateralization showed significant (>.8) but not perfect (1) similarity. Word encoding LI showed significant correlation only with listening comprehension LI (<i>p</i> = .016). Word recognition LI was significantly correlated with expressive language semantic description LI (<i>p</i> = .024) and receptive language reading and listening comprehension LIs (<i>p</i> = .015 and <i>p</i> = .019, respectively). There was no correlation between LIs of the visuospatial tasks and LIs of the language tasks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results support the association between language and verbal memory lateralization, optimally determined by LI quantification, and the introduction of quantitative means for language fMRI interpretation in clinical settings where verbal memory lateralization is imperative.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"34 1","pages":"95-107"},"PeriodicalIF":2.4,"publicationDate":"2023-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.13171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134649155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cansu Özden, Victor-Felix Mautner, Said Farschtschi, Isabel Molwitz, Inka Ristow, Peter Bannas, Lennart Well, Susanne Klutmann, Gerhard Adam, Ivayla Apostolova, Ralph Buchert
Background and Purpose
Thalamic hypometabolism is a consistent finding in brain PET with F-18 fluorodeoxyglucose (FDG) in patients with neurofibromatosis type 1 (NF1). However, the pathophysiology of this metabolic alteration is unknown. We hypothesized that it might be secondary to disturbance of peripheral input to the thalamus by NF1-characteristic peripheral nerve sheath tumors (PNSTs). To test this hypothesis, we investigated the relationship between thalamic FDG uptake and the number, volume, and localization of PNSTs.
Methods
This retrospective study included 22 adult NF1 patients (41% women, 36.2 ± 13.0 years) referred to whole-body FDG-PET/contrast-enhanced CT for suspected malignant transformation of PNSTs and 22 sex- and age-matched controls. Brain FDG uptake was scaled voxelwise to the individual median uptake in cerebellar gray matter. Bilateral mean and left-right asymmetry of thalamic FDG uptake were determined using a left-right symmetric anatomical thalamus mask. PNSTs were manually segmented in contrast-enhanced CT.
Results
Thalamic FDG uptake was reduced in NF1 patients by 2.0 standard deviations (p < .0005) compared to controls. Left-right asymmetry was increased by 1.3 standard deviations (p = .013). Thalamic hypometabolism was higher in NF1 patients with ≥3 PNSTs than in patients with ≤2 PNSTs (2.6 vs. 1.6 standard deviations, p = .032). The impact of the occurrence of paraspinal/paravertebral PNSTs and of the mean PNST volume on thalamic FDG uptake did not reach statistical significance (p = .098 and p = .189). Left-right asymmetry of thalamic FDG uptake was not associated with left-right asymmetry of PNST burden (p = .658).
Conclusions
This study provides first evidence of left-right asymmetry of thalamic hypometabolism in NF1 and that it might be mediated by NF1-associated peripheral tumors.
{"title":"Asymmetry of thalamic hypometabolism on FDG-PET/CT in neurofibromatosis type 1: Association with peripheral tumor burden","authors":"Cansu Özden, Victor-Felix Mautner, Said Farschtschi, Isabel Molwitz, Inka Ristow, Peter Bannas, Lennart Well, Susanne Klutmann, Gerhard Adam, Ivayla Apostolova, Ralph Buchert","doi":"10.1111/jon.13170","DOIUrl":"10.1111/jon.13170","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Thalamic hypometabolism is a consistent finding in brain PET with F-18 fluorodeoxyglucose (FDG) in patients with neurofibromatosis type 1 (NF1). However, the pathophysiology of this metabolic alteration is unknown. We hypothesized that it might be secondary to disturbance of peripheral input to the thalamus by NF1-characteristic peripheral nerve sheath tumors (PNSTs). To test this hypothesis, we investigated the relationship between thalamic FDG uptake and the number, volume, and localization of PNSTs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 22 adult NF1 patients (41% women, 36.2 ± 13.0 years) referred to whole-body FDG-PET/contrast-enhanced CT for suspected malignant transformation of PNSTs and 22 sex- and age-matched controls. Brain FDG uptake was scaled voxelwise to the individual median uptake in cerebellar gray matter. Bilateral mean and left-right asymmetry of thalamic FDG uptake were determined using a left-right symmetric anatomical thalamus mask. PNSTs were manually segmented in contrast-enhanced CT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thalamic FDG uptake was reduced in NF1 patients by 2.0 standard deviations (<i>p</i> < .0005) compared to controls. Left-right asymmetry was increased by 1.3 standard deviations (<i>p</i> = .013). Thalamic hypometabolism was higher in NF1 patients with ≥3 PNSTs than in patients with ≤2 PNSTs (2.6 vs. 1.6 standard deviations, <i>p</i> = .032). The impact of the occurrence of paraspinal/paravertebral PNSTs and of the mean PNST volume on thalamic FDG uptake did not reach statistical significance (<i>p</i> = .098 and <i>p</i> = .189). Left-right asymmetry of thalamic FDG uptake was not associated with left-right asymmetry of PNST burden (<i>p</i> = .658).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study provides first evidence of left-right asymmetry of thalamic hypometabolism in NF1 and that it might be mediated by NF1-associated peripheral tumors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"34 1","pages":"138-144"},"PeriodicalIF":2.4,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.13170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71521798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and extra-articular manifestation of rheumatoid arthritis (RA). However, in patients with RA, it is not always possible to clinically distinguish an actual CTS from other RA-based complaints.
Methods
We evaluated the diagnostic role of nerve ultrasound (NUS) as supportive tool in the diagnostic process of CTS in patients with RA and tried to provide etiological clarification in cases of secondary CTS. Fifty-eight patients with RA and clinical suspicion of CTS were enrolled. All patients underwent a standardized clinical-neurological, electrophysiological (nerve conduction studies [NCS]), and NUS examination and completed the Boston CTS Questionnaire (BCTQ).
Results
In 96 of 116 hands examined, a clinical suspicion of CTS was documented. In 43 of 96 (44.8%) CTS-positive hands, the diagnosis was primarily confirmed by NCS, whereas in another 16 of 96 (30.2%) hands, the diagnosis could only be verified by NUS, leading to a diagnosis of CTS in 59 of 116 (50.8%) hands. In 19 of 59 (32.3%) CTS-positive hands, tenosynovial hypertrophy was observed, and in 7 of 59 (11.8%), a cystic mass was identified as the underlying cause of secondary CTS. A good correlation between NCS and NUS findings was documented, but no significant correlation was found between NCS, NUS, and clinical findings/BCTQ.
Conclusions
In people with RA, a diagnosis of CTS purely on a clinical basis is nonspecific and should be supported by NCS and/or NUS. NUS markedly facilitates the diagnosis of CTS in these patients and enables differentiation between primary and secondary causes.
{"title":"Nerve sonography in the diagnostic evaluation of primary and secondary carpal tunnel syndrome in rheumatoid arthritis","authors":"Antonios Kerasnoudis, Etfhymia Ntasiou, Styliani Tsiami, Michael Sarholz, Xenofon Baraliakos, Christos Krogias","doi":"10.1111/jon.13169","DOIUrl":"10.1111/jon.13169","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy and extra-articular manifestation of rheumatoid arthritis (RA). However, in patients with RA, it is not always possible to clinically distinguish an actual CTS from other RA-based complaints.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated the diagnostic role of nerve ultrasound (NUS) as supportive tool in the diagnostic process of CTS in patients with RA and tried to provide etiological clarification in cases of secondary CTS. Fifty-eight patients with RA and clinical suspicion of CTS were enrolled. All patients underwent a standardized clinical-neurological, electrophysiological (nerve conduction studies [NCS]), and NUS examination and completed the Boston CTS Questionnaire (BCTQ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 96 of 116 hands examined, a clinical suspicion of CTS was documented. In 43 of 96 (44.8%) CTS-positive hands, the diagnosis was primarily confirmed by NCS, whereas in another 16 of 96 (30.2%) hands, the diagnosis could only be verified by NUS, leading to a diagnosis of CTS in 59 of 116 (50.8%) hands. In 19 of 59 (32.3%) CTS-positive hands, tenosynovial hypertrophy was observed, and in 7 of 59 (11.8%), a cystic mass was identified as the underlying cause of secondary CTS. A good correlation between NCS and NUS findings was documented, but no significant correlation was found between NCS, NUS, and clinical findings/BCTQ.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In people with RA, a diagnosis of CTS purely on a clinical basis is nonspecific and should be supported by NCS and/or NUS. NUS markedly facilitates the diagnosis of CTS in these patients and enables differentiation between primary and secondary causes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"34 1","pages":"120-126"},"PeriodicalIF":2.4,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.13169","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Skull lesions in pediatric population are common findings on imaging and sometimes with heterogeneous manifestations, constituting a diagnostic challenge. Some lesions can be misinterpreted for their aggressiveness, as with larger lesions eroding cortical bone, containing soft tissue components, leading to excessive and, in some cases, invasive inappropriate etiological investigation. In this review, we present multiple several conditions that may present as skull lesions or pseudolesions, organized by groups (anatomic variants, congenital and development disorders, traumatic injuries, vascular issues, infectious conditions, and tumoral processes). Anatomic variants are common imaging findings that must be recognized by the neuroradiologist. Congenital malformations are rare conditions, such as aplasia cutis congenita and sinus pericranii, usually seen at earlier ages, the majority of which are benign findings. In case of trauma, cephalohematoma, growing skull fractures, and posttraumatic lytic lesions should be considered. Osteomyelitis tends to be locally aggressive and may mimic malignancy, in which cases, the clinical history can be the key to diagnosis. Vascular (sickle cell disease) and tumoral (aneurismal bone cyst, eosinophilic granuloma, metastases) lesions are relatively rare lesions but should be considered in the differential diagnosis, in the presence of certain imaging findings. The main difficulty is the differentiation between the benign and malignant nature; therefore, the main objective of this pictorial essay is to review the main skull lytic lesions found in pediatric age, describing the main findings in different imaging modalities (CT and MRI), allowing the neuroradiologist greater confidence in establishing the differential diagnosis, through a systematic and simple characterization of the lesions.
{"title":"Imaging of pediatric skull lytic lesions: A review","authors":"Mariana Santos, Bruno Cunha, Vasco Abreu, Suely Ferraciolli, Luís Godoy, Rodrigo Murakoshi, Lázaro Luís Faria Amaral, Carla Conceição","doi":"10.1111/jon.13166","DOIUrl":"10.1111/jon.13166","url":null,"abstract":"<p>Skull lesions in pediatric population are common findings on imaging and sometimes with heterogeneous manifestations, constituting a diagnostic challenge. Some lesions can be misinterpreted for their aggressiveness, as with larger lesions eroding cortical bone, containing soft tissue components, leading to excessive and, in some cases, invasive inappropriate etiological investigation. In this review, we present multiple several conditions that may present as skull lesions or pseudolesions, organized by groups (anatomic variants, congenital and development disorders, traumatic injuries, vascular issues, infectious conditions, and tumoral processes). Anatomic variants are common imaging findings that must be recognized by the neuroradiologist. Congenital malformations are rare conditions, such as aplasia cutis congenita and sinus pericranii, usually seen at earlier ages, the majority of which are benign findings. In case of trauma, cephalohematoma, growing skull fractures, and posttraumatic lytic lesions should be considered. Osteomyelitis tends to be locally aggressive and may mimic malignancy, in which cases, the clinical history can be the key to diagnosis. Vascular (sickle cell disease) and tumoral (aneurismal bone cyst, eosinophilic granuloma, metastases) lesions are relatively rare lesions but should be considered in the differential diagnosis, in the presence of certain imaging findings. The main difficulty is the differentiation between the benign and malignant nature; therefore, the main objective of this pictorial essay is to review the main skull lytic lesions found in pediatric age, describing the main findings in different imaging modalities (CT and MRI), allowing the neuroradiologist greater confidence in establishing the differential diagnosis, through a systematic and simple characterization of the lesions.</p>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"34 1","pages":"26-43"},"PeriodicalIF":2.4,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jon.13166","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71482546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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