Magnetic Resonance Imaging In Patients Research Articles

Arrhythmic Risk Stratification by Cardiovascular Magnetic ResonanceImaging in Patients With Nonischemic Cardiomyopathy.

Myocardial fibrosis (MF) forms part of the arrhythmic substrate for ventricular arrhythmias (VAs). This study sought to determine whether total myocardial fibrosis (TF) and gray zone fibrosis (GZF), assessed using cardiovascular magnetic resonance, are better than left ventricular ejection fraction (LVEF) in predicting ventricular arrhythmias in patients with nonischemic cardiomyopathy (NICM). Patients with NICM in a derivation cohort (n=866) and a validation cohort (n=848) underwent quantification of TF and GZF. The primary composite endpoint was sudden cardiac death or VAs (ventricular fibrillation or ventricular tachycardia). The primary endpoint was met by 52 of 866 (6.0%) patients in the derivation cohort (median follow-up: 7.5 years; Q1-Q3: 5.2-9.3 years). In competing-risks analyses, MF on visual assessment (MFVA) predicted the primary endpoint (HR: 5.83; 95%CI: 3.15-10.8). Quantified MF measures permitted categorization into 3 risk groups: a TF of >0g and≤10g was associated with an intermediate risk (HR: 4.03; 95%CI: 1.99-8.16), and a TF of >10g was associated with the highest risk (HR: 9.17; 95%CI: 4.64-18.1) compared to patients with no MFVA (lowest risk). Similar trends were observed in the validation cohort. Categorization into these 3 risk groups was achievable using TF or GZF in combination or in isolation. In contrast, LVEF of<35% was a poor predictor of the primary endpoint (validation cohort HR: 1.99; 95%CI: 0.99-4.01). MFVA is a strong predictor of sudden cardiac death and VAs in NICM. TF and GZF mass added incremental value to MFVA. In contrast, LVEF was a poor discriminator of arrhythmic risk.

Elevated plasma matrix metalloproteinase 9 in schizophrenia patients associated with poor antipsychotic treatment response and white matter density deficits

Oxidative stress and neuroinflammation contribute to schizophrenia (SCZ) pathology and may influence treatment efficacy. Matrix metalloproteinase 9 (MMP9) is a critical molecular node mediating the interaction between oxidative stress and inflammation, and so may influence treatment efficacy. Here we examined the associations of plasma MMP9 concentration with antipsychotic drug responses, clinical symptoms, and brain structure. A total of 129 healthy controls and 124 patients with SCZ were included in this study. Patients were monitored clinically during 8 weeks of antipsychotic treatment and classified as poor responders (n = 49) or good responders (n = 75). We then compared plasma MMP9 concentrations in healthy controls at baseline and both SCZ responder groups at baseline and after the 8-week antipsychotic treatment regimen. Cognitive function was also examined using the MATRICS Consensus Cognitive Battery. In addition, we extracted regional white matter density from magnetic resonance images of patients. Compared to healthy controls, plasma MMP9 levels were significantly elevated in poor responders at baseline and negatively correlated with both white matter density in the right superior temporal gyrus and the change in cognitive symptoms after treatment. Conversely, there was no significant difference in plasma MMP9 between good responders and healthy controls, and no associations of plasma MMP9 with cognitive symptoms or regional white matter density among good responders. Elevated plasma MMP9 is associated with poor antipsychotic drug efficacy and white matter deficits in SCZ patients, and so may be a useful biomarker to guide personalized treatment.

Myocardial Fibrosis Quantification Methods by Cardiovascular Magnetic Resonance Imaging in Patients with Fabry Disease.

Background/Objectives: The presence of late gadolinium enhancement (LGE) on cardiac magnetic resonance (CMR) in patients with Fabry disease (FD) is a predictor of adverse cardiac events. The aim of this study was to establish the most reliable and reproducible technique for quantifying LGE in patients with FD. Methods: Twenty FD patients with LGE who underwent CMR on the same scanner and LGE sequence were included. LGE quantifications were done using gray-scale thresholds of 2, 3, 4, 5 and 6 standard deviations (SD) above the mean signal intensity of the remote myocardium, the full width at half maximum method (FWHM), visual assessment with threshold (VAT) and the fully manual method (MM). Results: The mean amount of fibrosis varied between quantification techniques from 36 ± 19 at 2SD to 2 ± 2 g using the FWHM (p < 0.0001). Intraobserver reliability was excellent for most methods, except for the FWHM which was good (ICC 0.84; all p < 0.05). Interobserver reliability was excellent for VAT (ICC 0.94) and good for other techniques (all p < 0.05). Intraobserver reproducibility showed the lowest coefficient of variation (CV, 6%) at 5SD and at 2SD and VAT (35% and 38%) for interobserver reproducibility. The FWHM revealed the highest CV (63% and 94%) for both intra- and interobserver reproducibility. Conclusions: The available methods for LGE quantification demonstrate good to excellent intra- and interobserver reproducibility in patients with FD. The most reliable and reproducible techniques were VAT and 5SD, whereas the FWHM was the least reliable in the setting of our study. The total amount of LGE varies strongly with the quantification technique used.

Incremental prognostic value of cardiovascular magnetic resonance imaging in patients with severe LV dysfunction undergoing coronary artery bypass grafting.

Coronary artery disease (CAD) remains a significant global health issue, particularly when complicated by left ventricular ejection fraction (LVEF) < 35%. Although coronary artery bypass grafting (CABG) is recommended for such cases, the unclear prognosis necessitates further investigation. This retrospective study aimed to determine whether cardiovascular magnetic resonance (CMR) imaging provides additional prognostic value in guiding effective clinical management. The study included patients with CAD and LVEF < 35% who underwent CABG surgery after enhanced CMR between March 2016 and March 2023. CMR was performed using a 3.0T scanner with steady-state free precession and phase-sensitive inversion recovery sequences. Prognostic analysis of clinical and CMR data was conducted, with the endpoint defined as cardiovascular death, revascularization, hospitalization for heart failure, or stroke. Statistical analysis included Student's t-test, chi-squared test, univariate and multivariate Cox regression analysis, receiver operating characteristic analysis, Harrell C statistical analysis, integrated discrimination improvement (IDI), and net reclassification improvement (NRI) analysis. The study included 152 patients (mean age 58.6 ± 9.7 years; 138 men). During a mean follow-up of 2.0 years, 8 patients experienced cardiovascular death, while 1 case had revascularization, 13 had hospitalization for heart failure, and 11 had a stroke. Left atrial diameter index (LADi) (hazard ratio [HR], 1.08 [95% confidence interval (CI): 1.02-1.15]; P = 0.04) and late gadolinium enhancement (LGE) mass (HR, 1.03 [95% CI: 1.01-1.06]; P < 0.001) were associated with the endpoint, even after adjusting for multiple clinical variables. Adding LADi and LGE mass improved risk prediction for adverse events, as indicated by the C-index (0.738, p < 0.01), IDI (0.36), and NRI (0.13). Left atrial diameter index (LADi) and scar burden are valuable prognostic indicators in patients with LVEF < 35% undergoing CABG. They offer enhanced risk stratification beyond traditional clinical factors, highlighting their importance in guiding clinical management.

Assessment of Sub Clinical Left Ventricular Ischemia using Oxygen Sensitive Cardiovascular Magnetic Resonance Imaging in Patients with Systemic Sclerosis

Assessment of Sub Clinical Left Ventricular Ischemia using Oxygen Sensitive Cardiovascular Magnetic Resonance Imaging in Patients with Systemic Sclerosis

Assessment of Sub Clinical Right Ventricular Ischaemia Using Oxygen Sensitive Cardiac Magnetic Resonance Imaging in Patients with Systemic Sclerosis: Mechanistic Insights From Advanced Cardiac Imaging

Assessment of Sub Clinical Right Ventricular Ischaemia Using Oxygen Sensitive Cardiac Magnetic Resonance Imaging in Patients with Systemic Sclerosis: Mechanistic Insights From Advanced Cardiac Imaging

Is JAK effective in treating recurrent SAPHO syndrome? TwHF might be a good choice.

Recently, JAKi has also been widely proved to be an effective alternative to conventional treatment for Synovitis acne pustulosis-hyperostosis-osteitis (SAPHO) cases, after failure of multiple drugs including those described above. But what to do when all these treatments fail? We report a case of remission from Tripterygium wilfordii Hook (TwHF) treatment. The patient was treated with nonsteroidal anti-inflammatory drugs, oral prednisone, minocycline, bisphosphonate injection, etanercept, and tofacitinib, but the symptoms did not change significantly. Treatment with TwHF (1.0 mg/kg/day, patient weight 60 kg) was started for 24 weeks. After 50 months of unsatisfactory treatment, this patient was finally treated with herbal TwHF, and after 6 months of treatment, the patient's magnetic resonance imaging and inflammatory indexes were significantly improved, indicating that the disease had been better controlled. In this study, TwHF was successful in treating a patient with refractory SAPHO syndrome who was refractory to multiple Western medications without significant adverse effects or toxicities, but further follow-up is needed to determine long-term efficacy. More case reports as well as clinical trials are still needed to confirm whether TwHF can effectively treat refractory SAPHO syndrome.

Diffusion-tensor magnetic resonance imaging in patients with consequences of obstetric brachial plexus palsy

BACKGROUND: Diffusion-tensor magnetic resonance imaging allows visualizing the conductive pathways of the brain and spinal cord and assessing their structure and integrity and has found wide application in practical medicine. Currently, brachial plexus diffusion-tensor magnetic resonance imaging is not a routine research technique, and very few studies have described its use in children and adolescents. AIM: This study aimed to evaluate the possibility of brachial plexus diffusion-tensor magnetic resonance imaging application in pediatric patients with obstetric brachial plexus palsy sequelae and identify correlations between the diffusion-tensor magnetic resonance imaging parameters of brachial plexus and parameters of electrophysiological study of the upper extremities in these patients. MATERIALS AND METHODS: A complex examination of 50 patients was performed. The main group included 30 patients aged 6–17 years, with contractures and secondary deformities of the bones of the shoulder girdle and upper limbs caused by unilateral obstetric brachial plexus palsy. The control group included 20 patients aged 7–17 (10.1 ± 2.1) years without clinical signs, and anamnestic data indicated the presence of damage to the brachial plexus and peripheral nerves of the upper limbs. RESULTS: No significant differences in diffusion-tensor magnetic resonance imaging parameters of the right and left brachial plexus were found in the control group. Significant differences in fractional anisotropy of the C5–C8 tracts on the side of the damaged brachial plexus were detected compared with those on the side of the undamaged brachial plexus. On the side of the injured brachial plexus, nonlinear correlations were found between the fractional anisotropy of the tracts of the spinal nerve and its branches and the amplitude of sensory responses from the sensory nerve, which originated from the anterior branches of this spinal nerve, and between the volume of the branches of the tracts of the spinal nerve and the amplitude of соmpound motor responses from the muscles, which were innervated by the anterior branches of this spinal nerve. CONCLUSIONS: Diffusion-tensor magnetic resonance imaging allows for the evaluation of the structural changes in the SNs that participate in the formation of the brachial plexus. The results can be used for further studies of diffusion-tensor magnetic resonance imaging of brachial plexuses in various pathologies in pediatric patients.

Association of audiovestibular findings with fluid-attenuated inversion recovery magnetic resonance imaging in patients with vestibular schwannoma

BackgroundVestibular schwannoma (VS) is a benign tumor of the vestibular nerve. Flair-attenuated inversion recovery (FLAIR) of magnetic resonance imaging (MRI) images are sensitive in detecting high protein contents of fluids. ObjectivesTo investigate the association between signal intensity (SI) on FLAIR images and audiovestibular findings in patients with VS. MethodsMedical records of twenty-five patients with VS were retrospectively analyzed. ResultsLarger tumors were associated with increased FLAIR SI of the cochlea, vestibule, and semicircular canal (SCC) on the affected side compared to those of the unaffected side. Pure-tone audiometry (PTA), and speech audiometry were associated with the SI of the affected cochlea. There was no significant correlation between the SI of the vestibule and vestibular evoked myogenic potential, SI of the SCC, and caloric test or video head impulse test results. ConclusionOur study suggests that tumor size was significantly associated with high SI on FLAIR imaging, and audiological findings were associated with the SI of the affected cochlea. Further studies with larger cohorts are required to confirm the association between vestibular function and FLAIR imaging in VS.

The relationship between prognosis and temporal muscle thickness in 102 patients with glioblastoma

Temporal muscle thickness measured on 3D MRI has recently been linked to prognosis in glioblastoma patients and may serve as an independent prognostic indicator. This single-center study looked at temporal muscle thickness and prognosis in patients with primary glioblastoma. Overall survival was the major study outcome. For a retrospective analysis from 2010 to 2020, clinical data from 102 patients with glioblastoma at the Department of Oncology Radiotherapy of the First Affiliated Hospital of Dalian Medical University were gathered. Fifty-five cases from 2016 to 2020 contained glioblastoma molecular typing data, of which 45 were IDH wild-type glioblastomas and were analysed separately. TMT was measured on enhanced T1-weighted magnetic resonance images in patients with newly diagnosed glioblastoma.Overall patient survival (OS) was calculated by the Kaplan–Meier method and survival curves were plotted using the log-rank-sum test to determine differences between groups, and multifactorial analyses were performed using a Cox proportional-risk model.The median TMT for 102 patients was 6.775 mm (range: 4.95–10.45 mm). Patients were grouped according to median TMT, and the median overall survival (23.0 months) was significantly longer in the TMT > median group than in the TMT median group (P 0.001; Log-rank test). Analysing 45 patients with IDH wild type alone, the median overall survival (12 months) of patients in the TMT > median group was significantly longer than that of patients in the TMT ≤ median group (8 months) (P < 0.001; Log-rank test).TMT can serve as an independent prognostic factor for glioblastoma.

Safety of magnetic resonance imaging in patients with cardiac implantable electronic devices and abandoned or epicardial leads: a systematic review and meta-analysis.

Persistent reluctance to perform magnetic resonance imaging (MRI) in patients with abandoned and/or epicardial leads of cardiac implantable electronic devices is related to in vitro studies reporting tip heating. While there is a plethora of data on the safety of MRI in conditional and non-conditional implantable devices, there is a clear lack of safety data in patients with abandoned and/or epicardial leads. Relevant literature was identified in Medline and CINAHL using the key terms 'magnetic resonance imaging' AND 'abandoned leads' OR 'epicardial leads'. Secondary literature and cross-references were supplemented. For reporting guidance, the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 was used. International Prospective Register of Systematic Reviews (PROSPERO) registration number 465530. Twenty-one publications with a total of 656 patients with 854 abandoned and/or epicardial leads and 929 MRI scans of different anatomical regions were included. No scan-related major adverse cardiac event was documented, although the possibility of under-reporting of critical events in the literature should be considered. Furthermore, no severe device dysfunction or severe arrhythmia was reported. Mainly transient lead parameter changes were observed in 2.8% in the subgroup of patients with functional epicardial leads. As a possible correlate of myocardial affection, subjective sensations occurred mainly in the subgroup with abandoned epicardial leads (4.0%), but no change in myocardial biomarkers was observed. Existing publications did not report any relevant adverse events for MRI in patients with abandoned and/or epicardial leads if performed according to strict safety guidelines. However, a more rigorous risk-benefit calculation should be made for patients with epicardial leads.

Cardiopulmonary exercise testing in correlation with magnetic resonance imaging in patients with cardiac amyloidosis

Cardiopulmonary exercise testing in correlation with magnetic resonance imaging in patients with cardiac amyloidosis

Prognostic value of delayed gadolinium enhancement on cardiac magnetic resonance imaging in patients with ischemic cardiomyopathy and an implanted cardioverter-defibrillator

Aim. To examine the impact of late gadolinium enhancement (LGE) in the left ventricular myocardium on magnetic resonance imaging (MRI) on overall mortality and the phases of arrhythmic events in patients with ischemic cardiomyopathy and implantable cardioverter defibrillator (ICD).Methods. This was a single-center retrospective study. A total of 382 medical records of patients from the period between 2019 and 2022, who underwent ICD implantation as part of primary prevention of sudden cardiac death at National Centre of Cardiovascular Surgery, were analyzed. Seventy-four patients were selected for the study. Observation was conducted through in-person examinations and remote monitoring. Endpoints evaluated included overall mortality and arrhythmic events. The cause of death was determined based on the “Promed” medical database. Patients who reached a specific endpoint constituted the case group, while those who did not reach any endpoint formed the control group.Results. During the observation period, arrhythmic events were registered in 26 patients (35.1%), with a total of 27.1±13.2 events. Twenty-one patients (28.4%) deceased. In univariate regression analysis, the presence of LGE, the extent of LGE (%), and the number of segments with LGE served as predictors of ICD activation and overall mortality. Two multivariate logistic regression models were constructed. ROC curves were used to determine the quality of the regression model, with an area under the curve of 0.807 for ICD activation and 0.789 for mortality. The highest sensitivity and specificity of the method were observed with a LGE value equal to or greater than 14% for ICD activation (sensitivity 81%, specificity 75%) and 26% for overall mortality (sensitivity 89%, specificity 64%).Conclusion. Substantiated ICD activations (shock/antitachycardia pacing) were observed in 35.1% of cases, and the overall mortality rate was 28.4%. The association between ICD activation and the extent of LGE occurred when LGE was &gt;14%. The association between overall mortality and the extent of LGE occurred when LGE was &gt;26%.

Whole exome sequencing in young atrial fibrillation patients

Abstract Background Up to 10% of atrial fibrillation (Afib) patients develop the condition in the young age and in the absence of any related risk factors. Recent publications emphasized the importance of genetic testing in this population. However, the yield of the investigation is highly variable and ranges from 1 to 24% precents. Purpose The purpose of this study is to evaluate the prevalence of causative genetic variants in young Afib patients without risk factors and evaluate any structural changes of the heart. Methods We performed whole exome sequencing in 54 young (age of Afib onset less than 65 years) Afib patients without any Afib related risk factors (original cohort). Using ACMG guidelines we performed analysis of 349 previously described cardiomyopathy and arrhythmia associated genes. If a pathogenic (P) or likely pathogenic (LP) variant was found, a cardiac magnetic resonance imaging (CMR) was performed to exclude any structural abnormalities of the heart. We also extracted 107 young Afib patients without any risk factors from UK Biobank (UK Biobank cohort) and performed analysis of the same genes in the subgroup. Results The prevalence of P and LP variants was 24% (13 cases) in the original cohort and 8% (9 cases) in the UK Biobank cohort (p=0.006). We observed variants in cardiac structural and developmental genes only in both cohorts (Table 1 and 2). In the original cohort there were nine (17%) patients with P and LP variant in TTN gene. Moreover, five patients were positive for the same TTN variant NM_001267550.2:c.13696C&amp;gt;T p.(Gln4566Ter). In six (46%) original cohort patients we observed structural changes of the heart on CMR – in five patients there was dilation of one or both ventricles and in one there was increased T1 mapping intensity of septal wall segments. Conclusions 1. There is a high prevalence of pathogenic and likely pathogenic causative genetic variants in young atrial fibrillation patients without any risk factors. 2. All variants are localized in cardiac structural or developmental genes only. 3. There is a high grade of structural changes of the heart observed on cardiac magnetic resonance imaging in patients with monogenic atrial fibrillation.Table 1.WES data in original cohortTable 2.WES data in UK Biobank cohort

Predicting atrial fibrillation risk following embolic stroke of unknown source using cardiac magnetic resonance imaging

Abstract Background Approximately 25% of embolic strokes of unknown source (ESUS) are attributed to undiagnosed atrial fibrillation (AF).1 The European Stroke Organisation (ESO) recommends implantable loop recorder (ILR) monitoring to identify ESUS patients with AF, permit the initiation of anticoagulation and reduce risk of recurrent stroke.2 However, this approach delays treatment and carries significant cost and resource implications. An alternative approach, where early anticoagulation is initiated in the absence of AF has failed to reduce recurrent stroke in four randomised controlled trials (NAVIGATE ESUS, RE-SPECT ESUS, ATTICUS and ARCADIA).3-6 An urgent need exists for new strategies to identify ESUS patients with undiagnosed AF that are at high risk of future thromboembolism. Purpose The primary objective of this study was to produce a substrate-based predictive model for AF in ESUS patients using atrial cardiac magnetic resonance imaging (CMRi). Method The Atrial CARdiac Magnetic resonance imaging in patients with embolic stroke of unknown source without documented AF (CARM-AF) Study is a prospective, multi-centre, observational study. All patients underwent CMRi and ILR insertion for AF detection within 3 months of ESUS. The main inclusion criteria were expected survival &amp;gt;12 months, CHA2DS2VASc≥3 and eGFR &amp;gt;30ml/min. Patients were allocated to the study group if AF &amp;gt;30 seconds was detected by ILR during the first year of follow-up and control group if no AF detected (Figure 1). Univariable analysis was used to identify clinical, echocardiographic and CMR parameters associated with AF diagnosis. Parameters with p&amp;lt;0.2 and no co-linearity were used to develop multivariable logistic regression models for AF prediction. Results From September 2020 to September 2022, 102 patients were enrolled and 91 were included in the final analysis. AF was detected in 17 patients during the first year of follow-up (18.6%). In univariable analysis, patients with AF were more likely to be female (p=0.02), but there were no significant differences in age, race, body mass index (BMI) or CHA2DS2VASc score (p=0.06, 0.272, 0.195, 0.211) between groups. Increased left atrial (LA) volume, surface area and reduced LA ejection fraction were associated with increased risk of AF detection at 1 year (p=0.006, 0.044, 0.008). LA fibrosis and sphericity were not associated with AF (p=0.84, 0.98). Logistic regression models for AF risk prediction were developed using patient, echocardiographic and CMR parameters. A combined model of patient and CMR parameters outperformed assessment of patient characteristics alone, achieving an AUC of 0.85 for predicting AF occurrence (p&amp;lt;0.005). Pseudo R2 of 0.30 (McFadden) indicated excellent model fit (Figure 2). Conclusion CARM-AF is the first study to demonstrate feasibility and utility of CMR imaging to predict AF risk following ESUS. A randomised controlled trial initiating anticoagulation using the developed model is recommended.Study DesignModel Comparison (ROC Curves)

A Rare Case of an Adult with Spinal Cord Injury Without Neuroimaging Abnormality (SCIWONA)

BackgroundSpinal cord injury without radiographic abnormality (SCIWORA) is defined as having clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability. An abnormal finding, such as a fracture, subluxation, or abnormal intersegmental motion at the level of the spinal cord injury, excludes SCIWORA as the diagnosis. Prevalence of SCIWORA is highest among children younger than 8 years, and is a diagnosis seen primarily in children, owing to anatomic differences that put children at more risk of this condition. In more recent years, with the increasing use of magnetic resonance imaging in patients with suspected spinal cord injury, a new term, spinal cord injury without neuroimaging abnormality (SCIWONA) has been suggested as a more specific way to describe cases of SCIWORA that have negative neuroimaging. Case ReportHere we describe a case of a woman who presented with symptoms consistent with a spinal cord injury after a traumatic fall. Her presentation and imaging were consistent with SCIWONA. The patient subsequently had rapid and complete recovery of her neurologic function. Why Should an Emergency Physician Be Aware of This? Early recognition of SCIWONA and subsequent medical management is imperative for improved outcomes for these patients. Operative treatment is rare and typically only necessary in patients with consistent spinal cord instability.

Combining convolution neural networks with long‐short term memory layers to predict Parkinson's disease progression

AbstractParkinson's disease (PD) is a neurological condition that occurs in nearly 1% of the world's population. The disease is manifested by a sharp drop in dopamine production, resulting from the death of the related producing cells in an area of the midbrain called the substantia nigra. Early diagnosis and accurate staging of the disease are essential to apply the appropriate therapeutic approaches to slow cognitive and motor decline. At present, there is not a singular blood test or biomarker accessible for diagnosing PD or monitoring the progression of its symptoms. Clinical professionals identify the disease by assessing the symptoms, which, however, may vary from case to case, as well as their progression speed. Magnetic resonance imaging (MRIs) have been used for the past three decades to diagnose and distinguish between PD and other neurological conditions.However, to the best of our knowledge, no neural network models have been designed to identify the disease stage. This paper aims to fill this gap. Using the “Parkinson's Progression Markers Initiative” dataset, which reports the patient's MRI and an indication of the disease stage, we developed a model to identify the level of progression. The images and the associated scores were used for training and assessing different deep learning models. Our analysis distinguished four distinct disease progression levels based on a standard scale (Hoehn and Yah scale). The final architecture consists of the cascading of a 3D‐CNN network, adopted to reduce and extract the spatial characteristics of the MRI for efficient training of the successive LSTM layers, aiming at modeling the temporal dependencies among the data. Before training the model, the patient's MRI is preprocessed to correct acquisition errors by applying image registration techniques, to extract irrelevant content from the image, such as nonbrain tissue (e.g., skull, neck, fat). We also adopted template‐based data augmentation techniques to obtain a balanced dataset about progression classes. Our results show that the proposed 3D‐CNN + LSTM model achieves state‐of‐the‐art results by classifying the elements with 91.90 as macro averaged OVR AUC on four classes.

Comparison of Cardiac Activated Fibroblast Imaging and Magnetic Resonance Imaging in Patients with COVID-19-Related Myocarditis.

This study aimed to explore the association between cardiac fibroblast activation and cardiac magnetic resonance (CMR) imaging parameters in patients with myocarditis following infection with coronavirus 2019 (COVID-19). In this prospective study, four patients with COVID-19-related myocarditis underwent 99mTc-labeled-hydrazinonicotinamide-fibroblast activation protein inhibitor-04 (99mTc-HFAPi) single photon emission computed tomography/computed tomography (SPECT/CT) and CMR imaging. Segmental 99mTc-HFAPi activity was quantified as the percentage of average segmental myocardial count global left ventricular target-to-background ratio. T1/T2 values, extracellular volume (ECV), and late gadolinium enhancement (LGE) were analyzed by CMR. The consistency between myocardial 99mTc-HFAPi activity and CMR parameters was explored. In patients with myocarditis, the proportion of segments with abnormal 99mTc-HFAPi activity was significantly higher than in those with abnormal LGE (81.25% vs. 60.93%, p = 0.011), abnormal T2 (81.25% vs. 50.00%, p 0.001), and abnormal ECV (81.25% vs. 59.38%, p = 0.007); however, they were similar in those with abnormal native T1 (81.25% vs. 73.43%, p = 0.291). Meanwhile, 99mTc-HFAPi imaging exhibited good consistency with native T1 (kappa = 0.69). Increased cardiac 99mTc-HFAPi activity is present in COVID-19-related myocarditis, which is correlated with the native T1 values in CMR.

Are Chiari Malformation and Basilar Invagination Associated with Jugular Foramen Stenosis?

ObjectiveTo compare the diameter of the jugular foramen (JF) between normal individuals and those with the diagnosis of craniovertebral junction abnormalities, such as Chiari malformation type I (CMI) and/or basilar invagination (BI). MethodsThis cross-sectional analytical study measured the diameter of right and left JF in magnetic resonance imaging of patients that were split into four groups: 68 with combined CMI and BI (CMI+BI), 42 with isolated BI, 45 with isolated CMI, and 102 control cases. The t test determined sex differences, while univariate ANOVA with Tukey's post-hoc test assessed JF differences between groups. ResultsConsidering all combinations of laterality and sex, CMI+BI had JF narrower than their respective controls. The JF was bilaterally narrower in BI than the control, only in females. Regardless of laterality, CMI had wider JF than the CMI+BI in males, and it did not differ from the control. In the females of CMI, the right JF did not differ from the control, and it was wider than the CMI+BI; while the left JF was narrower than the control, and it did not differ from the CMI+BI. ConclusionJF narrowing is associated with CMI and BI when they are found combined in the same patient. When CMI or BI are detected separately, they do not imply evident changes in JF morphometry. It is expected that these findings could bring empiric substrate to support theories that claims a possible role of intracranial pressure disturbances as a triggering factor for CMI.

Magnetic resonance imaging in patients with immune check point inhibitors induced hypophysitis

Magnetic resonance imaging in patients with immune check point inhibitors induced hypophysitis