Magnetic Resonance Imaging Features Research Articles

Magnetic resonance imaging characteristics of ovarian torsion: insights into diagnostic features.

We aimed to describe the magnetic resonance imaging (MRI) features of adnexal torsion, additional radiological findings and apparent diffusion coefficient (ADC) measurements of the affected and non-affected ovaries. We retrospectively examined the MRI of 34 torsed adnexa of 34 cases. We specifically examined the peripherally displaced follicle sign, stromal edema, lack of stromal contrast enhancement, follicular rim sign, T2 hypointense rim sign, uterine deviation, adnexal displacement, whirlpool sign, T2 hypointense dot sign, and tubal thickening. These signs were systematically compared between the torsed and non-torsed adnexa. In addition to that, the presence of free fluid was recorded. As a quantitative analysis, ovarian size and stromal ADC values in torsed and non-torsed ovaries were measured. The average age was 36.6years. The right ovary was torsed in 21 (61.8%) of the cases, and the left ovary was torsed in 13 (38.2%). There were significant differences between groups in all signs except the follicular rim sign. The highest accuracy was at the whirlpool sign (0.93). This was followed by uterine deviation and stromal edema (0.85). The accuracy rates of other findings are, respectively, lack of stromal contrast enhancement (0.81), T2 hypointense dot sign (0.79), peripherally displaced follicle sign (0.77), displacement of the adnexa (0.66), tubal thickening (0.66), T2 hypointense rim sign (0.62) and follicular rim sign (0.54). The largest size of ovary in patients with torsion was significantly larger, with an average of 67.5 ± 16.3mm, compared to 38.8 ± 7.7mm in non-torsed adnexa (p < 0.001). Additionally, the stromal ADC value was significantly higher in torsed ovarian stroma, averaging 1930.5 ± 455.4 (10⁻⁶ mm2/s) compared to 1655.7 ± 349.3 (10⁻⁶ mm2/s) in non-torsed ovarian stroma (p < 0.001). In our study, we conducted a comprehensive evaluation of various imaging signs associated with adnexal torsion. The most reliable indicators of adnexal torsion, based on their high accuracy rates, include an enlarged ovary, the presence of the whirlpool sign, uterine deviation, and stromal edema.

Graph Convolutional Network for AD and MCI Diagnosis Utilizing Peripheral DNA Methylation: Réseau de neurones en graphes pour le diagnostic de la MA et du TCL à l'aide de la méthylation de l'ADN périphérique.

Blood DNA methylation (DNAm) alterations have been widely reported in the onset and progression of mild cognitive impairment (MCI) and Alzheimer's disease (AD); however, DNAm is underutilized as a diagnostic biomarker for these diseases. We aimed to evaluate the diagnostic performance of DNAm for MCI and AD, both individually and in combination with well-established AD biosignatures. A total of 1,891 blood samples from Alzheimer's Disease Neuroimaging Initiative (ADNI) studies were used to identify potential candidate DNAm biomarkers. Multimodal clinical data from 635 samples (normal control (NC), n = 193; MCI, n = 352; AD, n = 90) in the TADPOLE dataset were utilized to construct eight different classification models using a graph convolutional network, a machine learning framework. After feature selection, 17 DNAm sites were selected for subsequent analysis. Remarkable differences in DNAm levels were observed at the screened DNAm loci in all three cohorts. Adopting DNAm features into multimodal models significantly improved the classification performance for three dichotomous subtasks (NC vs. non-NC, MCI vs. non-MCI, and AD vs. non-AD), especially when combined with cerebrospinal fluid (CSF) features for NC (area under the curve (AUC): 0.8534) and MCI classification (AUC: 0.7675). A weak correlation between DNAm and both magnetic resonance imaging and CSF features in the NC and MCI cohorts suggests good complementarity between modalities (correlation coefficient ≤0.2). Our study offers new insights into peripheral DNAm in MCI and AD and suggests promising diagnostic performance of models integrating epigenomics, imaging, or CSF biomarkers.

Association of imaging biomarkers with molecular subtypes of medulloblastoma.

Background and purpose: The World Health Organization (WHO) subdivided medulloblastoma into genetic and histopathological groups, each with a specific therapeutic intervention and different clinical outcomes. These subtypes may present with distinct imaging features. Therefore, the current study aimed to identify magnetic resonance imaging (MRI) biomarkers to predict the precise pathological characteristics of medulloblastoma. Methods: This study included 28 patients with a first diagnosis of medulloblastoma who underwent preoperative brain MRI with subsequent surgical resection and histopathological confirmation at our hospital between 2010 and 2022. Conventional MRI parameters, including apparent diffusion coefficient (ADC) mean values, were correlated with molecular subtypes to identify distinct MRI biomarkers. Results: Out of 28 tumors, two (7.1%) tumors exhibited wingless (WNT) activation, thirteen (46.4%) exhibited sonic hedgehog (SHH) activation, and thirteen (46.4%) exhibited non-WNT/non-SHH activation (Group 3 or 4). Statistical analysis revealed a significant association of SHH-activated tumors with paramidline/cerebellar location and the presence of peritumoral edema (p value = <0.0001). No significant correlations were found between the genetic subtypes and the other MRI parameters. A distinctive distribution of the ADC-mean values among the various genetic subtypes with recognizable tendencies was identified. However, it was statistically insignificant. Conclusion: Conventional MRI features of the paramidline/hemispheric location and the presence of peritumoral edema were significantly correlated with the SHH activated pathway and hence can be used to facilitate the preoperative implementation of SHH-targeted therapeutic intervention. Although the ADC-mean measurements were not statistically significant, a recognizable distribution of values among the various genetic subtypes was identified.

Gadoxetic Acid-Enhanced MRI in Differentiating Focal Nodular Hyperplasia from Hepatocellular Adenoma in Children.

To investigate the diagnostic performance of Gd-EOB-enhanced magnetic resonance imaging (MRI) for distinguishing focal nodular hyperplasia (FNH) from hepatocellular adenoma (HCA) in children. Twenty-two patients (6 with HCA and 16 with FNH) were retrospectively included in this study. After qualitative analyses of MRI, quantitative analyses were performed by calculating the relative signal intensity ratios (SIR) between lesion and liver parenchyma both on precontrast and hepatobiliary phase images. Two equations, SIRpost-pre and liver-to-lesion contrast enhancement ratio (LLCER), using both SIRs of precontrast and hepatobiliary phase (HBP) imaging together were also calculated. The most distinguishing non-contrast-enhanced MRI feature of HCA was intralesional fat since all HCA contained fat but none of FNHs. All FNHs were iso- or hyperintense relative to the adjacent liver on HBP images, but all HCAs except one were hypointense. The mean SIRpost-pre and LLCER of FNH were significantly higher than that of HCA (p < 0,001). SIRpost-pre and LLCER provided sensitivity and specificity values of 100%. Although intralesional fat is a strong discriminative feature for distinguishing between HCA and FNH, qualitative properties of these lesions may not be enough for confident diagnosis. Gd-EOB uptake in the HBP provides high diagnostic accuracy, but overlap can be seen. SIRpost-pre and LLCER overcome the difficulties and have the best sensitivity and specificity. Although there are many similar studies in adult group, this is one of the rare studies that will contribute to the literature in the pediatric group.

The nomogram model and its value study of Gd-EOB-DTPA enhanced MRI for preoperative diagnosis of proliferative hepatocellular carcinoma

Objective: To develop a nomogram model for preoperative diagnosis of proliferative hepatocellular carcinoma(HCC) based on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI), and to explore its clinical value. Methods: MRI and clinical pathological data of patients confirmed by pathology as proliferative HCC (178 cases) and non-proliferative HCC (378 cases) between September 2017 and November 2022 who underwent preoperative Gd-EOB-DTPA enhanced MRI scans were retrospectively collected. The MRI features and clinical pathological characteristics of proliferative and non-proliferative HCC were evaluated. Multivariable logistic regression analysis was utilized to identify independent predictive factors for proliferative HCC, the R software was used to construct the nomogram prediction model, and its diagnostic performance was evaluated through receiver operating characteristic (ROC) curve. The calibration curve and decision curve analysis (DCA) were drawn to evaluate the calibration performance and clinical application value of the nomogram model. The optimal cut-off value was selected by calculating the Youden index to distinguish high risk and low risk. Kaplan-Meier survival curve was used to analyze the survival prognosis of proliferative and non-proliferative HCC, and log-rank test was used for comparison. Results: There were significant differences in AFP level(χ2=17.244, P<0.001), morphology of tumor(χ2=13.669, P<0.001), intertumoral fat(χ2=10.495, P=0.001), arterial phase peritumoral enhancement(χ2=37.662, P<0.001), tumor capsule(χ2=23.961, P<0.001), substantial intratumoral necrosis(χ2=77.184, P<0.001), intratumoral hemorrhage(χ2=4.892, P=0.027), peritumoral hypointense in hepatobiliary phase(χ2=47.675, P<0.001), rim arterial phase hyperenhancement(χ2=115.976, P<0.001), intratumoral artery(χ2=15.528, P<0.001) and venous tumor thrombus(χ2=10.532, P=0.001) between proliferative and non-proliferative HCC groups. Multivariate Logistic regression analysis showed that AFP>200 ng/ml(OR=0.640, P=0.044), no intertumoral fat(OR=1.947, P=0.033), substantial intratumoral necrosis(OR=0.480, P=0.003), peritumoral hypointense in hepatobiliary phase(OR=0.432, P=0.001), and rim arterial phase hyperenhancement(OR=0.180, P<0.001) were independent predictors of preoperative diagnosis of proliferative HCC. Based on the independent predictors, a nomogram model for preoperative prediction of proliferative HCC was established. The area under the ROC curve of the model for predicting proliferative HCC was 0.772 (95%CI: 0.735～0.807), the sensitivity was 69.1%, and the specificity was 75.4%. The calibration curve and DCA curve showed that the calibration performance and clinical applicability of the nomogram model were good. Kaplan-Meier curve showed that the survival rate of patients with proliferative HCC after hepatectomy was significantly lower than that of non-proliferative HCC (P<0.001), and the high-risk group was significantly lower than the low-risk group (P<0.001). Conclusions: The nomogram prediction model based on Gd-EOB-DTPA enhanced MRI imaging features combined with AFP >200 ng/ml can accurately diagnose proliferative HCC before operation and predict prognosis.

Computed Tomography and Magnetic Resonance Imaging Features of Gracilis Myopathy in Dogs.

Gracilis myopathy is a well-recognized syndrome of weight-bearing gait abnormality; however, detailed description of computed tomography (CT) and magnetic resonance imaging (MRI) features of gracilis myopathy is lacking in the literature. This study aims to describe in detail CT and MRI features of gracilis myopathy. This is a retrospective study. Medical records of dogs with characteristic gait and available pelvic limb MRI or CT, presenting to four referral institutions, were reviewed. Seven cases with MRI (3/7) or CT (4/7) were included, all German Shepherd dogs. MRI findings in all cases included a well-defined, T1-/T2-/proton density-weighted hypointense band along the axial margin of the gracilis muscle, shorter affected muscles, thickening and T2W/STIR hyperintensity with contrast enhancement at the symphyseal tendon, and concurrent focal indentation of the axial border of the gracilis muscle. CT findings included a hyperattenuating band (4/4), single instances of contrast enhancement at the origin of the muscle, thickening of the tendon at the origin and insertion, and concurrent thickening at the musculotendinous muscle. CT and MRI can present advantages in correctly identifying the specific muscles affected within the gracilis-semitendinosus muscle complex. Both modalities can localize anatomically lesions in detail, for instance at the origin or insertion of the muscle, which could present advantages in novel treatment strategies for this condition.

Prevalence of Spinal Meningeal Diverticula in Autosomal Dominant Polycystic Kidney Disease.

Patients with autosomal dominant polycystic kidney disease (ADPKD) develop cysts in the kidneys, liver, spleen, pancreas, prostate, and arachnoid spaces. In addition, spinal meningeal diverticula have been reported. To determine whether spinal meningeal diverticula are associated with ADPKD, we compared their prevalence in subjects with ADPKD with a control cohort without ADPKD. Subjects with ADPKD and age- and sex-matched controls without ADPKD undergoing abdominal MRI from the midthorax to the pelvis from 2003 to 2023 were retrospectively evaluated for spinal meningeal diverticula by 4 blinded observers. The prevalence of spinal meningeal diverticula in ADPKD was compared with that in control subjects, using t tests and correlated with clinical and laboratory data and MR imaging features, including cyst volumes and cyst counts. Identification of spinal meningeal diverticula in ADPKD (n = 285, median age, 47; interquartile range [IQR], 37-56 years; 54% female) and control (n = 285, median age, 47; IQR, 37-57 years; 54% female) subjects had high interobserver agreement (pairwise Cohen κ = 0.74). Spinal meningeal diverticula were observed in 145 of 285 (51%) subjects with ADPKD compared with 66 of 285 (23%) control subjects without ADPKD (P < .001). Spinal meningeal diverticula in ADPKD were more prevalent in women (98 of 153 [64%]) than men (47 of 132 [36%], P < .001). The mean number of spinal meningeal diverticula per affected subject with ADPKD was 3.6 ± 2.9 compared with 2.4 ± 1.9 in controls with cysts (P < .001). The median volume (IQR, 25%-75%) of spinal meningeal diverticula was 400 (IQR, 210-740) mm3 in those with ADPKD compared with 250 (IQR, 180-440) mm3 in controls (P < .001). The mean spinal meningeal diverticulum diameter was greater in the sacrum (7.3 [SD, 4.1] mm) compared with thoracic (5.4 [SD, 1.8] mm) and lumbar spine (5.8 [SD, 2.0] mm), (P < .001), suggesting that hydrostatic pressure contributed to enlargement. ADPKD has a high prevalence of spinal meningeal diverticula, particularly in women.

Gadoxetic Acid-Enhanced Magnetic Resonance Imaging Features Can Predict Immune-Excluded Phenotype of Hepatocellular Carcinoma

Introduction: Immunotherapy is the first-line treatment for intermediate-advanced stage hepatocellular carcinoma (HCC), although its outcomes vary. This study aimed to identify imaging biomarkers of immunotherapy susceptibility linked to gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) and immune phenotypes, particularly immune-excluded phenotypes, with a tumor immune barrier. Methods: We performed immunohistochemical staining with a CD8+ antibody, and samples were classified into immune-inflamed, -intermediate, -excluded, and -ignored phenotypes. We assessed EOB-MRI findings obtained from 104 patients who underwent hepatectomy for HCC and evaluated the relationship between MRI findings and immune phenotype. Spatial transcriptome analysis of tumor tissues in each immune phenotype was performed to characterize the MRI findings. For validation, we analyzed the treatment effect on 60 nodules in another cohort of 27 patients who received combined immunotherapy using anti-programmed death-ligand 1 and anti-vascular endothelial growth factor (VEGF) antibodies. Results: HCCs with rim arterial phase hyperenhancement (APHE) (odds ratio [OR] 17.3 P=0.009), peritumoral enhancement on the arterial phase (OR 8.6, P&lt;0.004), and intermediate intensity on the hepatobiliary phase (HBP) measured with a visual 3-point scale (OR 28.2, P=0.002) were associated with immune-excluded phenotype, where tumors tended to be larger and of the single nodular type with extranodular growth and confluent multinodular rather than the simple nodular type. Spatial transcriptome analysis revealed a spatial relationship among cytotoxic T lymphocytes, VEGF signals, and cancer-associated fibroblasts at the tumor-invasive margins in this phenotype. From the validation study, nodules with any one of these three imaging findings had a significantly prolonged time to-nodular progression (P=0.007, median not reached vs. 226 days). Conclusion: HCCs with rim APHE, peritumoral enhancement on arterial phase, and intermediate intensity on HBP with visual 3-point scale could be non-invasive biomarkers to predict the immune-excluded phenotype with tumor immune barrier. These HCCs were most likely to respond to the combined immunotherapy.

Prognostic significance of collagen content in solitary fibrous tumors of the central nervous system.

We aimed to explore the prognostic significance of collagen content in solitary fibrous tumors (SFTs) of the central nervous system (CNS) and preliminarily investigate its relationship with magnetic resonance imaging (MRI) features of SFTs. Collagen content was identified using Masson's trichrome staining, and quantitatively assessed. Radiomic methods were applied to extract quantitative MRI features of SFTs, which were then analyzed in relation to collagen content. The collagen content in CNS SFTs was categorized into high- and low-content groups, with a cutoff value of 6%. Survival analysis indicated a positive correlation between collagen content and overall survival (OS). In multivariate Cox regression analysis, incorporating factors such as mitosis, necrosis, Ki67, and collagen content and other indicators, collagen content emerged as an independent prognostic factor. Collagen content demonstrated a negative correlation with tumor histological phenotype, Ki67, WHO grade, mitosis, necrosis, and brain invasion. Additionally, the signal intensity of SFTs on T2-weighted imaging (T2WI) decreased with increasing collagen content. Radiomics analysis identified 1,702 features from each patient's region of interest, with 12 features showing significant differences between the high and low collagen content groups. Among the quantitative parameters and radiomic models, the combined T1- and T2WI models exhibited the highest diagnostic performance. These findings suggest that collagen content is an independent prognostic risk factor for OS. Furthermore, combined radiomic models based on T1-and T2WI sequences may offer a more comprehensive, objective, and accurate assessment of collagen content in CNS SFTs.

Automatic segmentation-based multi-modal radiomics analysis of US and MRI for predicting disease-free survival of breast cancer: a multicenter study

BackgroundSeveral studies have confirmed the potential value of applying radiomics to predict prognosis of breast cancer. However, the tumor segmentation in these studies depended on delineation or annotation of breast cancer by radiologist, which is often laborious, tedious, and vulnerable to inter- and intra-observer variability. Automatic segmentation is expected to overcome this difficulty. Herein, we aim to investigate the value of automatic segmentation-based multi-modal radiomics signature and magnetic resonance imaging (MRI) features in predicting disease-free survival (DFS) of patients diagnosed with invasive breast cancer.MethodsThis retrospective multicenter study included a total of 643 female patients with invasive breast cancer who underwent preoperative ultrasound (US) and MRI for prognostic analysis. Data (n = 480) from center 1 were divided into training and internal testing sets, while data (n = 163) from centers 2 and 3 were analyzed as the external testing set. We developed automatic segmentation frameworks for tumor segmentation by deep learning. Then, Least absolute shrinkage and selection operator Cox regression was used to select features to construct radiomics signature, and corresponding radiomics score (Rad-score) was calculated. Finally, six models for predicting DFS were constructed by using Cox regression and assessed in terms of discrimination, calibration, and clinical usefulness.ResultsThe multi-modal radiomics signature combining intra- and peri-tumoral radiomics signatures of US and MRI achieved a higher C-index in the internal (0.734) and external (0.708) testing sets than most other radiomics signatures in predicting DFS, and successfully stratified patients into low- and high-risk groups. The multi-modal clinical imaging model combining the multi-modal Rad-score and clinical traditional MRI model-score resulted in a higher C-index (0.795) than other models in the external testing set, and it had a better calibration and higher clinical benefit.ConclusionsThis study demonstrates that the multi-modal radiomics signature derived from automatic segmentations of US and MRI is a promising risk stratification biomarker for breast cancer, and highlights that the appropriate combination of multi-modal radiomics signature, clinical characteristics, and MRI feature can improve performance of individualized DFS prediction, which might assist in guiding decision-making related to breast cancer.

Added-value of dynamic contrast-enhanced MRI to conventional MRI for the differentiation between inflammatory myofibroblastic tumor and squamous cell carcinoma in the sinonasal region.

The purpose of this study was to evaluate the additional value of dynamic contrast-enhanced (DCE) MRI and diffusion weighted MRI (DWI) in differentiation between inflammatory myofibroblastic tumor (IMT) and squamous cell carcinoma (SCC) in the sinonasal cavity. Patients with pathologically proven IMT and SCC in the sinonasal region were enrolled in this retrospective study. All participants underwent conventional MRI and dynamic contrast-enhanced MRI, while a subset of them performed DWI. All the MRI parameters were independently analyzed by two investigators. This retrospective study included 21 patients with IMT and 55 patients with SCC. Significant differences were found in the conventional MR imaging features including mass margin, T2 signal intensity and track sign of maxillary (p < 0.05). For DCE-MRI features, significant differences were found in progressive centripetal continual enhancement and CImax (p < 0.001 and p = 0.026, respectively). A marginal significant difference was found in ADC values between IMT (0.86 ± 0.59) and SCC (1.14 ± 0.25) (p = 0.061). The conventional MRI analysis revealed that the combination of mass margin and track sign of maxillary yielded an accuracy of 81.6%. Using a combination of progressive centripetal continual enhancement on DCE-MRI and track sign of maxillary in multivariate logistic regression analysis, the accuracy was elevated to 92.1%. The incorporation of DCE-MRI features into conventional MRI showed improved diagnostic performance in differentiating IMT from SCC in the sinonasal region. The novel progressive centripetal continual enhancement on DCE-MRI is the most effective feature of IMT.

NIMG-87. MULTIREGIONAL, MRI-LOCALIZED SAMPLING OF HIGH GRADE GLIOMAS REVEAL SEX-DISTINCT PATTERNS OF 5-ALA FLUORESCENCE AND IMAGING FEATURES

Abstract High grade gliomas (HGGs) are aggressive brain tumors that are difficult to remove completely, leading to poor survival rates. Contrast enhancement on T1Gd magnetic resonance imaging (MRI) has traditionally been used to guide resection, however it often underestimates true tumor burden, adding a layer of uncertainty for surgeons during pre-operative planning. Fluorescence guided surgery using 5-aminolevulinic acid (5-ALA) has emerged as an intraoperative solution and understanding it in conjunction with MRI features can address the limitations of routine T1Gd imaging during surgical planning. Here we investigate sex-specific patterns in HGGs using 5-ALA fluorescence and imaging features. We analyzed a patient dataset of 202 multiregional MRI-localized biopsies from 42 HGG patients (20 male and 22 female). Data included patient demographics, 5-ALA status (positive or negative), MRI annotations (CE = contrast enhancement, NE = non-enhancement, BAT = brain around tumor non-enhancement), and survival outcomes. Statistical analyses included Wilcoxon rank-sum tests, Kruskal-Wallis tests, and chi-squared tests to assess differences in imaging annotations and 5-ALA positive vs negative status among sex cohorts. Among all samples, CE and BAT were associated with higher 5-ALA positivity, while NE was associated with higher 5-ALA negativity (p = 0.02119). Female patients were less likely to have detectable 5-ALA in their multiregional biopsy samples than males (p &amp;lt; 0.0001). CE at the biopsy location was more likely to be indicative of 5-ALA positivity in males than females (p = 0.001927); whereas NE was associated with higher 5-ALA negativity in females than males (p = 0.03426). BAT was associated with higher 5-ALA positivity in males than females (p = 0.03895). Our study reveals sex-specific patterns in 5-ALA fluorescence and image features among HGG patients. These unique features may serve as potential pre-surgical markers for tumor regions that are more likely to benefit from 5-ALA-guided resection.

Chronic sclerosing sialadenitis of the parotid gland mimicking a neoplasm

Chronic sclerosing sialadenitis or Küttner tumor is a benign chronic inflammatory disease of the salivary gland, most commonly involving the submandibular salivary gland in middle aged adults. We describe the magnetic resonance imaging features of a rare case of Küttner tumor with isolated parotid gland involvement in a child, to emphasize on the need for increased awareness among radiologists regarding the possibility and imaging features of this condition, and to enable its timely diagnosis and appropriate management.

Valuing the importance of sex differences in prodromal Alzheimer's disease based on structural magnetic resonance imaging.

Alzheimer's disease (AD) can be optimally managed from a healthcare point of view if detected at a prodromal stage. Amnestic mild cognitive impairment (MCI) is known as prodromal AD, has attracted extensive attention and research. To identify the differences in cognitive function and structural magnetic resonance imaging (MRI) features between men and women with MCI on the basis of A/T/N classification system ("A" means amyloid-β biomarker, "T" means tau biomarker, and "N" means neurodegeneration biomarker as determined by clinical imaging (e.g., positron emission tomography, magnetic resonance imaging (MRI)) or by the measurement of total tau protein (T-tau) in the cerebrospinal fluid (CSF)) and to further explore the correlation between them. 406 MCI subjects were selected from the Alzheimer's Disease Neuroimaging Initiative database and divided into male and female MCI groups. Differences in demographic characteristics, biomarkers, cognitive assessment performance, and regions of interest (ROIs) of structural MRI were compared between the two groups. The correlations between brain structural changes quantified by MRI and cognitive abilities were investigated through linear regression models. Compared with male MCI subjects, females had significantly higher T-tau concentration in CSF. There were significant differences in ROIs between the sex groups. In the male MCI group, the average cortical thicknesses of the right posterior cingulate, right anterior cingulate and right supramarginal gyrus were more closely correlated with cognitive function. In the female MCI group, the volume of the right rostral anterior cingulate, and the surface area and average cortical thickness of the right isthmus of the cingulate gyrus were more closely correlated with cognitive function. Based on A/T/N classification system, the structural MRI data analysis was closely correlated with the difference of cognitive function from patients with prodromal AD in a sex-dependent manner.

Analysis of ultrasound and magnetic resonance imaging characteristics of kaposiform hemangioen dothelioma

ObjectiveThe present study aims to investigate the ultrasound and magnetic resonance imaging (MRI) characteristics of kaposiform hemangioen dothelioma (KHE).MethodsA retrospective analysis was conducted on the clinical data of children diagnosed with KHE through postoperative pathology. Patients were divided into two groups: the KHE group and the KHE with Kasabach-Merritt Phenomenon (KMP) group (KMP group). Laboratory indicators, ultrasound, and MRI data were collected and analyzed statistically to summarize the imaging characteristics of the disease.ResultsThe levels of platelets and fibrinogen in the KHE group were significantly higher than those in the KMP group, while D-dimer levels, prothrombin time, and activated partial thromboplastin time were lower (P < 0.05). Ultrasound characteristics comparison revealed that lesions extending to the fat layer (42.47% vs. 54.24%) and invading the muscle layer (38.36% vs. 69.49%) were less common in the KHE group compared to the KMP group, with the lesion diameter being smaller in the KHE group (P < 0.05). The Adler grading predominantly showed Grade II (45.21%) in the KHE group, whereas Grade III (93.22%) was more prevalent in the KMP group (P < 0.05). MRI analysis indicated that the incidence of lesions invading the muscle layer and the presence of flow voids were lower in the KHE group compared to the KMP group (P < 0.05).ConclusionKHE patients with KMP exhibit lesions that are more prone to extending into the fat layer and invading the muscle layer, with larger diameters and abundant blood flow. Additionally, the MRI images of the lesions may exhibit flow voids.

Histopathological substrate of increased T2 signal in the anterior temporal lobe white matter in temporal lobe epilepsy associated with hippocampal sclerosis.

This study was undertaken to analyze the histology underlying increased T2 signal intensity (iT2SI) in anterior temporal lobe white matter (aTLWM) epilepsy due to hippocampal sclerosis (TLE/HS). Twenty-three patients were included: 16 with increased T2 signal in the aTLWM and seven with HS only. Magnetic resonance imaging (MRI) findings were consistent across two neuroradiologists (kappa = .89, p < .001). Quantification of neuronal cells, astrocytes, oligodendrocytes, and vacuolization in the white matter of temporal lobe specimens was performed by immunohistochemistry (neuronal nuclear antigen, glial fibrillary acidic protein, oligodendrocyte transcription factor, and basic myelin protein, respectively). Surgical specimens from TLE/HS patients with and without iT2SI in the aTLWM were compared. Samples of aTLWM were divided into three groups, according to MRI features: G1 = samples of iT2SI, G2 = samples with normal T2 signal intensity from patients without white matter imaging abnormalities, and G3 = samples with normal T2 signal intensity adjacent to areas with iT2SI. Patients with increased T2 signal had a significantly younger age at epilepsy onset (p < .035). Histological analysis revealed a higher percentage of vacuolar area in these patients (p < .004) along with a lower number of ectopic neurons (p = .042). No significant differences were found in astrocyte or oligodendrocyte counts among groups. A higher proportion of vacuoles in regions with iT2SI may be the histopathologic substrate of this signal alteration in the white matter of the temporal lobe in patients with TLE/HS. This method of quantifying vacuoles using digital image analysis proved reliable and cost-effective.

Association of inflammatory cytokines with magnetic resonance imaging features of the brain in patients with depression.

There is growing evidence that the imbalance of inflammatory cytokines plays an important role in the pathophysiological mechanism of depression. However, the effects of inflammatory cytokines on the whole brain in patients with depression are still not fully elucidated. The present study aimed to investigate the relationship between inflammatory cytokines and cerebral magnetic resonance imaging (MRI) features using voxel-based whole-brain analysis in patients with depression. A total of 60 patients with depression and 60 healthy controls (HCs) were included. Interleukin-1 was positively correlated with gray matter volume (GMV) in the left putamen and negatively correlated with regional homogeneity (ReHo) and degree centrality (DC) in the left anterior cingulate cortex. Interleukin-6 was positively correlated with GMV in the right superior parietal lobule and ReHo in the left pallidum and putamen. Interferon-α was negatively correlated with DC in the left postcentral gyrus. The ReHo in the left pallidum in depressed patients was lower than that in HCs. The FCs based on the left pallidum as the seed in depressed patients were significantly reduced. The imaging features of the left pallidum had good performance (area under the curve: 0.891) for identifying depressed patients. Inflammatory cytokines are associated with cerebral imaging features in patients with depression and in particular, the abnormal imaging features of the left pallidum may be a potential neuroimaging biomarker of depression.

The clinical characteristics of Hirayama disease in females

IntroductionTo characterize Hirayama disease in female patients, and increase awareness among clinicians regarding the specifics of this disease. MethodsBaseline data, clinical manifestations, characteristics of cervical-flexion magnetic resonance imaging, and electromyography were collected and compared among females and males with Hirayama disease. In addition, the literature on Hirayama disease in females up to October, 2021 was searched in PubMed and the relevant data were compared with the data from our study. ResultsTwenty female and 40 male patients were included in this study. The average ages of onset and menarche were 14.65 and 12.75 years old. All patients suffered from muscular weakness and atrophy of the upper limb(s), with flattening and/or atrophy of the lower cervical spinal cords in cervical-flexion magnetic resonance imaging, and neurogenic patterns in the atrophic muscles as determined using electromyography. The age of onset in females was about 2 years later than the age of menarche, and the age of onset in females was 2 years earlier than that in males. There were no obvious differences in clinical presentation between males and females. DiscussionAlthough females presented with Hirayama disease two years earlier than males, no other clinical differences were observed. Hirayama disease is likely associated with growth and development in puberty, and early identification, regardless of whether patients are male or female, is critical to optimizing prognosis.

Ultrasound and magnetic resonance imaging (MRI) features of angioleiomyoma.

Vascular leiomyoma or angioleiomyoma is a rare benign tumor which belongs to the group of benign smooth muscle tumors. They are commonly located at the extremities, usually presented as a painful solitary lesion in the subcutaneous tissue. To date, very few reports describe its characteristics from an imaging point of view, especially their ultrasound characteristics, making it difficult to do a pre-surgical diagnosis. Our purpose is to describe the clinical, pathologic and imaging features of angioleiomyoma [ultrasound, Doppler ultrasound and magnetic resonance imaging (MRI) findings]. We retrospectively reviewed from the pathology database from Hospital Universitario Fundación Alcorcón, Madrid, Spain, the clinical histories of 139 patients who had surgical excision and histologic diagnosis of angioleiomyoma during the last 17 years, from May 31st 2006 to April 17th 2023. Of those patients, we focused on 50 who had soft tissue angioleiomyoma with imaging study [ultrasonography (US) and/or MRI] performed in our institution, making a descriptive cross-sectional study. In our series, a very characteristic ultrasonographic and US Doppler pattern was found. It consists in the presence of a well defined, homogeneous and highly vascularized soft tissue tumor, sometimes with the presence of a feeding vessel. When the described US features appear in a mobile and elastic subcutaneous slow growing tumor on an extremity, the diagnosis of angioleiomyoma should be considered as highly probable.

Quantitative assessments of white matter hyperintensities and plasma biomarkers can predict cognitive impairment and cerebral microbleeds in cerebral small vessel disease patients

The objective of this study is to examine the efficacy of magnetic resonance imaging (MRI) features and peripheral blood biomarkers in assessing cognitive function in patients with cerebral small vessel disease (CSVD). A total of 58 CSVD patients were recruited. Six features of white matter hyperintensities (WMHs) were derived from MRI scans. Additionally, five neurodegenerative biomarkers (Aβ40, Aβ42, t-tau, p-tau181, NfL) and 13 serum inflammatory cytokines (VILIP-1, CCL2, IL-6, IL-18, TNF-α, CX3CL, sTREM-1/2, VEGF, s-RAGE, BNDF, TGF-β1, β-NGF) were quantified. Cognitive assessments were conducted using standardized neuropsychological scales. Spearman analysis revealed that the volumetric characteristics (absolute area, upper area, bottom area, absolute area percentage, upper percentage, and bottom percentage) of WMHs were negatively correlated with performance on all cognitive scale measures except the verbal fluency test (VFT) (r < -0.3, p > 0.05), while they were positively correlated with plasma neurofilament light (NFL) levels (r > 0.4, p < 0.05). Additionally, serum tumor necrosis factor-α (TNF-α) and soluble receptor for advanced glycation end-products (s-RAGE) showed significant correlations with scales of speech function. An integrated model incorporating WMHs features, neurodegenerative biomarkers, and neuroinflammatory markers was developed, demonstrating high predictive accuracy for cognitive impairment with an area under the curve (AUC) of 0.95 (accuracy 0.88, sensitivity 0.87, specificity 0.89). Another integrated model that includes features of WMHs and inflammatory cytokines for predicting cerebral microbleeds (CMBs) achieved an AUC of 0.95 (accuracy 0.88, sensitivity 0.82, specificity 0.92). Our findings suggest that these markers have the potential to be used for the early detection of cognitive decline and CMBs in patients with CSVD.