Neuroradiology最新文献

Purpose: Cortical thickness (CTh) is a valuable imaging biomarker of brain development and aging. The assessment of CTh using the two most widely utilized software packages, Computational Anatomy Toolbox (CAT12) and FreeSurfer, reveals systematic differences between the two tools. Nonetheless, longitudinal results are supposed to be less affected by such differences. To date, there is no comparison of longitudinal CTh data obtained with these preprocessing pipelines.

Methods: We evaluated cross-sectional and longitudinal measurements of CTh using CAT12 and FreeSurfer in healthy older individuals with structural brain MRI. First, we compared cross-sectional CTh values obtained with these two methods using paired t-tests and correlation analyses. Second, we compared longitudinal CAT12 and FreeSurfer-based data using annualized percent change (APC) of CTh between two timepoints.

Results: Cross-sectional CTh values were higher in FreeSurfer compared to CAT12 in most regions, albeit highly correlated and similarly distributed. In contrast, longitudinal analyses revealed significant differences in APC values with only weak to moderate correlation between the two methods.

Conclusion: Significant differences in longitudinal results between CAT12 and FreeSurfer emphasize the need to consider the preprocessing methods used when interpreting MRI data in brain aging research. Further technical developments are warranted for reliable longitudinal CTh assessment in elderly cohorts.

Background: The woven EndoBridge (WEB) device has been introduced for the treatment of wide-neck bifurcation aneurysms; however, device selection remains a major challenge inWEB treatment. This study aimed to demonstrate the effectiveness of WEB selection using volumetric analysis and its 1-year radiological outcomes.

Methods: We retrospectively analysed patients with unruptured wide-neck bifurcation aneurysms who underwent WEB treatment between August 2021 and January 2023. Aneurysm volume was measured semi-automatically using a three-dimensional volume-rendering programme. Radiological outcomes were analysed using the WEB Occlusion Scale (WOS) at 1-year catheter angiography follow-up. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the prognostic performance of the device-to-aneurysm volume (DAV) ratio for predicting complete occlusion. Univariate and multivariate analyses were performed to assess the predictive factors for complete occlusion.

Results: Fifty-seven unruptured intracranial aneurysms, in 56 patients were treated with the WEB device. The device was changed in 14 patients (24.6%) following the + 1/-1 rule, and volume-based recommendations were appropriate for all patients. At the 1-year follow-up, complete occlusion (WOS A and B) was confirmed in 35 patients (61.4%), and adequate occlusion (WOS A, B, and C) was confirmed in 87.7% (50 of 57 patients). The ROC curve analysis showed a significant relationship for 1-year complete occlusion (area under the curve: 0.74, 95% confidence interval [CI]: 0.59-0.88) with an optimal cut-off of 0.92. The DAV ratio was the only significant predictive factor for 1-year complete occlusion in the univariate (odds ratio [OR]: 7.0, 95% CI: 2.20-24.7, p = 0.001) and multivariate (OR: 20.39, 95% CI: 3.56-111.73, p = 0.0007) analyses.

Conclusions: Volume-based WEB selection was appropriate for initial device selection and 1-year radiological outcomes. The selection of a WEB device with a volume exceeding 92% of that of the targeted aneurysm could be considered for 1-year radiological outcomes.

Purpose: The aim of this study was to leverage fluorodeoxyglucose-positron emission tomography (FDG-PET) and blood oxygen level dependent-functional magnetic resonance imaging (BOLD-fMRI) to perform a comprehensive multi-modal analysis of metabolic alteration and individualized functional connectivity in Alzheimer's Disease (AD) and mild cognitive impairment (MCI) and characterize the relationship of these alterations with neurocognitive scores.

Methods: We analyzed data from 71 subjects, including those with AD, MCI and Health Control (HC), using FDG-PET and BOLD-fMRI acquired from Alzheimer's Disease Neuroimaging Initiative (ADNI). We examined network functional connectivities (FC) base on Independent Component Analysis (ICA), analyzed regional standardized uptake value ratios (SUVR) and their relationships with neurocognitive scores.

Results: Both AD and MCI showed metabolic and functional connectivity abnormalities in Default Mode Network (DMN) region. We also found abnormalities in the somatomotor system in AD, which may be an early predictive indicator of AD. In MCI, both metabolic and functional connectivity abnormalities appear in precuneus, and these two modes were closely related, indicating that the precuneus may be a core region in the transition of healthy individuals to MCI.

Conclusion: This study demonstrated that the individual brain network technology based on ICA, combined with the metabolic characteristics of FDG-PET, facilitates the development of personalized early diagnosis for AD/MCI, enhances our understanding of the underlying neuropathological mechanisms, and also promotes the development of interdisciplinary technologies.

Purpose: This study aimed to optimize three-dimensional real inversion recovery (3D-real IR) with T2 preparation (T2Prep) protocols to improve perilymphatic enhancement (PE) and endolymphatic hydrops (EH) detection.

Methods: Fifty-three consecutive participants with unilateral Ménière's disease were prospectively recruited. All participants underwent 3D-zoomed imaging technique with parallel transmission real IR (z-3D real IR), z-3D real IR with T2Prep (tz-3D real IR), and optimized tz-3D real IR (otz-3D real IR). Overall image quality, the separation of endolymph and perilymph and EH were scored/graded and compared among three 3D real IRs respectively. The signal intensity ratio (SIR), contrast to noise ratio (CNR), and signal to noise (SNR) were quantitatively calculated and compared among three 3D real IRs respectively.

Results: Tz-3D real IR was superior to z-3D real IR in overall image quality, SIR, SNR, and CNR (P < 0.017 for all), moreover, the vestibular EH detection of tz-3D real IR sequence were inferior to z-3D real IR (P = 0.005). On otz-3D real IR images, overall image quality, endolymph visualization, and the SIR and CNR significantly increased compared to those of the tz-3D real IR sequence and z-3D real IR sequence (P < 0.017 for all). Moreover, the cochlear and vestibular EH detection of otz-3D real IR sequence were significant superior to tz-3D real IR (P = 0.008 for both).

Conclusion: The optimized otz-3D real IR sequence, incorporating T2Prep, significantly improves PE and EH detection. These enhancements highlight its potential utility in clinical settings for accurate and timely diagnosis of EH.

Purpose: The Woven EndoBridge (WEB) device is an intrasaccular flow disruptor designed for the treatment of wide-neck intracranial bifurcation aneurysms. The purpose of this study was to evaluate various factors associated with clinical and angiographic outcomes following WEB treatment.

Methods: This multicenter, retrospective study analyzed 405 patients with 412 aneurysms treated with the WEB device across 22 neurovascular centers. Clinical and radiologic data were reviewed to identify factors influencing patients' clinical outcome and target aneurysmal occlusion at short-term (within 6 months) and long-term (beyond 1 year) follow-up. Occlusion status of target aneurysms was analyzed in relation to the various clinical and morphological factors. Outcomes were also compared based on institutional treatment volume.

Results: Centers with higher WEB treatment volumes (more than 30 cases) demonstrated lower thromboembolic events with sequelae (0.8% vs. 5.9%, p = 0.003). The rate of aneurysmal adequate occlusion, defined by Raymond-Roy occlusion class 1 and 2, increased from 70.2% at short-term (mean, 133 ± 42 days) to 83.2% at long-term (mean, 499 ± 134 days) follow-up (p = 0.003). Aneurysm diameter was inversely correlated with complete occlusion, with a 6-mm cutoff identified. Wide-neck aneurysms exhibited lower occlusion rates at short-term period, but this effect was not observed at later periods. Aneurysms at the basilar apex and internal carotid artery terminus demonstrated higher rates of complete occlusion (p = 0.046). Smoking acted as an inhibitor of long-term occlusion of target aneurysms.

Conclusion: Institutional experience appeared to play a role in reducing procedure-related thromboembolic complications. Aneurysmal diameter, neck width, location and patients' smoking status influenced angiographic outcomes.

Objective: To compare short (TR = 7000 ms) and long (TR = 10000 ms) repetition time 3D-real inversion recovery (IR) sequences with 3D-FLAIR MRI in terms of image quality and diagnostic performance for evaluating endolymphatic hydrops (EH) after a single intravenous dose of gadobutrol in patients with unilateral Ménière's disease.

Materials and methods: Thirty-seven patients with definite unilateral Ménière's disease underwent inner ear MRI 4 h after administration of gadobutrol (0.1 mmol/kg). Each patient was scanned using 3D-real IR sequences with two different TR values (7000 ms and 10000 ms), as well as a conventional 3D-FLAIR sequence. Quantitative image analysis included contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR), while qualitative scoring and inter-/intra-observer agreement were also assessed.

Results: The short TR (7000 ms) 3D-real IR sequence failed to demonstrate adequate perilymphatic enhancement in most cases. In contrast, both the long TR (10000 ms) 3D-real IR and 3D-FLAIR sequences consistently visualized perilymphatic enhancement and EH. The TR = 10,000 ms sequence provided significantly higher image quality metrics (CNR and SNR, P < 0.001), particularly improving detection in the cochlear apex. It also showed better inter-observer agreement than 3D-FLAIR.

Conclusion: The 3D-real IR sequence with a TR of 10,000 ms offers superior image quality and enhanced diagnostic confidence for EH evaluation compared to both the shorter TR sequence and conventional 3D-FLAIR. These findings support the use of a longer TR protocol for inner ear MRI following single-dose gadolinium administration in clinical settings.

Fenestrations of the posterior communicating artery (PCom) are rare vascular variants, and their association with aneurysm formation is uncommon. This report describes a ruptured aneurysm from a PCom fenestration, successfully managed with the Nautilus intrasaccular neck-bridging device. The patient presented with subarachnoid hemorrhage, and 3D-angiography showed a wide-necked aneurysm at the origin of a fenestrated PCom. Endovascular embolization using the Nautilus device and coil placement led to complete aneurysm occlusion while preserving the parent vessel. The patient recovered without neurological deficits, and a 12-month angiographic follow-up confirmed stable occlusion. This case demonstrates the technical feasibility and safety of the Nautilus device in treating complex ruptured aneurysms associated with rare vascular variants, contributing to the limited literature on PCom fenestration aneurysms. KEY POINTS: Fenestrations of the posterior communicating artery (PCom) are extremely rare, with only a few cases described in the literature. Aneurysms arising from PCom fenestration are even more uncommon and represent a technical challenge for both surgical and endovascular treatment. We report a ruptured aneurysm at a PCom fenestration successfully treated with the Nautilus neck-bridging device. This case illustrates the feasibility of Nautilus in complex ruptured aneurysms and ads to the scarce literature on PCom fenestrations and their association with aneurysms.

Purpose: To review recent advances in structural MRI post-processing for pediatric drug-resistant epilepsy, with emphasis on artificial intelligence-driven and quantitative techniques, including MELD-Graph, MAP18, FLAT1, and SUPR-FLAIR, and to evaluate their impact on lesion detection, epileptogenic zone localization, and presurgical planning.

Methods: Novel post-processing approaches were examined with respect to their computational foundations, imaging requirements, and diagnostic performance. Techniques employing machine learning, deep learning, voxel-based morphometry, cortical surface projection, and FLAIR/T1 ratio mapping were assessed for their applicability in children and their integration into multimodal evaluation pathways alongside electrophysiology and functional imaging.

Results: Advanced post-processing tools substantially increase sensitivity for detecting subtle cortical abnormalities, particularly in MRI-negative pediatric epilepsy. MELD-Graph identify features of focal cortical dysplasia through automated surface-based analysis and deep neural network classification, achieving notable lesion detection even when conventional MRI findings are normal. MAP18 provides complementary voxel-wise morphometric assessment, improving specificity and benefiting from optimized structural sequences. FLAT1 enhances lesion conspicuity by quantifying FLAIR/T1 signal relationships, while SUPR-FLAIR improves visualization of cortical signal abnormalities through normalized FLAIR intensity projection onto the cortical surface. When incorporated into multimodal diagnostic workflows, these methods refine epileptogenic zone localization, inform individualized surgical strategies, and can reduce reliance on invasive testing.

Conclusion: Advanced structural MRI post-processing is transforming the neuroradiological evaluation of pediatric drug-resistant epilepsy. By revealing subtle cortical abnormalities not visible on conventional imaging, these tools support more precise lesion characterization and surgical planning. Ongoing efforts toward standardization, clinical validation, and workflow integration will be essential to ensure widespread adoption and maximize clinical impact within precision-medicine approaches to pediatric epilepsy.

Background and purpose: The right and left lateral ventricles are symmetrically positioned and typically mirror each other by size and shape. Therefore, they often serve as a primary reference point on magnetic resonance imaging (MRI) scans. However, volumetric ventricular asymmetry is a frequent radiological finding. In this study, we aimed to assess whether one ventricle is, on average, larger than the other.

Methods: We carried out a systematic search for articles published by August 2024 in three large electronic databases. The articles included reported left and right lateral ventricle volumes from MRI in healthy individuals. As a subsidiary analysis, we performed meta-regressions to examine total ventricular volume, age, and sex as potential moderators of ventricular asymmetry.

Results: A total of 58 studies (8,642 subjects) were considered eligible and included in the meta-analysis. In nearly all studies, an asymmetry in the lateral ventricles was found; in 47 of them, the left ventricle was the larger. The pooled effect size was considered significant (p < 0.0001), as the left lateral ventricle was 6.5% larger than the right lateral ventricle. The meta-regression analyses revealed that the degree of asymmetry is correlated with ventricular volume, but not with age and sex.

Conclusion: This meta-analysis confirms that the left lateral ventricle is typically larger than the right. Given this asymmetry's links to neurological and psychiatric conditions, future research should focus on defining the limits of healthy asymmetry and clarifying the sources of heterogeneity to enhance diagnostic and clinical applications.