Journal of neuroimaging : official journal of the American Society of Neuroimaging
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Spinal cord (SC) cross-sectional areas (CSAs) assessed with MRI have proven to be extremely valuable imaging markers in several diseases. Among the challenges is the delineation of vertebral levels to determine level-dependent changes in cord atrophy. With this study, we aimed to (1) test the hypothesis that there is proportionality in the position of the first six intervertebral discs and the length of the upper portion of the SC and (2) show that a proportionality approach can simplify the CSA assessment across vertebrae offering good reliability. ⋯ With this study, we propose a proportionality method for the assignment of cervical SC vertebral levels that can simplify the processing of MRI datasets in the context of CSA measurements.
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Observational Study
Continuous transcranial ultrasound in large vessel stroke: Image guidance for high-intensity focused sonothrombolysis.
Sonothrombolysis is a potential adjunctive therapy for large vessel occlusion (LVO) stroke. Bedside ultrasound image-guided high-intensity focused ultrasound (HIFU) therapy could deliver higher energy therapeutic ultrasound to the thrombus with higher precision than what was previously accomplished in human trials. The aim is to test the feasibility of diagnostic transcranial contrast-enhanced ultrasound (CEUS) to image the occlusion site and continuously maintain the guidance image on-target for a sufficient exposure time for HIFU to be effective during LVO stroke evaluation and treatment. ⋯ This feasibility study explored the use of diagnostic transcranial CEUS for continuous imaging of occlusion sites in LVO strokes. Challenges in maintaining target image during HIFU were identified, highlighting the need for technical advances for clinical application.
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Susceptibility estimates derived from quantitative susceptibility mapping (QSM) images for the cerebral cortex and major subcortical structures are variably reported in brain magnetic resonance imaging (MRI) studies, as average of all ( μ all ${{{{\mu}}}_{{\mathrm{all}}}}$ ), absolute ( μ abs ${{{{\mu}}}_{{\mathrm{abs}}}}$ ), or positive- ( μ p ${{{{\mu}}}_{\mathrm{p}}}$ ) and negative-only ( μ n ${{{{\mu}}}_{\mathrm{n}}}$ ) susceptibility values using a region of interest (ROI) approach. This pilot study presents a reliability analysis of currently used ROI-QSM metrics and an alternative ROI-based approach to obtain voxel-weighted ROI-QSM metrics ( μ wp ${{{{\mu}}}_{{\mathrm{wp}}}}$ and μ wn ${{{{\mu}}}_{{\mathrm{wn}}}}$ ). ⋯ Among the evaluated ROI-QSM metrics, μ all ${{{{\mu}}}_{{\mathrm{all}}}}$ and μ abs ${{{{\mu}}}_{{\mathrm{abs}}}}$ estimates were less reliable, whereas separating positive and negative values (using μ p , μ n , μ wp , μ wn ${{{{\mu}}}_{\mathrm{p}}},\ {{{{\mu}}}_{\mathrm{n}}},\ {{{{\mu}}}_{{\mathrm{wp}}}},\ {{{{\mu}}}_{{\mathrm{wn}}}}$ ) improved the reproducibility within, and the comparability between, subjects, even when reducing the slice thickness. These preliminary findings may offer valuable insights toward standardizing ROI-QSM metrics across different patient cohorts and imaging settings in future clinical MRI studies.
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To develop and test a decision tree for predicting contrast enhancement quality and shape using precontrast magnetic resonance imaging (MRI) sequences in a large adult-type diffuse glioma cohort. ⋯ The proposed EPDT has high accuracy in predicting enhancement patterns of gliomas irrespective of rater experience.
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Neuropathic pain (NP) is a debilitating condition following spinal cord injury (SCI). The role of periaqueductal gray (PAG) in NP development following SCI remains underexplored. Using resting-state functional MRI (rsfMRI), our study aimed to demonstrate the alterations in functional connectivity (FC) of PAG in NP following SCI. ⋯ Altered FC between PAG and right anterior insula, VPL, DRN, RN, SN, cerebellar vermis lobules IV and V, frontal cortex, and PCC was associated with NP sequelae of SCI. Additionally, SCI was independently associated with decreased FC between PAG and right posterior insula, cerebellar lobules IV and V, and cerebellar vermis lobules III, IV, and V.