Journal of Neuroimaging最新文献_第5页

Optic Nerve Sheath Diameter: Which Axis Should Be Measured? 视神经鞘直径：应测量哪个轴？

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-08-03 DOI: 10.1111/jon.70076

Jakob Pansell, Tina Thomsson, Emelie Eng, Andreas Wallin, Mohammad Hirzallah

Background and purpose

Optic nerve sheath diameter (ONSD) measured by point-of-care ultrasound (POCUS) is a commonly used non-invasive estimate of intracranial pressure (ICP). However, methodological variations limit standardization of this promising technique. Different imaging axes are identified as one such source of ONSD POCUS methodological variation. This study aimed to evaluate the agreement and diagnostic accuracy for elevated ICP between transverse and sagittal ONSD measurements.

Methods

We conducted a post-hoc analysis of 213 intensive care patients from three prior studies. ONSD was measured in both transverse and sagittal planes, externally (ONSDext) and internally (ONSDint) of the dura mater. Agreement was assessed using Lin's concordance correlation coefficient (CCC). Diagnostic accuracy for detecting ICP ≥20 mmHg was evaluated using area under the receiver operator characteristics curve (AUROC) analyses in a subset of 139 patients.

Results

Sagittal ONSD was significantly larger than transverse ONSD (median difference 0.2 mm, p<0.001). Agreement between transverse and sagittal ONSD was poor (CCC: 0.65 and 0.70 for right and left side ONSDext, and 0.43 and 0.51 for right and left side ONSDint). No significant differences in AUROC were found between transverse, sagittal, or averaged measurements.

Conclusions

Transverse and sagittal ONSD measurements are not interchangeable due to significant differences and poor agreement. Diagnostic accuracy was similar across methods. These findings support continued use of transverse measurement as the standard approach for ONSD POCUS in clinical practice.

背景与目的视神经鞘直径（ONSD）是一种常用的无创颅内压（ICP）测量方法。然而，方法上的差异限制了这项有前途的技术的标准化。不同的成像轴被认为是ONSD POCUS方法差异的一个来源。本研究旨在评估横向和矢状面ONSD测量之间ICP升高的一致性和诊断准确性。方法：我们对之前三项研究中的213例重症监护患者进行了事后分析。在横切面和矢状面，硬脑膜外部（ONSDext）和内部（ONSDint）测量ONSD。采用Lin’s一致性相关系数（CCC）评价一致性。对139例患者进行受试者操作特征曲线下面积（AUROC）分析，评估检测ICP≥20 mmHg的诊断准确性。结果矢状面ONSD明显大于横面ONSD（中位数差0.2 mm, p<0.001）。横向和矢状面ONSD的一致性较差（左右两侧ONSDext的CCC分别为0.65和0.70，左右两侧ONSDint的CCC分别为0.43和0.51）。横切面、矢状面或平均测量的AUROC无显著差异。结论横切面和矢状面ONSD测量结果差异显著且一致性差，不能互换。不同方法的诊断准确性相似。这些发现支持在临床实践中继续使用横向测量作为ONSD POCUS的标准方法。

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引用次数: 0

SPECT Cerebral Perfusion Patterns in Isolated Cervical Dystonia 孤立性颈肌张力障碍的SPECT脑灌注模式

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-08-03 DOI: 10.1111/jon.70073

Byungseok Kim, Ik-Dong Yoo, Hyeonseok S. Jeong, Yong-An Chung, In-Uk Song

Background and Purpose

Isolated cervical dystonia is characterized by sustained or intermittent neck movements caused by involuntary muscle contractions, resulting in abnormal movements or postures of cervical areas. We measured altered regional cerebral blood flow (rCBF) in patients with idiopathic cervical dystonia compared to healthy controls and explored the correlation between dystonia severity and rCBF patterns.

Methods

A total of 38 patients with isolated cervical dystonia and 29 healthy controls were recruited. All subjects underwent Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS) and Tc-99m HMPAO SPECT; TWSTRS was used to assess the severity of dystonia. rCBF was compared between groups using voxel-wise statistical analyses. Associations between rCBF in significant clusters and TWSTRS scores were examined using linear regression.

Results

Compared with controls, patients with cervical dystonia exhibited reduced rCBF in brain regions implicated in sensory processing, motor control, and higher cognitive functions, including the left middle temporal gyrus, right postcentral gyrus, right lingual gyrus, left precuneus, right temporal pole, right middle cingulate gyrus, and right anterior cingulate gyrus. Although reduced rCBF was observed in seven regions, only the right temporal pole showed a significant correlation with TWSTRS motor scores. Reduced rCBF in the right temporal pole negatively correlated with higher TWSTRS scores in dystonia patients.

Conclusion

The negative correlation between reduced rCBF in the right temporal pole and increased TWSTRS scores highlights a potential association between altered cerebral perfusion and dystonic symptom severity. Understanding these alterations could offer insights into the neurobiological basis of cervical dystonia, aiding targeted therapeutic interventions.

背景和目的孤立性颈肌张力障碍的特点是由不随意肌收缩引起的持续或间歇的颈部运动，导致颈部区域的异常运动或姿势。与健康对照相比，我们测量了特发性宫颈肌张力障碍患者区域脑血流量（rCBF）的变化，并探讨了肌张力障碍严重程度与rCBF模式之间的相关性。方法选取孤立性宫颈张力障碍患者38例，健康对照29例。所有受试者均接受多伦多西部痉挛性斜颈评定量表（TWSTRS）和Tc-99m HMPAO SPECT检查；采用TWSTRS评估肌张力障碍的严重程度。采用体素统计分析比较两组间rCBF。使用线性回归检验显著簇rCBF与TWSTRS评分之间的关系。结果与对照组相比，颈张力障碍患者表现出与感觉加工、运动控制和高级认知功能相关的脑区rCBF减少，包括左侧颞中回、右侧中央后回、右侧舌回、左侧楔前叶、右侧颞极、右侧扣带中回和右侧扣带前回。虽然在7个区域观察到rCBF减少，但只有右颞极与TWSTRS运动评分显着相关。肌张力障碍患者右颞极rCBF减少与TWSTRS评分升高呈负相关。结论右颞极rCBF减少与TWSTRS评分升高呈负相关，提示脑灌注改变与张力障碍症状严重程度之间存在潜在关联。了解这些改变可以深入了解颈肌张力障碍的神经生物学基础，有助于有针对性的治疗干预。

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引用次数: 0

Sex Differences in White Matter Structure in Attention Deficit Hyperactivity Disorder: MR Diffusion Fixel-Based Analysis 注意缺陷多动障碍患者白质结构的性别差异：基于MR扩散固定的分析

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-08-01 DOI: 10.1111/jon.70072

Yan Yu, Jiancheng Fu, Meihao Wang, Ronghui Zhou, Chenhao Shan, Xinye Sun, Yuanjing Feng

Background and Purpose

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder prevalent among adolescents and exhibits notable sex dimorphism. Despite an increasing body of research, the impact of sex on ADHD remains underexplored. This study aimed to examine sex differences in white matter organization in children with ADHD using magnetic resonance (MR) diffusion data analyzed with fixel-based analysis (FBA), a novel technique that enables detailed assessment of both microstructural and macrostructural properties of white matter.

Methods

Fifty-five children with ADHD and 37 age-matched typically developing controls underwent MR diffusion. FBA was used to assess white matter structure. Group comparisons examined sex differences within and between groups, and correlation analyses were conducted between white matter features and clinical symptoms in the ADHD group.

Results

The results demonstrated that no significant sex differences were identified among healthy controls. However, within the ADHD group, the fiber cross-section (FC) metric revealed significant white matter alterations in several tracts, including the arcuate fasciculus, corpus callosum (CC), cingulum (CG), superior longitudinal fascicle, striato-fronto-orbital (ST_FO), and striato-precentral. In addition, the fiber density and cross-section metrics showed comparable abnormalities in the CC, CG, and ST_FO. Females with ADHD showed stronger correlations between FC metrics in bundles of white matter and clinical symptoms.

Conclusions

This study is the first to demonstrate sex differences in ADHD white matter bundles using FBA, contributing to a deeper understanding of the pathological mechanisms of ADHD and offering new insights for its diagnosis and treatment.

背景与目的注意缺陷多动障碍（ADHD）是一种在青少年中普遍存在的神经发育障碍，表现出明显的性别二态性。尽管有越来越多的研究，但性对多动症的影响仍未得到充分探讨。本研究旨在研究ADHD儿童白质组织的性别差异，使用基于固定蛋白分析（FBA）的磁共振（MR）扩散数据进行分析，FBA是一种能够详细评估白质微观结构和宏观结构特性的新技术。方法55例ADHD患儿和37例年龄匹配的典型发育对照进行磁共振扩散检查。FBA评价脑白质结构。组间比较检查了组内和组间的性别差异，并分析了ADHD组中白质特征与临床症状之间的相关性。结果结果显示，在健康对照组中，性别差异不显著。然而，在ADHD组中，纤维横截面（FC）测量显示几个束的白质明显改变，包括弓状束、胼胝体（CC）、扣带（CG）、上纵束、纹状体-额-眶（ST_FO）和纹状体-中央前。此外，纤维密度和横截面指标显示CC、CG和ST_FO有类似的异常。患有ADHD的女性在白质束中的FC指标与临床症状之间表现出更强的相关性。结论本研究首次利用FBA分析ADHD白质束的性别差异，有助于深入了解ADHD的病理机制，为ADHD的诊断和治疗提供新的见解。

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引用次数: 0

Endovascular Therapy Outcomes for Cerebral Vasospasm in Poor-Grade Aneurysmal Subarachnoid Hemorrhage 低级别动脉瘤性蛛网膜下腔出血脑血管痉挛的血管内治疗结果

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-07-31 DOI: 10.1111/jon.70066

Rami Fakih, Ibrahim A. Bhatti, Rehan Ahmed, Xiaoyu Ma, Syed A. Gillani, Farhan Siddiq, Camilo R. Gomez, Adnan I. Qureshi

Background and Purpose

The impact of endovascular therapy (EVT) on outcomes in World Federation of Neurological Societies (WFNS) grade ≥ 4 aneurysmal subarachnoid hemorrhage (aSAH) remains unclear.

Methods

We conducted a retrospective cohort study of 80 patients with WFNS grade ≥ 4 aSAH and secondary vasospasm treated between 2010 and 2023. EVT included intra-arterial vasodilators and/or balloon angioplasty. The primary outcome was favorable functional status at 90 days (modified Rankin Scale 0–3). Multivariable logistic regression was used to assess associations between EVT and outcomes, adjusting for age, sex, and time-to-aneurysm securement.

Results

EVT was performed in 77.5% of patients (n = 62). Favorable outcomes occurred in occurred in 42.5% of all patients (n = 34), and were significantly more frequent in the EVT group (48.4% versus 22.2%; p = 0.038). EVT was independently associated with greater odds of favorable outcome (adjusted odds ratio [aOR] 3.15, 95% confidence interval [CI] 1.12–8.85; p = 0.030) and reduced mortality (aOR 0.24, 95% CI 0.07–0.82; p = 0.023). Early aneurysm treatment (≤ 12 h) also independently predicted favorable outcomes (aOR 2.38, p = 0.044) and lower mortality (aOR 0.42, p = 0.045).

Conclusions

Among patients with poor-grade aSAH and vasospasm, EVT was independently associated with improved functional outcomes and survival. These findings challenge historical nihilism and support timely, aggressive endovascular intervention as a critical component of care in this high-risk population.

背景与目的血管内治疗（EVT）对世界神经学会联合会（WFNS）分级≥4级动脉瘤性蛛网膜下腔出血（aSAH）预后的影响尚不清楚。方法对2010年至2023年间80例WFNS分级≥4级aSAH伴继发性血管痉挛患者进行回顾性队列研究。EVT包括动脉内血管扩张和/或球囊血管成形术。主要终点为90天的良好功能状态（修正Rankin量表0-3）。采用多变量逻辑回归评估EVT与预后之间的关系，调整年龄、性别和动脉瘤固定时间。结果62例（77.5%）患者行EVT。42.5%的患者（n = 34）出现了良好结果，EVT组出现良好结果的频率更高(48.4% vs 22.2%；P = 0.038)。EVT与更大的有利结局几率独立相关(调整优势比[aOR] 3.15, 95%可信区间[CI] 1.12-8.85；p = 0.030)和降低死亡率(aOR 0.24, 95% CI 0.07-0.82；P = 0.023)。动脉瘤早期治疗（≤12 h）也独立预测了良好的预后（aOR 2.38, p = 0.044）和较低的死亡率（aOR 0.42, p = 0.045）。结论：在低度aSAH和血管痉挛患者中，EVT与改善功能结局和生存率独立相关。这些发现挑战了历史虚无主义，并支持及时、积极的血管内干预作为高危人群护理的关键组成部分。

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引用次数: 0

Neuroimaging Training Programs, Certification Pathways, and Credentialing Issues 神经影像学培训计划，认证途径和认证问题

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-07-31 DOI: 10.1111/jon.70049

Syeda Maria Muzammil, Yasaman Pirahanchi, Ammar Tarabichi, Joseph C. Masdeu

Neurologists have a unique ability to interpret neuroimaging in conjunction with clinical context and disease pathology, making their role vital in accurate interpretation. Neuroimaging education is essential for enhancing these skills, typically provided through neurology residency programs and specialized neuroimaging fellowships. Neuroimaging training experience in neurology residency programs can be quite variable. Neurology residents typically gain substantial exposure to neuroimaging techniques through the sheer volume of cases they encounter during training, often under direct guidance of subspeciality neurologists. However, curriculum implementation and proper documentation of training often lacks consistency, and opportunities for advanced neuroimaging training are limited. The number of fellowship-trained neuroimaging specialists is insufficient to meet the growing demand for neuroimaging expertise. Credentialing and certification issues related to neuroimaging training for neurologists hinder the integration of qualified neurologists into the neuroimaging field. The need for additional years of specialized training, financial burden associated with maintaining certification, opposition by radiological societies, complexities of reimbursement which vary by insurer, region, and hospital policies are some of the challenges. This article explores these issues and suggests that solutions may include the establishment of more accredited neuroimaging fellowship programs or an increase in the neuroimaging component of subspecialty training, as well as addressing credentialing and hospital privileging issues.

神经科医生有独特的能力来解释神经影像学结合临床背景和疾病病理，使他们的作用在准确的解释至关重要。神经影像学教育对于提高这些技能至关重要，通常通过神经内科住院医师项目和专门的神经影像学奖学金提供。神经内科住院医师项目的神经影像学培训经验可能非常多变。神经内科住院医师通常在亚专科神经科医生的直接指导下，通过在培训期间遇到的大量病例，获得大量接触神经影像学技术的机会。然而，课程实施和适当的培训文件往往缺乏一致性，并且高级神经影像学培训的机会有限。研究金训练的神经影像专家的数量不足以满足对神经影像专业知识日益增长的需求。与神经科医生的神经影像学培训相关的资格和认证问题阻碍了合格的神经科医生融入神经影像学领域。需要额外年数的专业培训、与维持认证相关的经济负担、放射学会的反对、因保险公司、地区和医院政策而异的报销复杂性是一些挑战。本文探讨了这些问题，并建议解决方案可能包括建立更多认可的神经影像学奖学金计划或增加亚专科培训的神经影像学组成部分，以及解决证书和医院特权问题。

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引用次数: 0

Multimodal Quantitative MRI Atlas of the Human Brain in Healthy Young Adults 健康年轻人大脑的多模态定量MRI图谱

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-07-25 DOI: 10.1111/jon.70074

Julia Pfirrmann, Anne Adlung, Ingo Hermann, Claudia E. Weber, Anne Ebert, Frank G. Zöllner, Achim Gass, Philipp Eisele

Background and Purpose

Quantitative MRI provides insights into (patho-) physiological processes of the brain macro- and microstructure. In this study, we applied a multimodal MRI approach to determine quantitative values of the brain in healthy young adults.

Methods

3 T MRI including sodium MRI (4.0 mm nominal isotropic resolution), 3D T1-weighted magnetization-prepared rapid acquisition gradient-echo (spatial resolution = 0.9 mm × 0.9 mm × 0.9 mm), T2-fluid attenuated inversion recovery (spatial resolution = 0.4 mm × 0.4 mm × 5.0 mm), diffusion-weighted imaging (spatial resolution = 1.0 mm × 1.0 mm × 4.0 mm), PD/T2 (spatial resolution = 1.0 mm × 1.0 mm × 2.0 mm), and MR fingerprinting including T1 and T2* relaxation times (spatial resolution = 1 mm × 1 mm × 2 mm) was performed on 40 healthy young adults (28 women, mean age: 24.55 years).

Results

Mean values for the gray matter were as follows—apparent diffusion coefficient (ADC): 0.95 ± 0.03 × 10⁻³ mm²/s, total sodium concentration (TSC): 41.99 ± 2.35 mM, T1: 1338.04 ± 46.29 ms, T2*: 63.39 ± 2.94 ms. For the white matter, mean values were as follows—ADC: 0.79 ± 0.02 × 10⁻³ mm²/s, TSC: 36.08 ± 5.62 mM, T1: 968.47 ± 48.35 ms, T2*: 53.62 ± 8.06 ms, and for the deep gray matter, mean values were as follows—ADC: 0.85 ± 0.04 × 10⁻³ mm²/s, TSC: 38.23 ± 2.91 mM, T1: 1087.24 ± 39.77 ms, T2*: 54.53 ± 7.15.

Conclusion

Our multimodal, quantitative MRI atlas of the human brain in healthy young adults provides meaningful in vivo insights into the brain microstructure and can be used for reference in future studies.

背景与目的定量MRI提供了对大脑宏观和微观结构（病理）生理过程的深入了解。在这项研究中，我们应用多模态MRI方法来确定健康年轻人大脑的定量值。方法3 T MRI包括钠核磁共振（4.0 mm名义各向同性分辨率）、三维t1加权磁化制备快速采集梯度回波（空间分辨率= 0.9 mm × 0.9 mm × 0.9 mm）、T2流体衰减反演恢复（空间分辨率= 0.4 mm × 0.4 mm × 5.0 mm）、弥散加权成像（空间分辨率= 1.0 mm × 1.0 mm × 4.0 mm）、PD/T2（空间分辨率= 1.0 mm × 1.0 mm × 2.0 mm）、对40例健康青年（女性28例，平均年龄24.55岁）进行T1和T2*弛豫时间（空间分辨率= 1 mm × 1 mm × 2 mm） MR指纹识别。结果脑灰质表观扩散系数（ADC）平均值：0.95±0.03 × 10−3 mm2/s，总钠浓度（TSC）： 41.99±2.35 mM, T1: 1338.04±46.29 ms, T2*: 63.39±2.94 ms。白质平均值为：adc: 0.79±0.02 × 10−3 mm2/s, TSC: 36.08±5.62 mM, T1: 968.47±48.35 ms, T2*: 53.62±8.06 ms；深灰质平均值为：adc: 0.85±0.04 × 10−3 mm2/s, TSC: 38.23±2.91 mM, T1: 1087.24±39.77 ms, T2*: 54.53±7.15。结论我们的多模态、定量的健康年轻人大脑MRI图谱提供了对大脑微观结构有意义的活体洞察，可为未来的研究提供参考。

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引用次数: 0

Double Stent Retriever Mechanical Thrombectomy for Distal Medium Vessel Clots in the Middle Cerebral Artery: Initial Experience 双支架机械取栓治疗大脑中动脉远端中血管血栓：初步经验

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-07-20 DOI: 10.1111/jon.70064

José Carlos Méndez, Pedro Vega, Alfonso Lopez-Frías, Teresa Díaz, Josep Puig, Eduardo Murias, Jordi Blasco, Carlos Pérez-García, Víctor Maestro, Manuel Moreu, Marc Comas-Cufí, Antonio Cruz-Culebras, María Antonia Prieto, Isabel Bermúdez-Coronel, Javier Blázquez, Jaime Masjuán

Background and Purpose

Mechanical thrombectomy (MT) is increasingly performed for distal medium vessel occlusions (DMVOs) of the anterior circulation in acute stroke patients. Although trials have not shown superiority over usual care, selected patients may still benefit from MT. The ideal endovascular technique is debated. We aimed to determine the safety and efficacy of double stent retriever MT (DSR-MT) for DMVOs.

Methods

We retrospective analyzed demographics, procedure characteristics, and clinical data from consecutive patients with acute primary DMVOs treated with DSR-MT at four comprehensive stroke centers. Reperfusion was defined by the extended Thrombolysis In Cerebral Infarction (eTICI) score. Clinical outcomes were measured by the National Institute of Health Stroke Scale (NIHSS) and modified Rankin scale (mRS) scores.

Results

We included 32 patients (median age, 78 years, interquartile range [IQR] 71–82; 16 [50%] female), of whom 26 (81.2%) had primary occlusion of the M2 segment of the middle cerebral artery and six (18.8%) had occlusion of M3. Clinical severity was moderate (median, NIHSS 13; IQR 10–15) in 24 patients (75%). First-pass effect (eTICI 2c/3) was achieved in 20 patients (62.5%). Final eTICI 2b/2c/3 was achieved in 30 patients (93.7%) and final eTICI 2c/3 in 25 (78.1%). Symptomatic intracranial hemorrhage developed in one patient (3.1%). Median NIHSS was 6 at 24 h (IQR 3–12) and 4 at discharge (IQR 1–9). At 90 days, 22 (73.3%) patients were functionally independent (mRS 0–2).

Conclusions

This preliminary study found good efficacy and safety of DSR-MT for DMVOs in patients with M2 and M3 occlusions.

背景与目的机械取栓术（MT）越来越多地被用于治疗急性脑卒中患者前循环远端中血管闭塞（DMVOs）。虽然试验并没有显示出MT优于常规护理，但选定的患者仍可能受益于MT。理想的血管内技术仍存在争议。我们的目的是确定双支架回收器MT （DSR-MT）治疗DMVOs的安全性和有效性。方法回顾性分析4个卒中综合中心连续接受DSR-MT治疗的急性原发性dmvo患者的人口统计学、手术特点和临床资料。再灌注由延长脑梗死溶栓（eTICI）评分定义。临床结果采用美国国立卫生研究院卒中量表（NIHSS）和改良Rankin量表（mRS）评分进行测量。结果纳入32例患者，中位年龄78岁，四分位数间距[IQR] 71 ~ 82；16例（50%）女性)，其中原发性大脑中动脉M2段闭塞26例（81.2%），M3段闭塞6例（18.8%）。临床严重程度为中度(NIHSS中位数为13；24例（75%）患者IQR为10-15。20例患者（62.5%）达到首过效应（eTICI 2c/3）。30例（93.7%）患者达到最终eTICI 2b/2c/3, 25例（78.1%）患者达到最终eTICI 2c/3。1例患者出现症状性颅内出血（3.1%）。24 h时NIHSS为6 (IQR 3-12)，出院时NIHSS为4 （IQR 1-9）。90天时，22例（73.3%）患者功能独立（mRS 0-2）。结论本初步研究发现DSR-MT治疗M2和M3闭塞患者DMVOs具有良好的疗效和安全性。

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引用次数: 0

A Radiomic Approach to Clinical MRI Refines the Thalamus-Cognition Link in Multiple Sclerosis 临床MRI放射学方法改进多发性硬化症丘脑-认知联系

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-07-20 DOI: 10.1111/jon.70069

Korhan Buyukturkoglu, Lin Lu, Levi Davis, Renan E. Orellana, Charles C. White, Rongyi Sun, Sinem Ozcelik, Nina M. Isenstein, Kaho B. Onomichi, Rifat Iqbal, Binsheng Zhao, Yaakov Stern, Burcu Zeydan, Orhun H. Kantarci, Claire S. Riley, Philip L. De Jager

Background and Purpose

Radiomics extracts imaging features that may not be detectable through conventional volumetric analyses. Given their role in multiple sclerosis (MS), we applied radiomics to thalamic nuclei and examined their associations with cognitive performance.

Methods

A total of 601 individuals were included (342 people with MS [PwMS] from two cohorts and 259 healthy controls [HC]). Radiomic features (RF) and volumes were extracted from the whole thalamus, five thalamic nuclei, and the putamen segmented on three-dimensional T1-weighted images. Cognitive performance was assessed using the Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT) in PwMS and the Digit Symbol Substitution Test (DSST) in HC. In the first MS cohort, multivariate linear regression in a discovery set (N = 103) identified thalamus-derived RF associated with SDMT, which were retested in a replication set (N = 63). Their associations with PASAT in a second MS cohort (N = 176) and DSST in HC were also evaluated. We then tested whether the same RFs, when extracted from the putamen, was associated with SDMT. Least Absolute Shrinkage and Selection Operator (LASSO) models assessed the combined predictive value of RF and volumes.

Results

Twenty-eight RF–region of interest (ROI) pairs were associated with SDMT in the replication set (false discovery rate [FDR] < 0.05). Of these, 24 were also associated with PASAT (FDR ≤ 0.03), and 2 with DSST. Only ventral nuclei volume showed replicated associations among volumetrics. Only four putamen-derived pairs were associated with SDMT (FDR = 0.04). LASSO results confirmed RF outperformed volumes.

Conclusion

RF extracted from the thalamus is strongly associated with cognitive performance in PwMS, outperforming volumetric measures and supporting their potential as sensitive imaging biomarkers.

背景和目的放射组学提取的影像特征可能无法通过传统的体积分析检测到。鉴于它们在多发性硬化症（MS）中的作用，我们将放射组学应用于丘脑核，并研究了它们与认知表现的关系。方法共纳入601例患者，其中MS [PwMS] 342例，健康对照[HC] 259例。在三维t1加权图像上提取整个丘脑、五个丘脑核和壳核的放射学特征（RF）和体积。采用符号数字模态测试（SDMT）、节奏性听觉序列加法测试（PASAT）和数字符号替代测试（DSST）评估认知表现。在第一个MS队列中，发现集（N = 103）的多元线性回归确定了与SDMT相关的丘脑衍生RF，并在复制集（N = 63）中重新进行了测试。他们与第二组MS队列（N = 176）中的PASAT和HC中的DSST的关联也被评估。然后，我们测试了从壳核中提取的相同rf是否与SDMT相关。最小绝对收缩和选择算子（LASSO）模型评估了射频和体积的综合预测值。结果28对rf感兴趣区域（ROI）对在复制集中与SDMT相关(错误发现率[FDR] <；0.05)。其中24例伴有PASAT (FDR≤0.03)，2例伴有DSST。只有腹侧核体积在体积测量中显示出重复的相关性。只有4对壳核衍生对与SDMT相关（FDR = 0.04）。LASSO结果证实射频优于体积。结论从丘脑提取的射频与PwMS的认知表现密切相关，优于体积测量，支持其作为敏感成像生物标志物的潜力。

{"title":"A Radiomic Approach to Clinical MRI Refines the Thalamus-Cognition Link in Multiple Sclerosis","authors":"Korhan Buyukturkoglu, Lin Lu, Levi Davis, Renan E. Orellana, Charles C. White, Rongyi Sun, Sinem Ozcelik, Nina M. Isenstein, Kaho B. Onomichi, Rifat Iqbal, Binsheng Zhao, Yaakov Stern, Burcu Zeydan, Orhun H. Kantarci, Claire S. Riley, Philip L. De Jager","doi":"10.1111/jon.70069","DOIUrl":"https://doi.org/10.1111/jon.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Radiomics extracts imaging features that may not be detectable through conventional volumetric analyses. Given their role in multiple sclerosis (MS), we applied radiomics to thalamic nuclei and examined their associations with cognitive performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 601 individuals were included (342 people with MS [PwMS] from two cohorts and 259 healthy controls [HC]). Radiomic features (RF) and volumes were extracted from the whole thalamus, five thalamic nuclei, and the putamen segmented on three-dimensional T1-weighted images. Cognitive performance was assessed using the Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT) in PwMS and the Digit Symbol Substitution Test (DSST) in HC. In the first MS cohort, multivariate linear regression in a discovery set (<i>N</i> = 103) identified thalamus-derived RF associated with SDMT, which were retested in a replication set (<i>N</i> = 63). Their associations with PASAT in a second MS cohort (<i>N</i> = 176) and DSST in HC were also evaluated. We then tested whether the same RFs, when extracted from the putamen, was associated with SDMT. Least Absolute Shrinkage and Selection Operator (LASSO) models assessed the combined predictive value of RF and volumes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-eight RF–region of interest (ROI) pairs were associated with SDMT in the replication set (false discovery rate [FDR] < 0.05). Of these, 24 were also associated with PASAT (FDR ≤ 0.03), and 2 with DSST. Only ventral nuclei volume showed replicated associations among volumetrics. Only four putamen-derived pairs were associated with SDMT (FDR = 0.04). LASSO results confirmed RF outperformed volumes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RF extracted from the thalamus is strongly associated with cognitive performance in PwMS, outperforming volumetric measures and supporting their potential as sensitive imaging biomarkers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666214","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}

引用次数: 0

Association of Carotid Plaque Calcification Attenuation With Intraplaque Hemorrhage Volume: 3D-Segmentation Analysis 颈动脉斑块钙化衰减与斑块内出血量的关系：3d分割分析

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-07-14 DOI: 10.1111/jon.70071

Jeremy Rubin, Quy Cao, Yu Sakai, Nathan Arnett, Huy Q. Phi, Andrew C. Hu, Brett L. Cucchiara, Daniel Bos, Luca Saba, Elias Johannson, Jarcy Zee, Jae W. Song

Background and Purpose

Despite the high prevalence of plaque calcifications in carotid atherosclerosis, the association between morphologic and attenuation features of calcifications and intraplaque hemorrhage (IPH) remains unclear.

Methods

Calcific carotid plaques were identified on neck computed tomography angiographies (CTAs) from patients meeting criteria for embolic stroke of undetermined source. Plaque calcifications were manually segmented using 3D-Slicer to quantify features, including volume and attenuation (Hounsfield Units [HU]). IPH volume (IPHvol) was quantified using a semi-automated software. A linear mixed regression model evaluated associations between calcification features and IPHvol, adjusting for sex, age, and cardiovascular risk factors. An interaction term between calcification volume and attenuation was included after dichotomizing attenuation (>924HU) and volume (>30 millimeter [mm]³) as high versus low on the basis of median values.

Results

From 70 patients (median age 68 years, 50% female), 116 calcific plaques containing 269 plaque calcifications were analyzed. Adjusting for age, cardiovascular risk factors, and plaque calcification features, being female showed lower IPHvols compared to males (mean ratio 0.34, p = 0.002). A significant interaction between calcification volume and attenuation emerged (p = 0.042). Among plaques with low plaque calcification volumes, plaques with low-attenuation (<924HU) calcifications showed 5.53 times higher IPHvols than plaques with high-attenuation calcifications (p = 0.003). Among plaques with high-attenuation calcifications, plaques with high volumes of these calcifications showed 4.40 times higher IPHvols compared to low-volumes of high-attenuation calcifications (p = 0.011).

Conclusions

Plaque calcification attenuation characteristics are associated with IPHvols. Understanding calcification patterns that correlate with IPH could enable clinicians to infer plaque instability from readily visible calcifications on CTA.

背景和目的尽管颈动脉粥样硬化中斑块钙化的发生率很高，但钙化的形态学和衰减特征与斑块内出血（IPH）之间的关系尚不清楚。方法对符合来源不明的栓塞性卒中标准的患者进行颈动脉钙化斑块的ct血管造影检查。使用3d切片机对斑块钙化进行手动分割，量化特征，包括体积和衰减（Hounsfield单位[HU]）。使用半自动软件定量IPH体积（IPHvol）。线性混合回归模型评估钙化特征与IPHvol之间的关系，调整性别、年龄和心血管危险因素。在对衰减（>924HU）和体积（>；30毫米[mm]3）进行二分类后，在中位数的基础上纳入了钙化体积与衰减之间的相互作用项。结果70例患者（中位年龄68岁，女性50%），116个钙化斑块，其中269个斑块钙化。调整年龄、心血管危险因素和斑块钙化特征后，女性的iphol比男性低（平均比值0.34,p = 0.002）。钙化体积和衰减之间存在显著的相互作用（p = 0.042）。在低斑块钙化体积斑块中，低衰减（<924HU）钙化斑块的IPHvols是高衰减钙化斑块的5.53倍（p = 0.003）。在高衰减钙化斑块中，高体积钙化斑块的IPHvols是低体积高衰减钙化斑块的4.40倍（p = 0.011）。结论斑块钙化衰减特征与ivos有关。了解与IPH相关的钙化模式可以使临床医生从CTA上容易看到的钙化推断斑块的不稳定性。

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引用次数: 0

Blood-Brain Barrier Dysfunction in Adults With Heart Failure 成人心力衰竭的血脑屏障功能障碍

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-07-04 DOI: 10.1111/jon.70068

Bhaswati Roy, Xingfeng Shao, Kamlesh J. Jobanputra, Gregg C. Fonarow, Danny J. J. Wang, Mary Woo, Rajesh Kumar

Background and Purpose

Heart failure (HF) patients show brain tissue injury in sites that mediate autonomic, cognitive, and mood dysfunctions that are linked with increased morbidity and mortality. The pathological mechanisms that may contribute to brain tissue injury in HF are unclear, but may include blood brain barrier (BBB) dysfunction.

Methods

We performed diffusion-weighted pseudo-continuous arterial spin labeling (DW-pCASL) in 27 HF and 59 controls to examine BBB, using a 3.0-Tesla MRI scanner, and assessed anxiety, depressive symptoms, and cognition. Using DW-pCASL data, arterial transit time (ATT, an index of large artery integrity) and water exchange rates across the BBB (Kw, an index of BBB function) maps were generated, normalized, smoothed, and compared between HF and controls, and correlated with cognition and mood.

Results

Significantly increased mood deficits and reduced cognition appeared in HF over controls. Multiple brain areas, which are involved in mediating cognition and mood, showed altered Kw and ATT values in HF over controls. Increased Kw emerged in the insula, hippocampus, and cerebellum. ATT values decreased in the prefrontal cortices, cingulate, and cerebellum, and increased in a few sites in HF patients. Kw values from regions that are involved in mood and cognition functions showed significant associations with anxiety, depression, and cognition.

Conclusions

HF patients show impaired BBB function and altered large artery integrity. BBB alterations may introduce neural damage to autonomic, mood, and cognitive regulatory areas, contributing to abnormal functions found in HF. The findings suggest a need to repair BBB function to rescue brain tissue and functions in this condition.

背景和目的心力衰竭（HF）患者表现为介导自主神经、认知和情绪功能障碍的脑组织损伤，这些损伤与发病率和死亡率增加有关。导致HF患者脑组织损伤的病理机制尚不清楚，但可能包括血脑屏障（BBB）功能障碍。方法对27例HF患者和59例对照患者进行弥散加权伪连续动脉自旋标记（DW-pCASL），使用3.0特斯拉MRI扫描仪检查血脑密度，并评估焦虑、抑郁症状和认知能力。使用DW-pCASL数据，生成动脉传输时间（ATT，大动脉完整性指数）和血脑卒中水交换率（Kw，血脑卒中功能指数）图，将其归一化、平滑，并比较HF和对照组之间的图，并将其与认知和情绪相关联。结果与对照组相比，心衰患者情绪缺陷明显增加，认知能力明显下降。与对照组相比，HF患者涉及调节认知和情绪的多个脑区显示出Kw和ATT值的改变。脑岛、海马体和小脑的Kw增加。心衰患者的ATT值在前额皮质、扣带和小脑降低，在少数部位升高。涉及情绪和认知功能的区域的Kw值与焦虑、抑郁和认知有显著关联。结论HF患者血脑屏障功能受损，大动脉完整性改变。血脑屏障改变可引起自主神经、情绪和认知调节区神经损伤，导致心衰患者功能异常。研究结果表明，在这种情况下，需要修复血脑屏障功能来挽救脑组织和功能。

{"title":"Blood-Brain Barrier Dysfunction in Adults With Heart Failure","authors":"Bhaswati Roy, Xingfeng Shao, Kamlesh J. Jobanputra, Gregg C. Fonarow, Danny J. J. Wang, Mary Woo, Rajesh Kumar","doi":"10.1111/jon.70068","DOIUrl":"https://doi.org/10.1111/jon.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Purpose</h3>\u0000 \u0000 <p>Heart failure (HF) patients show brain tissue injury in sites that mediate autonomic, cognitive, and mood dysfunctions that are linked with increased morbidity and mortality. The pathological mechanisms that may contribute to brain tissue injury in HF are unclear, but may include blood brain barrier (BBB) dysfunction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed diffusion-weighted pseudo-continuous arterial spin labeling (DW-pCASL) in 27 HF and 59 controls to examine BBB, using a 3.0-Tesla MRI scanner, and assessed anxiety, depressive symptoms, and cognition. Using DW-pCASL data, arterial transit time (ATT, an index of large artery integrity) and water exchange rates across the BBB (Kw, an index of BBB function) maps were generated, normalized, smoothed, and compared between HF and controls, and correlated with cognition and mood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significantly increased mood deficits and reduced cognition appeared in HF over controls. Multiple brain areas, which are involved in mediating cognition and mood, showed altered Kw and ATT values in HF over controls. Increased Kw emerged in the insula, hippocampus, and cerebellum. ATT values decreased in the prefrontal cortices, cingulate, and cerebellum, and increased in a few sites in HF patients. Kw values from regions that are involved in mood and cognition functions showed significant associations with anxiety, depression, and cognition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>HF patients show impaired BBB function and altered large artery integrity. BBB alterations may introduce neural damage to autonomic, mood, and cognitive regulatory areas, contributing to abnormal functions found in HF. The findings suggest a need to repair BBB function to rescue brain tissue and functions in this condition.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16399,"journal":{"name":"Journal of Neuroimaging","volume":"35 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144550968","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}

引用次数: 0