[Ga68]DOTATATE PET in Schwannomas: Distinct Avidity Pattern Supporting Noninvasive Diagnosis

[镓 - 68] DOTATATE 正电子发射断层显像（PET）在神经鞘瘤中的应用：支持无创诊断的独特摄取模式

Schwannomas are a key diagnostic consideration in patients with enhancing extra-axial intracranial, skull base, and neck masses. While contrast-enhanced MRI is the diagnostic mainstay, its specificity can be limited, especially in small or atypical lesions. [Ga68]DOTATATE PET/MRI and PET/CT, which target somatostatin receptor 2 (SSTR2), represent an established tool in evaluating SSTR2-positive tumors, most notably meningiomas and paragangliomas, entities that can mimic schwannomas on conventional MRI. However, data on SSTR2 expression in schwannomas remain limited. We aimed to characterize [Ga68]DOTATATE PET imaging features in patients with imaging-defined schwannomas. Schwannomas exhibit minimal [Ga68]DOTATATE avidity, in contrast to SSTR2-expressing tumors such as meningiomas. [Ga68]DOTATATE PET may therefore aid in non-invasively differentiating schwannomas from SSTR2-expressing tumors with overlapping MRI features in diagnostically challenging cases.

神经鞘瘤是颅内轴外、颅底和颈部强化肿块患者的关键诊断考量因素。虽然增强磁共振成像（MRI）是主要的诊断手段，但其特异性可能有限，尤其是在小病灶或不典型病灶中。[镓 68] DOTATATE 正电子发射断层显像（PET）/MRI 和 PET/CT 靶向生长抑素受体 2（SSTR2），是评估 SSTR2 阳性肿瘤的成熟工具，尤其在评估脑膜瘤和副神经节瘤方面，这些肿瘤在常规 MRI 上可能与神经鞘瘤表现相似。然而，关于神经鞘瘤中 SSTR2 表达的数据仍然有限。我们旨在描述影像学确诊为神经鞘瘤患者的 [镓 68] DOTATATE PET 成像特征。与脑膜瘤等表达 SSTR2 的肿瘤相比，神经鞘瘤对 [镓 68] DOTATATE 的摄取极低。因此，在诊断困难的病例中，[镓 68] DOTATATE PET 可能有助于无创地区分神经鞘瘤和具有重叠 MRI 特征的 SSTR2 表达肿瘤。

REF: Luck S, Sathi N, Shaqra H, et al. [Ga68]DOTATATE PET in Schwannomas: Distinct Avidity Pattern Supporting Noninvasive Diagnosis. AJNR Am J Neuroradiol. Published online January 30, 2026. doi:10.3174/ajnr.A9183 PMID: 41617401

Detection of Osseous Spinal Metastasis with T1-Weighted Dynamic Contrast-Enhanced MRI and 18F-FDG PET/CT: Assessing Agreement in Biopsy Proven Cases

T1加权动态对比增强磁共振成像和18F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描检测脊柱骨转移：评估活检确诊病例中的一致性

18F-FDG PET/CT and conventional MRI are common first-line imaging modalities for assessment of osseous spinal lesions. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is an advanced imaging technique that quantifies vascular perfusion parameters like vessel permeability (Ktrans ) and plasma volume (Vp ), which are markers of viable tumor. Although DCE-MRI and 18F-FDG PET/CT are individually recognized for tumor detection, comparisons between Vp and PET-obtained SUVmax have not been performed. This study evaluates the concordance between Vp and SUVmax in detecting pathologically confirmed, non-treated osseous spinal metastases. Vp and SUVmax exhibit agreement in detecting osseous spinal metastases. However, when common thresholds for these metrics are applied, Vp exceeds SUVmax in identifying viable tumor. DCE-MRI plays a crucial role in detecting spinal metastases and offers complementary qualitative and quantitative information that can augment diagnosis and characterization of spinal metastases in addition to 18F-FDG PET/CT.

18F-氟代脱氧葡萄糖（18F-FDG）正电子发射断层显像/X线计算机体层成像（PET/CT）和常规磁共振成像（MRI）是评估脊柱骨病变常用的一线影像学检查方法。动态对比增强磁共振成像（DCE-MRI）是一种先进的成像技术，可量化血管灌注参数，如血管通透性（Ktrans）和血浆容积（Vp），这些参数是活性肿瘤的标志物。尽管DCE-MRI和18F-FDG PET/CT在肿瘤检测方面已得到认可，但尚未对Vp与PET获得的最大标准摄取值（SUVmax）进行比较。本研究评估了Vp和SUVmax在检测经病理证实的未治疗脊柱骨转移瘤中的一致性。Vp和SUVmax在检测脊柱骨转移瘤方面表现出一致性。然而，当应用这些指标的常用阈值时，Vp在识别活性肿瘤方面优于SUVmax。DCE-MRI在检测脊柱转移瘤中起着至关重要的作用，除18F-FDG PET/CT外，还能提供补充的定性和定量信息，有助于脊柱转移瘤的诊断和特征分析。

REF: Bejugam D, Peck KK, Saha A, et al. Detection of Osseous Spinal Metastasis with T1-Weighted Dynamic Contrast-Enhanced MRI and 18F-FDG PET/CT: Assessing Agreement in Biopsy Proven Cases. AJNR Am J Neuroradiol. Published online January 22, 2026. doi:10.3174/ajnr.A9181 PMID: 41571404

Periventricular Nodular Heterotopia, Cerebellar Hypodysgenesis, and Mesial Temporal Malformation detected on Fetal MRI: An Under-Recognized Association

胎儿磁共振成像检测到的室周结节性异位、小脑发育不全和内侧颞叶畸形：一种未被充分认识的关联

Periventricular nodular heterotopia (PNH) is a neuronal migrational anomaly frequently associated with filamin-A (FLNA) gene variants. However, in the absence of a pathogenic FLNA gene or in the context of other genetic mutations, PNH may demonstrate a distinct pattern of distribution, often accompanied by a variety of brain abnormalities. PNH associated with cerebellar hypodysgenesis (CHD) and malformation of cortical development (MCD) involving the mesial temporal lobes, without detectable FLNA variants, is a known, but under-reported, association. PNH in this context demonstrates a phenotypically distinct distribution (i.e., along the infrasylvian lateral ventricles). In this review, we report the prenatal MRI finding of this unusual association and provide key insights into this abnormality.

室周结节性异位（PNH）是一种神经元迁移异常，常与丝状肌动蛋白 - A（FLNA）基因变异有关。然而，在没有致病性 FLNA 基因或存在其他基因突变的情况下，PNH 可能表现出独特的分布模式，常伴有多种脑部异常。与小脑发育不全（CHD）和涉及内侧颞叶的皮质发育畸形（MCD）相关的 PNH，且未检测到 FLNA 变异，是一种已知但报道不足的关联情况。在此情况下，PNH 表现出表型上独特的分布（即沿外侧裂下侧脑室分布）。在这篇综述中，我们报告了这种不常见关联的产前 MRI 检查结果，并对这一异常情况提供了关键见解。

REF: Pai V, Shinar S, Krishnan P, et al. Periventricular Nodular Heterotopia, Cerebellar Hypodysgenesis, and Mesial Temporal Malformation detected on Fetal MRI: An Under-Recognized Association. AJNR Am J Neuroradiol. Published online January 21, 2026. doi:10.3174/ajnr.A9173 PMID: 41565358

Machine Learning-Driven Approach to Identify Freezing of Gait in Individuals with Parkinson’s Disease Using Conventional Structural MRI and Clinical Measures

利用传统结构磁共振成像和临床指标，采用机器学习驱动的方法识别帕金森病患者的步态冻结现象

Freezing of gait (FOG) presents a significant challenge in the management of Parkinson's disease (PD). Our study explored the potential to predict PD-FOG using an unbiased machine learning (ML) approach that leverages conventional T1-weighted MRI and clinical measures. Our results demonstrate that FreeSurfer-derived cortical area measures from 27 key regions across the frontal, temporal, parietal, and occipital lobes can moderately predict FOG in PD (AUC = 0.71) using a linear SVM model. While preliminary, our work outlines an MRI-based analytical approach that may inform future external validation efforts and contribute to understanding the potential role of cortical morphology in PD-FOG risk. However, given the limited sample size and constrained independent testing cohort, these findings should be interpreted as exploratory and warrant replication in larger, multi-center studies.

步态冻结（FOG）是帕金森病（PD）管理中的一个重大挑战。我们的研究探索了利用一种无偏机器学习（ML）方法预测帕金森病步态冻结（PD - FOG）的可能性，该方法结合了传统的T1加权磁共振成像（MRI）和临床指标。我们的研究结果表明，使用线性支持向量机（SVM）模型，通过FreeSurfer软件从额叶、颞叶、顶叶和枕叶的27个关键区域提取的皮质面积指标，能够适度预测PD患者的步态冻结情况（曲线下面积[AUC] = 0.71）。虽然这只是初步研究，但我们的工作提出了一种基于MRI的分析方法，这可能为未来的外部验证工作提供参考，并有助于理解皮质形态在PD - FOG风险中的潜在作用。然而，鉴于样本量有限且独立测试队列规模受限，这些研究结果应被视为探索性的，需要在更大规模的多中心研究中进行重复验证。

REF: Rathi GN, Gardner AJ, Longhurst JK, Mari Z, Mishra VR. Machine Learning-Driven Approach to Identify Freezing of Gait in Individuals with Parkinson's Disease Using Conventional Structural MRI and Clinical Measures. AJNR Am J Neuroradiol. Published online January 21, 2026. doi:10.3174/ajnr.A9171 PMID: 41565356

Superiority of Ferumoxytol MRI Over Pre-Contrast Imaging in Patients With Malignant Brain Lesions

恶性脑病变患者中， ferumoxytol 磁共振成像相对于平扫成像的优势

Patients with suspected brain tumors typically undergo MRI with an IV contrast agent to detect regions of disrupted BBB caused by the tumor. Gadolinium-based contrast agents are standard for enhancing lesion visualization but may be contraindicated in patients with renal insufficiency. Ferumoxytol is an iron oxide nanoparticle approved for the treatment of iron deficiency anemia, and unlike gadolinium-based contrast agents, is not contraindicated in patients with renal impairment. Our study aimed to evaluate whether ferumoxytol-enhanced MRI is superior to pre-contrast imaging for structural delineation of intra-axial malignant brain lesions. This study provides robust evidence that ferumoxytol-enhanced MRI improves lesion visualization compared to pre-contrast imaging. Ferumoxytol as an MRI contrast agent in brain tumor imaging may provide a valuable clinical alternative to gadolinium-based contrast agents in appropriate patient groups.

疑似脑肿瘤患者通常会接受静脉注射造影剂的磁共振成像（MRI）检查，以检测肿瘤导致的血脑屏障（BBB）破坏区域。钆类造影剂是增强病变可视化的标准药物，但肾功能不全患者禁用。羧基麦芽糖铁是一种获批用于治疗缺铁性贫血的氧化铁纳米颗粒，与钆类造影剂不同，肾功能受损患者使用它并无禁忌。我们的研究旨在评估羧基麦芽糖铁增强MRI在轴内恶性脑病变的结构勾勒方面是否优于造影前成像。这项研究提供了有力证据，表明与造影前成像相比，羧基麦芽糖铁增强MRI可改善病变的可视化效果。在脑肿瘤成像中，羧基麦芽糖铁作为MRI造影剂，可能为合适的患者群体提供一种有价值的临床替代钆类造影剂的选择。

REF: Strauss WE, Fu R, Szidonya LK, et al. Superiority of Ferumoxytol MRI Over Pre-Contrast Imaging in Patients With Malignant Brain Lesions. AJNR Am J Neuroradiol. Published online January 21, 2026. doi:10.3174/ajnr.A9172 PMID: 41565357

Preoperative Neuroimaging Markers, Clinical Severity Measures, and Shunt Characteristics for Predicting Shunt Revision in Idiopathic Intracranial Hypertension: An Explainable Machine-Learning Study

特发性颅内高压分流术翻修预测的术前神经影像学标志物、临床严重程度指标及分流管特征：一项可解释的机器学习研究

Surgical shunt placement is a common treatment for idiopathic intracranial hypertension (IIH) but is hampered by high revision rates. Prior predictive models for shunt revision in IIH have overlooked disease-specific neuroimaging markers. We developed an explainable machine learning model to identify the strongest predictors of shunt revision across neuroimaging markers, clinical severity variables, and shunt-specific factors. The primary objective was to assess the contribution of IIH-related neuroimaging markers within this multimodal predictive framework. In this cohort, MRI-derived optic nerve sheath diameter, papilledema, visual field deficits, and shunt characteristics were consistently among the most influential contributors to predicted risk of shunt revision. These findings highlight the added value of MRI-derived markers within a multimodal preoperative assessment, although prospective external validation is required before clinical adoption.

手术分流管置入是特发性颅内高压（IIH）的一种常见治疗方法，但高翻修率阻碍了其应用。此前针对IIH分流管翻修的预测模型忽略了疾病特异性的神经影像学标志物。我们开发了一个可解释的机器学习模型，以确定神经影像学标志物、临床严重程度变量和分流管特异性因素中与分流管翻修最强相关的预测因素。主要目的是评估在这个多模态预测框架中与IIH相关的神经影像学标志物的作用。在该队列中，磁共振成像（MRI）测得的视神经鞘直径、视乳头水肿、视野缺损和分流管特征一直是预测分流管翻修风险的最主要影响因素。这些发现凸显了在多模态术前评估中MRI衍生标志物的额外价值，不过在临床应用前还需要进行前瞻性外部验证。

REF: Gholampour S, Dehghan A, Carroll TJ, et al. Preoperative Neuroimaging Markers, Clinical Severity Measures, and Shunt Characteristics for Predicting Shunt Revision in Idiopathic Intracranial Hypertension: An Explainable Machine-Learning Study. AJNR Am J Neuroradiol. Published online January 20, 2026. doi:10.3174/ajnr.A9166 PMID: 41558813

Standalone middle meningeal artery embolization may obviate surgery among non-acute subdural hematoma patients with moderate-to-high comorbidity burden

对于合并症负担为中至重度的非急性硬膜下血肿患者，单纯脑膜中动脉栓塞术可能可避免手术治疗。

Middle meningeal artery embolization (MMAE) is an effective treatment for non-acute subdural hematoma (NASDH) patients, and it is increasingly being adopted into routine clinical practice as standard of care. This study aims to determine whether additional surgery is necessary to prevent treatment failure for NASDH patients treated with MMAE. For neurologically stable NASDH patients who underwent MMAE, baseline comorbidity burden significantly blunted the marginal benefit of surgery. Additional surgical evacuation was not associated with different rates of treatment failure for the majority of NASDH patients with medium to high comorbidity burdens.

脑膜中动脉栓塞术（MMAE）是非急性硬膜下血肿（NASDH）患者的一种有效治疗方法，并且越来越多地作为标准治疗方案被纳入常规临床实践。本研究旨在确定接受MMAE治疗的NASDH患者是否需要额外手术以防止治疗失败。对于接受MMAE治疗且神经功能稳定的NASDH患者，基线合并症负担显著降低了手术的边际效益。对于大多数合并症负担为中到高的NASDH患者，额外的手术清除与不同的治疗失败率无关。

REF: Chen H, Kakadiya J, Salim HA, et al. Standalone middle meningeal artery embolization may obviate surgery among non-acute subdural hematoma patients with moderate-to-high comorbidity burden. AJNR Am J Neuroradiol. Published online January 19, 2026. doi:10.3174/ajnr.A9170 PMID: 41554592

Longitudinal evolution of cerebral metabolic rate of oxygen in successfully reperfused ischemic stroke patients

成功再灌注的缺血性脑卒中患者脑氧代谢率的纵向演变

Cerebral Metabolic Rate of Oxygen (CMRO2) provides a direct measure of brain tissue metabolism and function, making it valuable in understanding physiological changes in infarct tissue in ischemic stroke patients. However, changes in cerebral metabolism and their significance in infarct tissue post-reperfusion remain underexplored. In this study, we examined the longitudinal changes in CMRO2 in infarct tissue in successfully reperfused ischemic stroke patients. Post successful thrombectomy, relative cerebral metabolism in the infarct is elevated in the acute stage, before stabilizing over time. Patients with better functional outcomes consistently show better cerebral metabolism than patients with poor functional outcomes.

脑氧代谢率（CMRO2）可直接衡量脑组织的代谢和功能，这使其在了解缺血性中风患者梗死组织的生理变化方面具有重要价值。然而，再灌注后梗死组织的脑代谢变化及其意义仍未得到充分研究。在这项研究中，我们观察了成功再灌注的缺血性中风患者梗死组织中脑氧代谢率的纵向变化。成功进行血栓切除术后，梗死区域的相对脑代谢在急性期会升高，随后随时间逐渐稳定。功能预后较好的患者的脑代谢始终优于功能预后较差的患者。

REF: Kataike VM, Desmond PM, Steward C, Campbell BCV, Ng F, Venkatraman V. Longitudinal evolution of cerebral metabolic rate of oxygen in successfully reperfused ischemic stroke patients. AJNR Am J Neuroradiol. Published online January 19, 2026. doi:10.3174/ajnr.A9165 PMID: 41554591

C-DIR: Double inversion recovery with controlled artifact suppression in brain MRI

C - DIR：大脑磁共振成像中采用可控伪影抑制的双重反转恢复序列

Double inversion recovery (DIR) is an MRI technique in which two types of tissue are suppressed, usually cerebrospinal fluid (CSF) and white matter (WM). The suppression is achieved with two inversion pulses prior to the acquisition of the imaging data. In the presence of strong inhomogeneities in the static magnetic field B0 and/or the radiofrequency (RF) field, inversion may be inadequate, resulting in bright signal in tissues that should have been suppressed. The purpose of this work was to develop a DIR scan with inversion pulses that are robust against inhomogeneities in the B0 and RF field. C-DIR exhibits improved inversion in the presence of inhomogeneities in the B0 and the radiofrequency field, resulting in the removal of artifactual signal. CNR increases ranged from 27% between gray matter and CSF (p<.001) to 102% between the brainstem and adjacent CSF (p<0.001). SNR in the cortical gray matter was 10.74±1.48 in DIR and 11.68±2.21 in C-DIR (p=.07).

双反转恢复（DIR）是一种磁共振成像（MRI）技术，可抑制两种类型的组织信号，通常是脑脊液（CSF）和白质（WM）。这种抑制是通过在采集成像数据之前施加两个反转脉冲来实现的。在静磁场B0和/或射频（RF）场存在强烈不均匀性的情况下，反转可能不充分，导致本应被抑制的组织出现高信号。本研究的目的是开发一种对B0和RF场不均匀性具有鲁棒性的反转脉冲的DIR扫描序列。在B0和射频场存在不均匀性的情况下，C - DIR序列的反转效果得到改善，从而消除了伪影信号。对比噪声比（CNR）的提升幅度为：灰质与脑脊液之间提升了27%（p < 0.001），脑干与相邻脑脊液之间提升了102%（p < 0.001）。皮质灰质的信噪比（SNR）在DIR序列中为10.74±1.48，在C - DIR序列中为11.68±2.21（p = 0.07）。

REF: Jaffray A, Graf C, Rund A, et al. C-DIR: Double inversion recovery with controlled artifact suppression in brain MRI. AJNR Am J Neuroradiol. Published online January 16, 2026. doi:10.3174/ajnr.A9167 PMID: 41545309