Cerebellar subpial hemorrhage – an underestimated location of fetal intracranial hemorrhage

小脑软膜下出血——一种被低估的胎儿颅内出血部位

Subpial hemorrhage (SPH) is a rare form of intracranial hemorrhage, typically observed in neonates. It differs from subarachnoid and subdural hemorrhages in both anatomical location and underlying pathophysiology. The primary aim of this study was to describe the distinct fetal MRI features of cerebellar SPH. Fetal cerebellar SPH are characterized by crescentic foci of signal abnormality that appear "attached" to the cerebellar surface. Cerebellar SPH constitutes a distinct entity that may be detected on prenatal imaging, either in isolation or in association with fetal germinal matrix-intraventricular hemorrhage (GM-IVH).

软脑膜下出血（SPH）是一种罕见的颅内出血形式，通常见于新生儿。它在解剖位置和潜在病理生理机制方面均与蛛网膜下腔出血和硬膜下出血不同。本研究的主要目的是描述小脑SPH独特的胎儿磁共振成像（MRI）特征。胎儿小脑SPH的特征是呈新月形的信号异常病灶，看起来“附着”于小脑表面。小脑SPH是一种独特的病变，可在产前影像学检查中被发现，可单独出现，也可与胎儿生发基质 - 脑室内出血（GM - IVH）同时存在。

REF: Haboosheh A, Amberg N, Haberler C, et al. Cerebellar subpial hemorrhage - an underestimated location of fetal intracranial hemorrhage. AJNR Am J Neuroradiol. Published online October 8, 2025. doi:10.3174/ajnr.A9019 PMID: 41015539

Disparities in Access to Specialized Care for Spontaneous Intracranial Hypotension

自发性颅内低压综合征患者在获得专科治疗方面存在的差异

Patients with spontaneous intracranial hypotension (SIH) often face substantial delays in diagnosis and treatment. Barriers to accessing specialized care for SIH remain poorly understood, particularly with regard to potential demographic and/or socioeconomic disparities. The purpose of this study is to evaluate whether patients seen in a specialized CSF leak clinic differ demographically or socioeconomically from those presenting to the emergency department (ED) with headache who receive neuroimaging. Patients accessing specialized care for SIH at a tertiary referral center are more likely to be white, English-speaking, and privately insured compared to patients presenting to the ED with headache, despite coming from farther geographic distances. These findings suggest significant disparities in access to specialty care for SIH, highlighting the need for targeted outreach, streamlined referral pathways, and broader diagnostic awareness in general practice and emergency settings.

自发性颅内低血压（SIH）患者在诊断和治疗方面往往会出现严重延误。目前，人们对获得SIH专科治疗的障碍仍知之甚少，尤其是在潜在的人口统计学和/或社会经济差异方面。本研究旨在评估在脑脊液漏专科门诊就诊的患者与因头痛到急诊科就诊并接受神经影像学检查的患者在人口统计学或社会经济方面是否存在差异。与因头痛到急诊科就诊的患者相比，在三级转诊中心接受SIH专科治疗的患者更有可能是白人、讲英语且有私人保险，尽管他们来自更远的地理区域。这些发现表明，在获得SIH专科治疗方面存在显著差异，凸显了在全科医疗和急诊环境中开展有针对性的宣传、简化转诊途径以及提高广泛诊断意识的必要性。

REF: Puello MP, Trivedi P, Kerrigan K, et al. Disparities in Access to Specialized Care for Spontaneous Intracranial Hypotension. AJNR Am J Neuroradiol. Published online October 8, 2025. doi:10.3174/ajnr.A9036 PMID: 41062183

Motion-Informed 3D Deep Learning Reconstruction in Patients with Cognitive Impairment

认知障碍患者的运动信息辅助三维深度学习重建

Motion artifacts remain a key limitation in brain MRI, particularly during 3D acquisitions in cognitively impaired patients. Most deep learning (DL) reconstruction techniques improve signal-to-noise ratio but lack explicit mechanisms to correct for motion. This study aims to validate a DL reconstruction method that integrates retrospective motion correction into the reconstruction pipeline for 3D T1-weighted brain MRI. Motion-informed DL reconstruction improved both morphometric accuracy and perceived image quality in 3D T1-weighted brain MRI. This technique may enhance diagnostic utility and reduce scan failure rates in motion-prone patients with cognitive impairment.

运动伪影仍然是脑部磁共振成像（MRI）的一个关键限制因素，尤其是在对认知障碍患者进行三维（3D）扫描时。大多数深度学习（DL）重建技术可提高信噪比，但缺乏明确的运动校正机制。本研究旨在验证一种将回顾性运动校正融入3D T1加权脑部MRI重建流程的DL重建方法。结合运动信息的DL重建方法提高了3D T1加权脑部MRI的形态测量准确性和主观图像质量。这项技术可能会提高诊断效能，并降低易出现运动伪影的认知障碍患者的扫描失败率。

REF: Fujita S, Polak D, Nickel D, et al. Motion-Informed 3D Deep Learning Reconstruction in Patients with Cognitive Impairment. AJNR Am J Neuroradiol. Published online October 8, 2025. doi:10.3174/ajnr.A8977 PMID: 41062184

Reliability of pseudocontinuous arterial spin labeling in ischemic stroke and comparison with other perfusion techniques: systematic review and meta-analysis

伪连续动脉自旋标记技术在缺血性卒中中的可靠性及与其他灌注技术的比较：系统评价与荟萃分析

Pseudocontinuous arterial spin labeling (pCASL) is a non-invasive, gadolinium-free MRI technique for assessing brain perfusion. To evaluate the test-retest reliability of pCASL-CBF measurements in ischemic stroke (IS) and compare pCASL metrics with those from DSC, CTP, and PET. Robust conclusions about the test-retest reliability of pCASL or the comparability of metrics obtained with this technique and DSC, CTP, or PET in different phases following ischemic stroke could not be drawn.

伪连续动脉自旋标记（pCASL）是一种用于评估脑灌注的非侵入性、无需钆对比剂的磁共振成像技术。旨在评估pCASL测量脑血流量（CBF）在缺血性卒中（IS）中的重测信度，并将pCASL指标与动态磁敏感对比增强磁共振成像（DSC）、计算机断层灌注成像（CTP）和正电子发射断层显像（PET）的指标进行比较。目前尚无法就pCASL的重测信度，或该技术与DSC、CTP、PET在缺血性卒中不同阶段所获指标的可比性得出可靠结论。

REF: Kroth JB, Guarda SNF, Wang DJ, Martin MGM, Conforto AB. Reliability of pseudocontinuous arterial spin labeling in ischemic stroke and comparison with other perfusion techniques: systematic review and meta-analysis. AJNR Am J Neuroradiol. Published online October 9, 2025. doi:10.3174/ajnr.A9031 PMID: 41067913

Locating Spinal Leaks in Spontaneous Intracranial Hypotension: How Many Dynamic Myelographies Does It Take?

自发性颅内低压综合征中脊髓漏的定位：需要进行多少次动态脊髓造影？

Localizing a cerebrospinal fluid (CSF) leak in spontaneous intracranial hypotension (SIH) patients is of utmost importance when pursuing a targeted therapy. The study aimed to evaluate the accuracy of dynamic myelography techniques in localizing spinal CSF leaks and report the number of examinations required, stratified by leak type and spinal level. Dynamic myelography exams accurately and reliably localize spinal CSF leaks in SIH patients with SLEC. In about half of the patients, the level of the leak can be localized with the first CDM. In case of a repeat dynamic myelography, the technique and patient positioning can be adopted according to the results of the previous exam. Primary dorsal leaks are rare, but due to the low level of suspicion, pose a diagnostic challenge.

在对自发性颅内低压（SIH）患者进行靶向治疗时，确定脑脊液（CSF）漏出部位至关重要。本研究旨在评估动态脊髓造影技术在定位脊髓脑脊液漏方面的准确性，并报告按漏出类型和脊髓节段分层所需的检查次数。动态脊髓造影检查能够准确、可靠地定位伴有硬脊膜外积液（SLEC）的SIH患者的脊髓脑脊液漏。约半数患者可通过首次动态CT脊髓造影（CDM）确定漏出节段。若需重复进行动态脊髓造影，可根据前次检查结果调整检查技术和患者体位。原发性背侧漏较为罕见，且由于临床怀疑程度低，诊断颇具挑战性。

REF: Rajbhandari S, Petutschnigg T, Häni L, et al. Locating Spinal Leaks in Spontaneous Intracranial Hypotension: How Many Dynamic Myelographies Does It Take?. AJNR Am J Neuroradiol. Published online October 9, 2025. doi:10.3174/ajnr.A9032 PMID: 41067914

CT Radiomic Features are Associated with DNA Copy Number Alterations of Head and Neck Squamous Cell Carcinomas

CT影像组学特征与头颈部鳞状细胞癌的DNA拷贝数改变相关

While a larger fraction of head and neck squamous cell carcinoma (HNSCC) genomes is characterized by a high prevalence of copy number alterations (CNA-positive), a smaller subset with more favorable oncologic outcome is instead driven by somatic mutations (CNA-negative). We aimed to investigate the radiomic phenotypes of CNA-positive and -negative HNSCCs in contrast CT images. CNA subgroups exhibit distinct radiomic phenotypes, primarily reflected in texture and intensity characteristics. These findings enhance our understanding of the biological significance of radiomic information in HNSCC. In the clinical setting, as CNA-positive and -negative HNSCCs may emerge as distinct subclasses with unique staging schemes and treatment implications, improved CT radiomics-based prediction models could offer a noninvasive, cost-effective method for CNA subtyping.

虽然大部分头颈部鳞状细胞癌（HNSCC）基因组的特征是拷贝数改变（CNA）发生率较高（CNA阳性），但一小部分预后较好的病例则是由体细胞突变驱动（CNA阴性）。我们旨在研究对比增强CT图像中CNA阳性和阴性HNSCC的影像组学表型。CNA亚组表现出不同的影像组学表型，主要体现在纹理和强度特征上。这些发现加深了我们对HNSCC影像组学信息生物学意义的理解。在临床环境中，由于CNA阳性和阴性HNSCC可能成为具有独特分期方案和治疗意义的不同亚类，基于CT影像组学的改进预测模型可为CNA亚型分类提供一种无创、经济有效的方法。

REF: Haider SP, Schreier A, Zeevi T, et al. CT Radiomic Features are Associated with DNA Copy Number Alterations of Head and Neck Squamous Cell Carcinomas. AJNR Am J Neuroradiol. Published online October 9, 2025. doi:10.3174/ajnr.A9029 PMID: 41067910

Study of Cerebellar Network Dynamics in Post-Stroke Aphasia Patients Based on Resting-State Functional Magnetic Resonance Imaging

基于静息态功能磁共振成像的卒中后失语症患者小脑网络动力学研究

This study investigated dynamic cerebellar networks in post-stroke aphasia patients using resting-state fMRI. We examined intra-cerebellar and cerebellar-cortical dynamic functional connectivity quantified their temporal properties and graph-theoretical topology. Post-stroke aphasia patients exhibited a segregated cerebellar state with reduced intra-cerebellar connectivity and efficiency, and an integrated state with enhanced connectivity and small-world properties, together with reduced variability in cerebellar-cortical connections to language-and cognition-related regions. These state-specific network alterations were linked to distinct behavioral domains independently of lesion volume, highlighting a dissociation between structural constraints and dynamic, lesion-independent plasticity.

本研究利用静息态功能磁共振成像（fMRI）探究了脑卒中后失语症患者的动态小脑网络。我们检测了小脑内部以及小脑 - 皮质的动态功能连接，量化了它们的时间特性和图论拓扑结构。脑卒中后失语症患者表现出一种分离的小脑状态，其小脑内部连接和效率降低；还表现出一种整合状态，其连接性增强且具有小世界特性，同时小脑与语言和认知相关脑区的皮质连接变异性降低。这些特定状态的网络改变与不同的行为领域相关，且与病灶体积无关，这凸显了结构限制与动态的、不依赖于病灶的可塑性之间的分离。

REF: Chen L, Dai Y, Mai W, et al. Study of Cerebellar Network Dynamics in Post-Stroke Aphasia Patients Based on Resting-State Functional Magnetic Resonance Imaging. AJNR Am J Neuroradiol. Published online October 9, 2025. doi:10.3174/ajnr.A9030 PMID: 41067912

Temporal Characteristics of Type 2 Lateral Spinal CSF Leaks on Digital Subtraction Myelography: Fast, Medium or Slow Leaks?

数字减影脊髓造影术中2型侧方脊髓脑脊液漏的时间特征：快速、中等还是缓慢漏出？

Type 2 leaks occur in up to 20% of spontaneous intracranial hypotension (SIH) due to a spinal lateral dural tear, typically accompanied by arachnoid hernia. Their CSF-outflow dynamics are unclear, but could have implications on performing myelography for best possible detection. This cross-sectional study analyzed temporal characteristics of type 2 leaks using digital subtraction myelography (DSM). Type 2 leaks show a wide range of CSF-outflow characteristics, with most being medium and slow. For DSM, we propose using a 90-second run with intrathecal pressurization and cone-beam CT standby for effective leak detection, whereas less than 1 fps (e.g., 0.5 fps) seems feasible to minimize radiation. Alternatively, dynamic CT myelography can be considered -although timing of CT scans has yet to be evaluated.

2型脑脊液漏发生于高达20%的自发性颅内低压综合征（SIH）患者中，由脊髓硬脊膜外侧撕裂所致，通常伴有蛛网膜疝。其脑脊液流出动力学尚不清楚，但可能会影响脊髓造影检查以实现最佳检测效果。这项横断面研究利用数字减影脊髓造影（DSM）分析了2型脑脊液漏的时间特征。2型脑脊液漏表现出广泛的脑脊液流出特征，大多数为中等和缓慢流出。对于数字减影脊髓造影，我们建议采用90秒扫描，同时进行鞘内加压，并准备好锥形束CT以有效检测漏口，而小于1帧/秒（如0.5帧/秒）的扫描速度似乎可在检测时将辐射剂量降至最低。此外，也可考虑采用动态CT脊髓造影——尽管CT扫描的时机还有待评估。

REF: Lützen N, Urbach H, Volz F, et al. Temporal Characteristics of Type 2 Lateral Spinal CSF Leaks on Digital Subtraction Myelography: Fast, Medium or Slow Leaks?. AJNR Am J Neuroradiol. Published online October 10, 2025. doi:10.3174/ajnr.A9040 PMID: 41073137

Microcatheter Intrathecal Selective Myelography for Intraprocedural CSF-Venous Fistula Evaluation Pre-and Post-Embolization

微导管鞘内选择性脊髓造影用于术中脑脊液 - 静脉瘘栓塞前后评估

Recognition of cerebrospinal fluid-venous fistulas as a cause of spontaneous intracranial hypotension is increasing. Currently, lateral decubitus digital subtraction myelography and lateral decubitus CT myelography are the mainstays for diagnosing cerebrospinal fluid- venous fistulas. Although various methods exist for diagnostic assessment of spinal cerebrospinal fluid-venous fistulas, real-time intraprocedural evaluation during endovascular treatment has yet to be described. We report our experience with real-time intraprocedural evaluation of a cerebrospinal fluid-venous fistula before and after transvenous embolization using the technique of microcatheter intrathecal selective myelography.

将脑脊液 - 静脉瘘视为自发性颅内低压的病因这一认知正在不断提高。目前，侧卧位数字减影脊髓造影和侧卧位 CT 脊髓造影是诊断脑脊液 - 静脉瘘的主要手段。尽管存在多种用于诊断评估脊髓脑脊液 - 静脉瘘的方法，但血管内治疗期间的实时术中评估尚未见报道。我们报告了我们使用微导管鞘内选择性脊髓造影技术对脑脊液 - 静脉瘘在经静脉栓塞前后进行实时术中评估的经验。

REF: Hutchins TA, Peled A, Peckham M, et al. Microcatheter Intrathecal Selective Myelography for Intraprocedural CSF-Venous Fistula Evaluation Pre-and Post-Embolization. AJNR Am J Neuroradiol. Published online October 10, 2025. doi:10.3174/ajnr.A9041 PMID: 41073139