Journal of Neuroimaging最新文献_第2页

Brain MRI Radiomic First-Order Features for Presurgical Prediction of Meningioma Grading 术前预测脑膜瘤分级的脑MRI放射一级特征。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2026-02-04 DOI: 10.1111/jon.70127

Camilo Pineda-Ibarra, Josep Puig, Diego Nuñez-Leiva, Yensa Rodríguez, Juan Mora, Santiago Medrano-Martorell, Jose Carlos Pariente, Marc Comas-Cufí, Aida Niñerola-Baizán, Arnau Farré-Melero, Daniel Alejandro Reyes-Barrios, Iban Aldecoa, Laura Oleaga, Sofia González-Ortiz

Background and Purpose

Grading meningioma guides treatment choices from follow-up to surgical resection with adjuvant radiation. Radiomics may offer a non-invasive alternative to biopsies. We assessed radiomic features (RFs) for distinguishing Grade 1 and Grade 2 meningiomas on preoperative multiparametric MRI.

Methods

Presurgical T1-weighted (T1), T2-weighted (T2), T2 gradient echo-weighted (T2GRE), fluid-attenuated inversion recovery (FLAIR), apparent diffusion coefficient (ADC), and T1-weighted contrast-enhanced (T1CE). MRI sequences of histopathologically diagnosed meningiomas were collected retrospectively. Each volume had 75 RFs extracted from semimanually segmented tumors using MintLesion Research (Version 3.10). The Lasso method selected variables from imputed data, and 10-fold cross-validation determined the optimal regularization parameter. For Lasso-retained variables, multivariate effects were estimated.

Results

Out of 150 patients (67.3% women), 110 (73.3%) had Grade 1 meningiomas, and 40 (26.7%) Grade 2. The strongest metrics to distinguish meningiomas Grade 1 versus Grade 2 were intensity histogram coefficient of variation on T1CE (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.23–0.88; p = 0.028), maximum histogram gradient on T1 (OR 2.11, 95% CI 1.18–4.82; p = 0.043), and intensity histogram quartile coefficient of dispersion on FLAIR (OR 0.53, 95% CI 0.31–0.89; p = 0.021). The combined RFs achieved an area under the curve of 0.814 (95% CI, 0.732–0.896) for grading differentiation. Texture features and metrics extracted from T2, T2GRE, and ADC sequences did not discriminate meningioma grading.

Conclusions

Histogram-based first-order RFs from T1, FLAIR, and T1CE may predict meningioma grades preoperatively. Larger, multicenter studies are needed to confirm these findings, providing insights for clinical decision-making and personalized treatment.

背景与目的：脑膜瘤分级指导从随访到手术辅助放疗的治疗选择。放射组学可能为活检提供一种非侵入性的替代方法。我们评估了术前多参数MRI的放射学特征（RFs）来区分1级和2级脑膜瘤。方法：术前T1加权（T1）、T2加权（T2）、T2梯度回波加权（T2GRE）、流体衰减反演恢复（FLAIR）、表观扩散系数（ADC）、T1加权对比增强（T1CE）。回顾性收集经组织病理学诊断为脑膜瘤的MRI序列。使用mint病变研究（版本3.10）从半手工分割的肿瘤中提取75个RFs。Lasso方法从输入数据中选择变量，通过10次交叉验证确定最优正则化参数。对于lasso保留的变量，估计了多变量效应。结果：150例患者（67.3%女性）中，110例（73.3%）为1级脑膜瘤，40例（26.7%）为2级脑膜瘤。区分1级脑膜瘤和2级脑膜瘤的最强指标是T1CE的强度直方图变异系数（比值比[OR] 0.47, 95%可信区间[CI] 0.23-0.88, p = 0.028）、T1的最大直方图梯度（OR 2.11, 95% CI 1.18-4.82, p = 0.043）和FLAIR的强度直方图四分位数离散系数（OR 0.53, 95% CI 0.31-0.89, p = 0.021）。综合RFs曲线下面积为0.814 （95% CI, 0.732-0.896）。从T2、T2GRE和ADC序列中提取的纹理特征和指标不能区分脑膜瘤的分级。结论：基于直方图的T1、FLAIR和T1CE一阶RFs可以预测术前脑膜瘤的分级。需要更大规模的多中心研究来证实这些发现，为临床决策和个性化治疗提供见解。

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引用次数: 0

Quantitative MRI Evaluation of Hemispheric Asymmetry in Circle of Willis Artery Diameters 威利斯动脉直径圆半球不对称的定量MRI评价。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2026-02-04 DOI: 10.1111/jon.70126

Stijn J. Stoutjesdijk, Phebe J. Groenheide, Iris N. Vos, Robin Bülow, Birgitta K. Velthuis, Ynte M. Ruigrok

Background

Previous studies have identified hemispheric asymmetries in cerebral blood flow and volume, favoring the left hemisphere. Accordingly, we hypothesized that arteries on the left side of the circle of Willis (CoW) are larger than on the right. We compared artery diameters between the hemispheres.

Methods

Cranial time-of-flight magnetic resonance angiography scans of 1052 participants from a population-based cohort were assessed. Diameters of major CoW arteries (> 1.2 mm) were measured using a semiautomatic tool (mean ± standard deviation) and compared between the left and right hemisphere using a paired-samples t-test. As the posterior communicating arteries (Pcom) are often small and non-normally distributed, they were measured manually, categorized as “present” (≥ 1 mm) or “aplastic/hypoplastic” (< 1 mm), and compared using odds ratios (OR) with 95% confidence intervals (CI).

Results

The A2 segment of the anterior cerebral artery was smaller on the left than on the right (1.97 ± 0.21 mm vs. 2.01 ± 0.22 mm; p < 0.001), while the vertebral artery (2.36 ± 0.44 mm vs. 2.25 ± 0.41 mm; p < 0.001) and P1 segment of the posterior cerebral artery (2.01 ± 0.28 mm vs. 1.98 ± 0.29 mm; p = 0.001) were larger on the left. The Pcom was less frequently present on the left (26.7%) than on the right (33.4%; OR 0.73, 95% CI 0.60−0.88). No left–right differences were found for the A1 segment, M1 segment of the middle cerebral artery, and internal carotid artery.

Conclusions

We found that some vessels were larger in the left hemisphere, whereas others were smaller. Future studies should investigate underlying mechanisms driving these specific asymmetries.

背景：先前的研究已经确定了脑血流和脑容量的半球不对称，倾向于左半球。因此，我们假设威利斯圈（CoW）左侧的动脉比右侧的动脉大。我们比较了两个半球之间的动脉直径。方法：对来自人群队列的1052名参与者进行颅脑飞行时间磁共振血管造影扫描。使用半自动工具（平均值±标准差）测量主动脉直径（> 1.2 mm），并使用配对样本t检验比较左、右半球的直径。由于后交通动脉（Pcom）通常较小且非正态分布，因此人工测量后交通动脉，将其分类为“存在”（≥1mm）或“再生/发育不良”（< 1mm），并使用95%置信区间（CI）的优势比（or）进行比较。结果：左侧大脑前动脉A2段比右侧小（1.97±0.21 mm比2.01±0.22 mm, p < 0.001），左侧椎动脉（2.36±0.44 mm比2.25±0.41 mm, p < 0.001）和大脑后动脉P1段（2.01±0.28 mm比1.98±0.29 mm, p = 0.001）较大。Pcom出现在左侧的频率（26.7%）低于右侧（33.4%;OR 0.73, 95% CI 0.60-0.88）。大脑中动脉A1段、M1段、颈内动脉左、右无差异。结论：我们发现左半球的一些血管较大，而另一些血管较小。未来的研究应该探究驱动这些特定不对称的潜在机制。

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引用次数: 0

Explainable Machine-Learning Model to Classify Culprit Calcified Carotid Plaque in Embolic Stroke of Undetermined Source 可解释的机器学习模型分类不明来源栓塞性卒中的罪魁祸首钙化颈动脉斑块。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2026-01-22 DOI: 10.1111/jon.70119

Yu Sakai, Jiehyun Kim, Huy Q. Phi, Andrew C. Hu, Pargol Balali, Konstanze V. Guggenberger, John H. Woo, Daniel Bos, Scott E. Kasner, Brett L. Cucchiara, Luca Saba, Zhi Huang, Daniel Haehn, Jae W. Song

Background and Purpose

Embolic stroke of undetermined source (ESUS) may be associated with carotid artery plaques with <50% stenosis. Plaque vulnerability is multifactorial, possibly related to intraplaque hemorrhage (IPH), lipid-rich necrotic core, perivascular adipose tissue (PVAT), and calcifications. Machine learning (ML)-based plaque classification is increasingly popular but often limited in clinical interpretability by black-box nature. We applied an explainable ML approach, using noncalcified plaque components and calcification features with the SHapley Additive exPlanations (SHAP) framework to classify plaques as culprit or nonculprit.

Methods

This was a retrospective, cross-sectional study. Patients with unilateral anterior circulation ESUS with calcified carotid plaques in neck computed tomography (CT) angiography were analyzed. Calcification-level features were derived from manual segmentations. Plaque-level features were assessed by a neuroradiologist and by semi-automated software. Plaques were classified as culprit if ipsilateral to stroke side. Eight classifiers were benchmarked, and a gradient-boosted decision tree (CatBoost) was further tuned. SHAP explained model decisions.

Results

Seventy patients yielded 116 calcified plaques (270 calcifications). Model based on five plaque- and calcification-level features achieved ROC-AUC (receiver operating characteristic area under the curve) 0.79 and precision-recall-AUC 0.86, outperforming classification based on plaque thickness ≥3 mm (ROC-AUC 0.59, p = 0.04) and IPH presence (ROC-AUC 0.51, p = 0.003). SHAP identified plaque thickness and PVAT volume as the most influential features with potential thresholds of >2.6 mm and ≥112 mm³, respectively.f

Conclusions

ML model trained with noncalcified plaque and calcification features can classify culprit calcified carotid plaque better than conventional criteria. Using clinically interpretable features with SHAP, the model explained its decisions and suggested hypothesis-generating thresholds.

背景和目的：来源不明的栓塞性卒中（ESUS）可能与颈动脉斑块有关。方法：这是一项回顾性横断面研究。本文对单侧前循环ESUS合并颈动脉钙化斑块的患者进行了分析。钙化水平特征来源于手工分割。斑块水平特征由神经放射学家和半自动软件评估。如果斑块与卒中侧同侧，则归类为罪魁祸首。对八个分类器进行了基准测试，并进一步调整了梯度增强决策树（CatBoost）。SHAP解释了模型决策。结果：70例患者出现116个钙化斑块（270个钙化）。基于5个斑块和钙化水平特征的模型达到ROC-AUC（曲线下的受试者工作特征面积）0.79和精度-召回- auc 0.86，优于基于斑块厚度≥3 mm （ROC-AUC 0.59, p = 0.04）和IPH存在（ROC-AUC 0.51, p = 0.003）的分类。SHAP确定斑块厚度和PVAT体积是影响最大的特征，潜在阈值分别为>2.6 mm和≥112 mm3。f结论：具有非钙化斑块和钙化特征的ML模型比常规标准能更好地分类罪魁祸首钙化的颈动脉斑块。利用SHAP的临床可解释特征，该模型解释了其决策并提出了假设生成阈值。

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引用次数: 0

T1w/T2w Ratio Identifies the Basolateral Amygdala as a Preferential Target in Autoimmune Limbic Encephalitis T1w/T2w比值确定基底外侧杏仁核是自身免疫性边缘脑炎的优先靶点。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2026-01-22 DOI: 10.1111/jon.70120

Rakshit Dadarwal, Andre Dik, Laura Bierhansl, Noëmi Gmahl, Nils C. Landmeyer, Tobias J. Brix, Veronika K. Jaeger, Jochen Bauer, Wilhelm Küker, Heinz Wiendl, Christian E. Elger, Stjepana Kovac, Antje Bischof

Background and Purpose

The amygdala plays a key role in the pathophysiology of autoimmune limbic encephalitis (ALE), contributing to epileptic seizures and neuropsychiatric symptoms. While no study has examined microstructural changes in individual amygdala nuclei in ALE, we used the T1-weighted/T2-weighted (T1w/T2w) ratio to explore amygdalar pathology and its associations with clinical manifestations, including epilepsy and neuropsychiatric symptoms.

Methods

This single-center study examined 57 patients diagnosed with ALE and 16 healthy controls (HC). Patients underwent a comprehensive assessment that included clinical, electroencephalogram (EEG), magnetic resonance imaging (MRI), and neuropsychological assessments. Patients were stratified by epileptic focus based on long-term EEG. T1w/T2w ratio and volumetric measures of the amygdala and its nuclei were analyzed and correlated with epileptic focus and neuropsychiatric outcomes.

Results

EEG revealed 26 left temporal, 26 bitemporal, and five right temporal epileptic foci. The T1w/T2w ratio in the left amygdala was markedly reduced in patients with left temporal (p = 0.013) and bitemporal (p = 0.018) epileptic foci compared to HC. This reduction was most pronounced in the left basolateral complex (p = 0.011). Whereas amygdalar volumes were similar between patients and HC, exploratory analyses showed an increased volume of the left lateral nucleus in left temporal ALE (p = 0.036). Furthermore, we found no correlations between MRI measures and neuropsychiatric scores.

Conclusion

Our findings indicate that the basolateral complex of the amygdala is preferentially affected in ALE, suggesting a region-specific vulnerability to autoimmune-mediated inflammation. T1w/T2w ratio alterations reflect the epileptogenic focus and may serve as a clinically accessible, noninvasive biomarker for early diagnosis and treatment monitoring in ALE.

背景与目的：杏仁核在自身免疫性边缘脑炎（ALE）的病理生理中起关键作用，有助于癫痫发作和神经精神症状。虽然没有研究检查ALE患者个体杏仁核的微观结构变化，但我们使用t1加权/ t2加权（T1w/T2w）比率来探索杏仁核病理及其与临床表现（包括癫痫和神经精神症状）的关系。方法：本单中心研究检查了57例诊断为ALE的患者和16例健康对照（HC）。患者接受了包括临床、脑电图（EEG）、磁共振成像（MRI）和神经心理学评估在内的综合评估。根据长期脑电图对患者进行癫痫病灶分层。分析杏仁核及其核的T1w/T2w比值和体积测量与癫痫灶和神经精神预后的相关性。结果：脑电图显示左侧颞区26个，双颞区26个，右侧颞区5个。与HC相比，左侧颞叶（p = 0.013）和双颞叶（p = 0.018）癫痫灶患者左侧杏仁核T1w/T2w比值明显降低。这种减少在左基底外侧复合体中最为明显（p = 0.011）。尽管患者和HC之间的杏仁核体积相似，但探索性分析显示，左侧颞叶ALE的左侧外侧核体积增加（p = 0.036）。此外，我们发现MRI测量与神经精神病学评分之间没有相关性。结论：我们的研究结果表明，杏仁核基底外侧复合体在ALE中优先受到影响，表明对自身免疫介导的炎症具有区域特异性易感性。T1w/T2w比值的改变反映了致痫灶，可作为ALE早期诊断和治疗监测的临床可及、无创的生物标志物。

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引用次数: 0

Brain Microstructural Damage as Potential Biomarker of Immune Cell-Associated Neurotoxicity Syndrome 脑微结构损伤作为免疫细胞相关神经毒性综合征的潜在生物标志物

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2026-01-16 DOI: 10.1111/jon.70115

Caterina Lapucci, Massimiliano Gambella, Emilio Cipriano, Anna Maria Raiola, Riccardo Varaldo, Anna Ghiso, M. Centanaro, E. Capello, A. Schenone, Lucio Castellan, Laura Barletta, Emanuele Angelucci, Matilde Inglese

Background and Purpose

Chimeric antigen receptor–engineered T-cell (CAR-T) therapy in hematological malignancies may be associated with severe complications, as Cytokine Release Syndrome (CRS) and Immune effector Cell-Associated Neurotoxicity Syndrome (ICANS). The aim of the study is to investigate MRI-derived macrostructural and microstructural features potentially able to identify patients at higher ICANS risk.

Methods

Forty-two patients treated with CAR-T from October 2020 to June 2025 performed brain MRIs before CAR-T administration, including diffusion-weighted imaging. A general linear model was used to compare patients who developed ICANS, CRS, or neither at baseline in terms of MRI macro- and microstructural features. A binary logistic regression analysis was performed to evaluate the role of microstructural features in predicting the risk of developing ICANS.

Results

Mean age 59.2 ± 13 years, 59.5% male; 21 (50%) patients received tisagenlecleucel, 21 (50%), axicabtagene ciloleucel or brexucabtagene autoleucel; 14 (33%) and 31 (73.8%) patients developed ICANS and CRS, respectively. At baseline MRI, fluid-attenuated inversion recovery (FLAIR) white matter (WM) hyperintensities were detected in 41/42 (97.6%). No significant differences between patients who developed ICANS, CRS and neither both were observed in terms of FLAIR hyperintensities nor total brain volume at baseline. Fractional anisotropy extracted from FLAIR hyperintensities and WM areas without macroscopic abnormalities was a predictor of ICANS in the logistic regression model (p = 0.03 and 0.02, respectively).

Conclusions

FLAIR hyperintensities and brain volume prior to CAR-T were not informative, whereas the severity of WM microstructural (axonal) damage predicted ICANS risk. Greater axonal damage was associated with a higher likelihood of ICANS.

背景和目的：嵌合抗原受体工程t细胞（CAR-T）治疗血液系统恶性肿瘤可能与严重的并发症相关，如细胞因子释放综合征（CRS）和免疫效应细胞相关神经毒性综合征（ICANS）。该研究的目的是研究mri衍生的宏观结构和微观结构特征，这些特征可能能够识别ICANS高风险患者。方法：2020年10月至2025年6月，42例接受CAR-T治疗的患者在CAR-T给药前进行了脑部mri检查，包括弥散加权成像。在MRI宏观和微观结构特征方面，采用一般线性模型比较发生ICANS、CRS或在基线时均未发生ICANS的患者。采用二元逻辑回归分析来评估微观结构特征在预测发生ICANS风险中的作用。结果：平均年龄59.2±13岁，男性59.5%；21例（50%）患者接受了tisagenlecleucel， 21例（50%）患者接受了axicabtagene ciloleucel或brexucabtagene autooleucel；14例（33%）和31例（73.8%）患者发生ICANS和CRS。在基线MRI中，41/42（97.6%）检测到液体衰减反转恢复（FLAIR）白质（WM）高信号。在发生ICANS、CRS的患者之间，在FLAIR高强度和基线时的总脑容量方面没有观察到显著差异。在逻辑回归模型中，从FLAIR高信号和无宏观异常的WM区域提取的分数各向异性是ICANS的预测因子（p分别= 0.03和0.02）。结论：CAR-T前的FLAIR高信号和脑容量不能提供信息，而WM微结构（轴突）损伤的严重程度可以预测ICANS的风险。轴突损伤越大，ICANS发生的可能性越大。

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引用次数: 0

Disrupted Sensorimotor Network Integration in Women With Fibromyalgia Revealed by Resting-State Functional MRI 静息状态功能MRI显示女性纤维肌痛患者感觉运动网络整合中断。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2026-01-10 DOI: 10.1111/jon.70118

Gina Rodrigues de Oliveira, Tamires Morett Gama, Lucas Rego Ramos, Marcos Fabio DosSantos

Background and Purpose

Fibromyalgia (FM) is a chronic syndrome characterized by widespread musculoskeletal pain, hypersensitivity, and cognitive impairments. Alterations in brain functional connectivity have been suggested as possible mechanisms underlying pain amplification in these patients. This study aimed to investigate patterns of brain functional connectivity in patients with FM using resting-state functional magnetic resonance imaging.

Methods

Data were obtained from the public OpenNeuro repository and acquired on a 3 Tesla scanner. The sample consisted of 33 women with a clinical diagnosis of FM (x̅ = 41.73 ± 6.09 years) and 33 age-matched healthy controls (x̅ = 41.52 ± 6.03 years), with no significant differences in age (p = 0.89) or education level (p = 0.81). Images were processed and analyzed using independent component analysis. Between-group comparisons were corrected for multiple comparisons using false discovery rate (FDR) correction (p < 0.05).

Results

Patients with FM showed a significant reduction in functional connectivity within the right sensorimotor network (SMN) compared to controls (p-FDR < 0.05). Moreover, a negative correlation was observed between connectivity in this network and the sensory dimension of pain assessed by the McGill Pain Questionnaire (r = −0.35; p = 0.05).

Conclusion

The reduced functional connectivity within the SMN may represent a neurobiological marker of FM, reflecting dysfunctions in sensorimotor integration and central modulation of pain. These findings support the hypothesis that FM involves functional brain alterations related to pain perception and amplification.

背景和目的：纤维肌痛（FM）是一种以广泛的肌肉骨骼疼痛、过敏和认知障碍为特征的慢性综合征。脑功能连接的改变被认为是这些患者疼痛放大的可能机制。本研究旨在利用静息状态功能磁共振成像研究FM患者的脑功能连接模式。方法：数据来自OpenNeuro公共数据库，并在3特斯拉扫描仪上获取。样本由33名临床诊断为FM的女性（x′s = 41.73±6.09岁）和33名年龄匹配的健康对照（x′s = 41.52±6.03岁）组成，年龄（p = 0.89）和文化程度（p = 0.81）无显著差异。采用独立分量分析对图像进行处理和分析。结果：与对照组相比，FM患者右侧感觉运动网络（SMN）功能连通性显著降低（p-FDR）。结论：SMN功能连通性降低可能是FM的神经生物学标志物，反映了感觉运动整合和中枢疼痛调节功能障碍。这些发现支持了FM涉及与疼痛感知和放大相关的功能性大脑改变的假设。

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引用次数: 0

Diffusion Kurtosis Shows a Smaller Ischemic Core Versus Diffusion-Weighted MR in Early or Subacute Post-Thrombectomy Stroke 弥散峰度显示早期或亚急性取栓后卒中与弥散加权MR相比，缺血核心较小。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-12-19 DOI: 10.1111/jon.70114

Christopher Steward, Vijay Venkatraman, Victoria Mercy Kataike, Peter J. Mitchell, Bruce C. V. Campbell, Patricia M. Desmond, Felix Ng

Background and Purpose

Diffusion-weighted imaging (DWI) is the gold standard for assessing ischemic core in acute stroke but may overestimate irreversible injury due to its assumption of Gaussian diffusion. Diffusion kurtosis imaging (DKI), which accounts for non-Gaussian water diffusion, may provide more accurate tissue characterization. Most prior studies examined DWI and DKI within 24 h or up to 1 month after stroke, but very few have captured both an ultra-early (e.g., 3-h) postreperfusion and a subacute (24–72 h) imaging window in the same population. This study compared DWI and DKI for measuring ischemic core evolution after reperfusion.

Methods

Fifty-two patients with anterior circulation large vessel occlusion stroke underwent endovascular thrombectomy and were imaged with both DWI and DKI at <3 h and again at 24–72 h postreperfusion in a prospective multicenter longitudinal cohort study. Lesion volumes for DWI and DKI were manually segmented to derive a mismatch between DWI and DKI, and reversal between the two time points. Diffusion metrics (apparent diffusion coefficient [ADC] and mean kurtosis [MK]) within regions of interest were also analyzed.

Results

DKI lesion volumes were significantly smaller than DWI at both time points (DWI 11.1 mL vs. DKI 8.5 mL, p = 0.007 at 3 h, and DWI 27.9 mL vs. DKI 19.3 mL, p = 0.002 at 24–72 h), with both increasing significantly over time. DKI(+ve)–DWI(-ve) mismatch regions showed higher ADC and lower MK, indicating less severe injury. The percentage amount of lesion that reversed in relation to the entire infarct was similar for both modalities (DWI: 15.9%, DKI: 12.4%, p > 0.05).

Conclusion

DKI offers additional information to DWI for identifying irreversibly injured tissue in acute stroke, with smaller lesion volumes and further information on tissue microstructure that reversed. These findings suggest DKI may enhance ischemic core assessment and help guide treatment decisions after reperfusion therapy.

背景与目的：弥散加权成像（DWI）是评估急性脑卒中缺血性核心的金标准，但由于其假设为高斯弥散，可能会高估不可逆损伤。扩散峰度成像（DKI），它解释了非高斯水扩散，可以提供更准确的组织表征。大多数先前的研究在卒中后24小时或1个月内检查DWI和DKI，但很少有研究在同一人群中同时捕获超早期（例如，灌注后3小时）和亚急性（24-72小时）成像窗口。本研究比较了DWI和DKI对再灌注后缺血核心演变的测量。方法：52例前循环大血管闭塞性卒中患者行血管内取栓术，并在2个时间点同时行DWI和DKI成像。结果：DKI病变体积在两个时间点均明显小于DWI (3 h时DWI 11.1 mL vs DKI 8.5 mL, p = 0.007； 24-72 h时DWI 27.9 mL vs DKI 19.3 mL, p = 0.002)，且随时间推移两者均显著增加。DKI(+ve)-DWI（-ve）失配区ADC较高，MK较低，说明损伤程度较轻。两种方式的病变逆转百分比与整个梗死区相似（DWI: 15.9%, DKI: 12.4%, p < 0.05）。结论：DKI为DWI识别急性卒中不可逆损伤组织提供了额外的信息，病变体积更小，组织微观结构的进一步信息相反。这些发现表明DKI可以增强缺血核心评估，并有助于指导再灌注治疗后的治疗决策。

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引用次数: 0

Subregional Amygdala Functional Connectivity at 3T: Comparison of High-Resolution 2D and 3D fMRI Acquisitions 3T分区域杏仁核功能连通性：高分辨率2D和3D fMRI采集的比较。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-12-17 DOI: 10.1111/jon.70110

Sheryl L. Foster, Ramon Landin-Romero, Sarah Lewis, Mayuresh S. Korgaonkar

Background and Purpose

Amygdala dysfunction is implicated in major depressive disorder. Despite wide acknowledgement of its heterogeneity, the amygdala is predominantly considered as a single entity and functional connectivity investigations have reported findings using standard or low spatial resolution functional MRI data. This study compared the capabilities of two high spatial resolution acquisition strategies, the gold standard 2D and a novel 3D, in identifying amygdala functional connectivity to other brain regions at a subregional level.

Methods

Resting state fMRI data were acquired at 3T in 10 healthy controls using both versions of a Gradient-Echo Echo Planar Imaging (GRE-EPI) sequence. Whole brain voxel-wise functional connectivity measures were calculated using the whole amygdala and six subregional seed regions-of-interest; left and right basolateral, centromedial and superficial.

Results

The 3D data identified multiple stronger bilateral connections between both centromedial subregions, most notably to subcortical structures including brainstem and hippocampus, as well as intra-amygdala subregional connections. The 2D data displayed stronger connections to several cortical regions. Whole amygdala and subregional FC results differed.

Conclusions

This study identified underutilized capability in current fMRI acquisition techniques at 3T. 2D GRE-EPI sequences optimized for high spatial resolution with voxel volumes of 15.6 mm³ capably demonstrate functional connectivity patterns of the amygdala at a subregional level, allowing interrogation of heterogeneous amygdala function at a more granular level. The novel 3D acquisition with voxel volumes of 8 mm³ showed promise in outperforming its 2D counterpart in identifying amygdala subregional connections to other subcortical structures that are traditionally difficult to image well.

背景与目的：杏仁核功能障碍与重度抑郁症有关。尽管人们广泛承认杏仁核的异质性，但它主要被认为是一个单一的实体，功能连通性调查已经报告了使用标准或低空间分辨率功能MRI数据的结果。本研究比较了两种高空间分辨率获取策略的能力，即黄金标准2D和一种新型3D，在次区域水平上识别杏仁核与其他大脑区域的功能连接。方法：使用两种版本的梯度-回声回声平面成像（GRE-EPI）序列，在3T时获得10名健康对照的静息状态fMRI数据。使用整个杏仁核和六个分区域感兴趣的种子区域计算全脑体素功能连接测量；左右基底外侧，中央内侧和浅表。结果：3D数据显示，在两个中央内侧亚区之间存在多个更强的双侧连接，最明显的是皮层下结构，包括脑干和海马，以及杏仁核内次区域连接。二维数据显示与几个皮质区域的连接更强。整个杏仁核和分区域FC结果不同。结论：本研究确定了当前fMRI 3T采集技术未充分利用的能力。二维grei - epi序列优化为高空间分辨率，体素体积为15.6 mm3，能够在次区域水平上展示杏仁核的功能连接模式，允许在更细粒度的水平上询问异质杏仁核功能。体素体积为8 mm3的新型3D采集技术在识别杏仁核与其他皮质下结构之间的分区域连接方面优于2D成像技术，这些结构在传统上很难成像。

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引用次数: 0

Beyond Parkinson's Disease: A Narrative Review of Neuromelanin MRI in Neurodegenerative Diseases 超越帕金森病：神经退行性疾病中神经黑色素MRI的叙述性回顾。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-11-30 DOI: 10.1111/jon.70113

Anushree Burade, Dhairya A. Lakhani, Richard Dagher, John Anosh, Haris I. Sair, Licia P. Luna

Background and Purpose

Neuromelanin-sensitive magnetic resonance imaging (NM-MRI) is an emerging noninvasive biomarker of catecholaminergic neurons. It assesses neuromelanin-rich regions such as the substantia nigra pars compacta (SNc) and locus coeruleus (LC). Although initially developed for Parkinson's disease (PD), evidence supports broader utility. This narrative review highlights the diagnostic and prognostic applications of NM-MRI in PD, atypical parkinsonian syndromes, spinocerebellar ataxias (SCA), and Alzheimer's disease (AD), while evaluating methodological heterogeneity, diagnostic performance across diseases, and directions for clinical implementation.

Results

In PD, reduced SNc volume and contrast-to-noise ratio (CNR) correlate with motor symptom severity. Early-stage PD shows lateral SNc signal attenuation progressing ventromedially with disease advancement. NM-MRI sensitivity and specificity range from 70%–92% to 65%–89%, respectively, with higher accuracy at 7T. In progressive supranuclear palsy (PSP), SNc degeneration is more pronounced medially; LC contrast ratio (CR) is elevated compared to PD. In multiple system atrophy (MSA), LC signal attenuation is particularly marked in the parkinsonian subtype (MSA-P). NM-MRI findings in SCA (notably SCA2 and SCA7) vary by genotype; AD is characterized by reduction in the middle and caudal segments of LC, reflecting early tau pathology. NM-MRI LC signal reduction variably correlates with cognitive scores and Braak staging, suggesting potential as a preclinical biomarker.

Conclusion

NM-MRI holds promise for early diagnosis and monitoring of neurodegenerative diseases. While its role in PD is well established, emerging data in PSP, MSA, SCA, and AD suggest wider applicability. Standardization, multimodal imaging integration, and machine learning are critical for clinical translation.

背景与目的：神经黑色素敏感磁共振成像（NM-MRI）是一种新兴的儿茶酚胺能神经元的无创生物标志物。它评估了富含神经黑色素的区域，如黑质致密部（SNc）和蓝斑（LC）。虽然最初是为帕金森病（PD）开发的，但证据支持更广泛的应用。本文综述了纳米磁共振成像在帕金森病、非典型帕金森综合征、脊髓小脑共济失调（SCA）和阿尔茨海默病（AD）中的诊断和预后应用，同时评估了方法的异质性、不同疾病的诊断性能和临床应用方向。结果：在PD中，SNc体积和噪声对比比（CNR）的减少与运动症状的严重程度相关。早期PD表现为SNc信号随疾病进展向腹内方向减弱。NM-MRI的敏感性和特异性分别为70%-92%和65%-89%，在7T时准确率更高。在进行性核上性麻痹（PSP）中，SNc变性在内侧更为明显；LC对比比（CR）较PD升高。在多系统萎缩（MSA）中，LC信号衰减在帕金森亚型（MSA- p）中尤为明显。SCA（尤其是SCA2和SCA7）的NM-MRI表现因基因型而异；AD的特点是LC的中部和尾端节段减少，反映了早期tau病理。纳米核磁共振LC信号减少与认知评分和Braak分期有不同的相关性，提示有可能作为临床前生物标志物。结论：纳米核磁共振成像对神经退行性疾病的早期诊断和监测具有重要意义。虽然其在PD中的作用已经确立，但在PSP、MSA、SCA和AD中的新数据表明其具有更广泛的适用性。标准化、多模态成像集成和机器学习对临床翻译至关重要。

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引用次数: 0

Neurodegeneration With Brain Iron Accumulation and Ferroptosis Disorders in Children and Adults: An Imaging Review 儿童和成人伴脑铁积累和铁下垂的神经退行性疾病：影像学回顾。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-11-30 DOI: 10.1111/jon.70112

Livja Mertiri, Maarten Lequin, Andrea Rossi, Chen Hoffmann, Thierry A. G. M. Huisman

Neurodegeneration with brain iron accumulation (NBIA) refers to a group of rare genetic disorders characterized by abnormal iron deposition in the basal ganglia and brainstem due to impaired iron homeostasis. Disease severity and manifestations vary according to the underlying genetic mutation and age of presentation; however, most subtypes share progressive neurological features such as dystonia, Parkinsonism, spasticity, cognitive decline, and intellectual disability.

In this review, we first outline the physiological role of iron in the central nervous system, emphasizing its importance for neurotransmitter synthesis, myelination, and mitochondrial metabolism, and discuss how disruption of homeostatic mechanisms may lead to ferroptosis and neuronal injury. We then explore the role of neuroimaging in the diagnosis of NBIA, with a focus on MRI as the modality of choice. Finally, we provide an overview of the clinical and imaging features of the major NBIA subtypes, highlighting both shared characteristics and distinctive patterns. Covered NBIA include primary disorders of iron metabolism, such as neuroferritinopathy and aceruloplasminemia, and secondary disorders with disrupted iron regulation, including Pantothenate Kinase-Associated Neurodegeneration, Phospholipase A2 Group VI-Associated Neurodegeneration, Mitochondrial Membrane Protein-Associated Neurodegeneration, Beta-Propeller Protein-Associated Neurodegeneration, Fatty Acid Hydroxylase-Associated Neurodegeneration, Coenzyme A Synthetase Protein-Associated Neurodegeneration, Woodhouse–Sakati syndrome, and Kufor–Rakeb Disease. By integrating genetics, pathophysiology, and imaging, this review aims to improve recognition of NBIA and support comprehensive clinical management.

神经变性伴脑铁积累（Neurodegeneration with brain iron accumulation， NBIA）是指一组罕见的遗传性疾病，其特征是铁稳态受损导致基底节区和脑干的铁沉积异常。疾病的严重程度和表现因潜在的基因突变和发病年龄而异；然而，大多数亚型具有进行性神经学特征，如肌张力障碍、帕金森症、痉挛、认知能力下降和智力残疾。在这篇综述中，我们首先概述了铁在中枢神经系统中的生理作用，强调了它在神经递质合成、髓鞘形成和线粒体代谢中的重要性，并讨论了体内平衡机制的破坏如何导致铁中毒和神经元损伤。然后，我们探讨了神经影像学在NBIA诊断中的作用，重点是MRI作为选择的方式。最后，我们概述了NBIA主要亚型的临床和影像学特征，强调了它们的共同特征和独特模式。涵盖的NBIA包括铁代谢的原发性疾病，如神经铁蛋白病和乙酰纤溶酶血症，以及铁调节紊乱的继发性疾病，包括泛酸激酶相关神经变性、磷脂酶A2组vi相关神经变性、线粒体膜蛋白相关神经变性、β - propeller蛋白相关神经变性、脂肪酸羟化酶相关神经变性、辅酶A合成酶蛋白相关神经变性、Woodhouse-Sakati综合征和Kufor-Rakeb病。通过整合遗传学、病理生理学和影像学，本综述旨在提高对NBIA的认识，并为全面的临床管理提供支持。

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引用次数: 0