Differentiation between spinal dural arteriovenous fistula (SDAVF) and perimedullary arteriovenous fistula (SPAVF) is crucial for treatment planning, but reliable non-invasive modalities remain limited. This study aimed to identify discriminative multimodal MRI features for differentiating SPAVF from SDAVF. This retrospective study enrolled 34 patients (13 SPAVF, 21 SDAVF) confirmed by digital subtraction angiography (DSA) between January 2016 and December 2025. All patients underwent conventional T2-weighted imaging (T2WI), T2-weighted sampling perfection with application-optimized contrasts using different flip-angle evolutions (T2W-SPACE), and contrast-enhanced magnetic resonance angiography (CE-MRA). Two neuroradiologists independently evaluated multimodal imaging characteristics. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis with bootstrap resampling. SPAVF predominantly demonstrated anterior/posterior spinal artery supply (84.61

Childhood trauma (CT) has been strongly linked to the course of obsessive-compulsive disorder (OCD), yet the manner in which CT interacts with OCD-related alterations in brain functional connectivity remains unclear. In this study, sixty-six patients with OCD and fifty healthy control participants underwent comprehensive clinical assessments and resting-state functional magnetic resonance imaging. Participants were further categorized according to exposure to childhood trauma, and functional connectivity networks were constructed based on key regions of the cortico-striato-thalamo-cortical (CSTC) circuit to examine the independent and interactive effects of CT and OCD on resting-state connectivity. Both OCD and CT were associated with altered CSTC functional connectivity, although opposite patterns were observed in patients and controls. Specifically, CT exposure in control participants was associated with a reduced density of strong CSTC connections, whereas in patients with OCD, CT was linked to increased connectivity density. Moreover, OCD patients exhibited instability in core network organization, involving the cingulate cortex, orbitofrontal cortex, putamen, and amygdala. Differential analyses revealed that the OCD patients with CT showed increased connectivity compared with both controls with CT (p = 0.005-0.038) and OCD patients without CT (p = 0.002-0.047). Taken together, these findings suggest that CT and OCD jointly modulate CSTC functional connectivity, manifesting as hyperconnectivity and disrupted network organization in OCD patients with a history of childhood trauma, and provide new insights into how early environmental adversity interacts with core neurobiological mechanisms in OCD.

To investigate cerebellar structural and functional alterations in cervical spondylotic myelopathy (CSM) using multimodal MRI. 127 CSM patients and 91 healthy controls (HCs) underwent resting-state fMRI. Gray matter volume (GMV), static functional connectivity (sFC), and dynamic functional connectivity (dFC) were analyzed across 34 cerebellar subregions using the spatially unbiased infratentorial template (SUIT) atlas. Associations between altered imaging metrics and clinical measures were assessed. (1) CSM patients showed reduced GMV in left lobule V and vermal Crus I compared with HCs; however, these GMV reductions were not significantly associated with clinical measures (all P > 0.05). (2) Widespread cerebello–cerebral sFC alterations were observed in CSM patients, mainly involving interactions between the sensorimotor network (SMN) and default mode network (DMN), visual network (VN) interactions, dorsal attention network (DAN)–DMN/frontoparietal network (FPN) interactions, and deep nuclei–SMN/FPN interactions. The strength of specific sFC connections correlated with motor function and anxiety in CSM patients. (3) Cerebello–cerebral dFC analysis revealed network-dependent alterations in temporal variability, including increased variability in DAN–DMN/FPN, DMN/FPN–VN, and SMN–multiple association and VN pathways, and decreased variability in VN–DMN/FPN pathways. The temporal variability of specific dFC connections correlated with cognitive function. CSM is associated with cerebellar atrophy and widespread alterations in cerebello–cerebral sFC and dFC. Some of these alterations were associated with clinical measures, providing evidence for cerebellar–cerebral network involvement in CSM, although their functional significance requires further clarification.

To investigate the features of local collateral vessel formation at the site of intracranial atherosclerotic stenosis (ICAS) and its relationship with cerebral infarction events. Retrospectively analyzed patients diagnosed with ICAS or moyamoya disease (MMD) who underwent three-dimensional T1-weighted turbo-spin-echo (3D T1W-TSE), 3D time-of-flight magnetic resonance angiography (TOF-MRA), and DSA between June 2018 and March 2025. Key imaging features, including ICAS with local collateral vessels (ICAS-lcv), hyperintense vessel sign score, degree and location of M1-MCA stenosis, plaque enhancement grade, and posterior cerebral artery (PCA) diameter, were independently quantified by two neuroradiologists blinded to clinical data. Subgroup and logistic-regression analyses were then performed. A total of 149 cases with atherosclerotic stenosis in the middle cerebral artery (MCA) and 41 cases with MMD were enrolled. Among them, 29 cases with ICAS-lcv, and 59 MMD lesions exhibited moyamoya vessels. More ICAS-lcv cases were observed in individuals with severe stenosis or occlusion. Multivariable logistic regression identified the degree of stenosis as an independent risk factor for collateral formation in non-infarcted ICAS. Inter-group and subgroup analyses revealed that the infarct group had a lower incidence of ICAS-lcv than the non-infarct group. After adjustment for confounders, multivariable logistic regression showed that the presence of ICAS-lcv (OR, 0.24; 95

The hyperintense vessel sign (HVS) on magnetic resonance imaging is a recognized surrogate marker of cerebral hemodynamic impairment, presumed to reflect slow-flowing collateral blood distal to arterial stenosis or occlusion. This narrative review critically synthesizes the literature on HVS across T2 fluid-attenuated inversion recovery (FLAIR), arterial spin labeling (ASL), contrast-enhanced T1-weighted imaging, and high-resolution vessel wall imaging (HR-VWI). On FLAIR, the FLAIR vascular hyperintensity sign provides evidence for noninvasive assessment of ischemia risk, disease progression, and clinical prognosis. On ASL, arterial transit artifacts indicate collateral recruitment and delayed arterial transit time. On HR-VWI, the intravascular enhancement sign offers complementary hemodynamic information alongside vascular wall assessment. Conventional enhanced T1WI is mainly applicable in Moyamoya disease assessment. Despite consistent evidence linking HVS to collateral recruitment, discrepancies regarding prognostic value persist across studies due to methodological heterogeneity. We propose a practical, sequence-specific provisional conceptual framework that incorporates ASPECTS-based FLAIR grading, multi-delay ASL protocols, and HR-VWI vessel counts to standardize assessment and facilitate cross-study comparability. Future priorities include longitudinal HVS monitoring, validated grading thresholds, and multi-modal quantitative tools.

OBJECTIVE:This study aims to investigate the evolution of intramural hematoma (IMH) in internal carotid artery dissection (ICAD) and identify predictors of favorable recanalization. METHODS:This study cohort comprised 53 patients diagnosed with IMH due to ICAD on the basis of high-resolution magnetic resonance vessel wall imaging (HR-VWI) between June 2018 and June 2025. Thirty-eight medically managed patients underwent follow-up imaging. Neuroradiologists blinded to clinical data independently reviewed imaging. The primary outcome was favorable recanalization (<50% luminal stenosis) at follow-up, with the interval from symptom onset to the follow-up HR-VWI examination used as the time scale. Analyses included Cox regression, time-dependent ROC, landmark analysis, and bootstrap validation. RESULTS:Among 38 patients with follow-up (median 138.0 days), IMH volume decreased to varying extents. Baseline normalized wall index (NWI) predicted favorable recanalization with an area under the curve (AUC) of 0.75 (95% CI, 0.58-0.87; P = 0.003). Time-dependent ROC analysis demonstrated improving predictive performance over time (AUCs: 0.57 at 90 days, 0.64 at 120 days, and 0.76 at 180 days). NWI cutoff values < 0.94 were associated with favorable recanalization. In multivariate Cox regression, NWI (adjusted hazard ratio, 0.13; 95% CI, 0.03-0.51; P = 0.003) was independently associated with the primary outcome. Landmark analysis at 90 days validated NWI's predictive value for delayed recanalization (AUC = 0.73). Bootstrap validation yielded an optimism-corrected AUC of 0.74 and C-index of 0.77. CONCLUSION:Baseline NWI is an independent predictor of favorable recanalization in ICAD-IMH, with time-dependent efficacy. This underscores the potential value of HR-VWI in guiding therapeutic reassessment in patients with ICAD-IMH.

RATIONALE AND OBJECTIVES:This study aimed to develop and validate an interpretable model using pretreatment multiparametric magnetic resonance imaging (mpMRI) radiomics and clinical data to predict neoadjuvant chemotherapy (NAC) sensitivity and recurrence-free survival (RFS) in breast cancer. The model was interpreted using the SHapley Additive exPlanations (SHAP) framework to enhance clinical transparency and support individualized treatment planning. MATERIALS AND METHODS:In this multicenter retrospective study, 373 patients with pretreatment mpMRI (T2, dynamic contrast-enhanced, diffusion-weighted imaging) were enrolled. Patients were classified as NAC-insensitive (Miller-Payne grades 1-3) or sensitive (grades 4-5). Radiomic features from manual segmentations were integrated with clinical variables. A combined model was built using random forest and interpreted via SHapley Additive exPlanations (SHAP). A nomogram score from the model was assessed for RFS using Cox regression. RESULTS:The combined model achieved an AUC of 0.859 (95% CI: 0.764-0.954) in the internal validation set, outperforming the clinical (AUC 0.643) and radiomics (AUC 0.844) models, with similar performance in external validation (AUC 0.862). SHAP analysis identified sigma_5_0_mm_3D_glcm_DifferenceEntropy_T2 as the most influential feature. A nomogram score ≥95 predicted high sensitivity probability. Lower nomogram scores were independently associated with worse RFS. CONCLUSION:The interpretable radiomics-clinical model based on pretreatment mpMRI effectively predicts NAC sensitivity and RFS, offering potential to aid personalized treatment decisions. By providing transparent, individualized predictions via SHAP, this tool shows potential for optimizing personalized treatment strategies and reducing unnecessary toxicity.

Background Identifying whether brain alterations in obsessive-compulsive disorder (OCD) represent the illness itself or an underlying genetic vulnerability is challenging, primarily due to the confounding effects of medication and chronic illness. To disentangle these disease-state and genetic-trait markers, we investigated a unique cohort of first-episode, drug-naïve patients and their unaffected first-degree relatives (UFDR). Methods Resting-state functional magnetic resonance imaging (fMRI) data were acquired from 72 first-episode, drug-naïve OCD patients, 23 UFDR, and 56 healthy controls (HC). We computed the amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo), and degree centrality (DC). Following covariate-controlled statistical comparisons, support vector machine (SVM) models with nested cross-validation were employed to evaluate the exploratory classification capacity of the identified functional features. Results No significant main effects were found for ReHo across groups. However, OCD patients exhibited significantly elevated ALFF in the left orbital middle frontal gyrus and left dorsolateral superior frontal gyrus compared to HC and UFDR, respectively. ALFF values in both regions were positively correlated with obsessive-compulsive symptom severity. Meanwhile, the UFDR group demonstrated distinct network alterations, including increased DC in the left caudate nucleus and decreased DC in the left orbital inferior frontal gyrus compared to HC. The SVM classifiers differentiated the groups with promising capacity, achieving areas under the curve of 0.834 (UFDR vs. HC), 0.791 (OCD vs. HC), and 0.801 (OCD vs. UFDR). Conclusions This study helps separate state-dependent from trait-related functional features in OCD. Prefrontal ALFF hyperactivity characterizes the active disease state, whereas striatal-frontal DC alterations in unaffected relatives represent candidate endophenotypes for genetic vulnerability. While these neural signatures show exploratory discriminatory capacity, their clinical utility for early diagnosis and risk stratification requires strict validation in larger, multi-site, and longitudinal cohorts.

BackgroundThe rising global incidence of thyroid nodules necessitates improved non-invasive methods for differentiating benign from malignant lesions. However, research on artificial intelligence (AI) models using multiphase CT imaging to differentiate benign from malignant thyroid nodules is limited.MethodsThis retrospective study analyzed multiphase CT data (noncontrast, arterial, and venous phases) from 604 patients with thyroid nodules confirmed by postoperative pathology. We developed and compared multiple machine learning and deep learning models using extracted radiomics features, raw 3D DICOM data, and key clinical factors (sex, age, thyroglobulin and thyrotropin levels). Model performance was evaluated using receiver operating characteristic (ROC) analysis, and Gradient-weighted Class Activation Mapping (Grad-CAM) was used for visualization.ResultsModels incorporating imaging data significantly outperformed a clinical-only model (AUC = 0.811). Nomograms combining either a radiomics score (Rad-Score) or a deep learning score (AI-Score) with clinical data demonstrated the highest diagnostic accuracy. The nomogram based on Rad-Score and clinical data achieved a peak AUC of 0.885. Similarly, the AI-Score-based nomogram reached an AUC of 0.881. Both integrated approaches proved superior to models relying on a single data type.ConclusionsAI models integrating multiphase CT radiomics or deep learning features with clinical data provide a robust and highly accurate approach for differentiating benign from malignant thyroid nodules. These integrated models show significant potential for improving clinical decision-making.

Purpose:High myopia (HM) is a severe ocular disorder that may cause irreversible damage to ocular structures and visual function. Although previous studies have identified cerebral functional alterations in HM, the patterns of hemispheric functional asymmetry and interhemispheric coordination remain insufficiently understood. This study aimed to investigate abnormalities in hemispheric lateralization and interhemispheric cooperation in patients with HM, and to further explore their potential neurotransmitter-related mechanisms. Methods:We enrolled 55 patients with HM and 55 matched healthy control subjects. All participants underwent resting-state functional magnetic resonance imaging. Group comparisons were performed by measuring the autonomy index (AI) and functional connectivity between homologous voxels (CFH). Subsequently, spatial correlation analysis was performed between the identified anomalous regions and the density distribution of various neurotransmitter receptors and transporters. Classification was then performed using a support vector machine (SVM) model. Results:The results demonstrated a widespread enhancement of AI in patients with HM, particularly in the right lingual gyrus and inferior temporal gyrus, among other regions. Conversely, CFH was significantly attenuated in the bilateral fusiform/parahippocampal gyri, as well as other homologous areas. Significantly, these anomalous regions exhibited a robust spatial correlation with the distribution of serotonin and dopamine receptors and acetylcholine transporter receptors. The SVM model, utilizing CFH features, achieved a classification accuracy of 72.73% (area under the curve [AUC] = 0.72). Conclusions:This investigation elucidates the abnormal functional lateralization and cooperation present in patients with HM. We propose that these functional anomalies are associated with a specific neurochemical basis, thereby providing invaluable insights into the pathophysiological mechanisms driving the disorder.

OBJECTIVE:The degree of plaque enhancement is critical for estimating the risk of incident and recurrent ischemic events in intracranial atherosclerotic stenosis. Hyperintensity caused by regional slow flow may confound plaque assessment. This study aimed to investigate methods for differentiating plaque from sluggish-flow-related hyperintense artifacts on high-resolution magnetic resonance vessel wall imaging (HR-VWI). METHODS:Imaging data from January 2020 to June 2025 were retrospectively reviewed for patients with intracranial atherosclerotic stenosis who underwent both HR-VWI and computed tomography angiography (CTA). By comparison with CTA, features of plaque and adjacent sluggish-flow-related hyperintense artifacts on HR-VWI were analyzed. RESULTS:Fifty-five patients (mean age 54.9 ± 9.35 years; 37 male and 18 female) with severe atherosclerotic stenosis or occlusion of the middle cerebral artery (MCA) were evaluated. Compared with plaque, slow-flow-related hyperintensity involved longer segments, showed a higher enhancement ratio, a lower standard deviation of signal intensity (SI) on pre-contrast images, and a higher mean post-contrast SI (all P < 0.05). All sluggish-flow-related hyperintensities exhibited central enhancement. The central enhancement pattern achieved an accuracy of 0.84, a sensitivity of 100%, and a specificity of 69% for discriminating plaque from sluggish-flow-related hyperintensities. Multivariable conditional logistic regression identified posterior enhancement location (OR, 16.62; 95% CI, 3.40-81.17; P < 0.001), post-contrast mean SI (odds ratio [OR], 1.33; 95% CI, 1.05-1.67; P = 0.016), and post-contrast SI standard deviation (OR, 0.05; 95% CI, 0.004-0.68; P = 0.024) as independent discriminators. CONCLUSION:Enhancement pattern, distribution location, and quantitative signal intensity parameters are useful clues for identifying sluggish-flow-related artifacts in patients with severe MCA stenosis or occlusion. Accurate interpretation still hinges on a standardized evaluation of the lumen.

The glymphatic system plays a critical role in brain waste clearance and has been implicated in neurodegenerative diseases. Primary angle-closure glaucoma (PACG) is increasingly recognized as a neurodegenerative disorder extending beyond the eye. This study aimed to investigate glymphatic system function in patients with PACG using diffusion tensor imaging analysis along the perivascular space (DTI-ALPS). This cross-sectional study included patients with PACG and age- and sex-matched healthy controls. All participants underwent magnetic resonance imaging, including diffusion tensor imaging. The DTI-ALPS index was calculated to assess glymphatic function. Group differences and correlations with disease severity were analyzed. Patients with PACG showed a significantly lower whole-brain DTI-ALPS index compared with healthy controls (1.50 ± 0.14 vs 1.60 ± 0.15, P = .030; Cohen d = 0.63). Lower DTI-ALPS values were significantly correlated with worse visual field mean deviation and thinner retinal nerve fiber layer thickness (P < .05). Glymphatic system function appears to be impaired in PACG and is associated with disease severity. These findings provide further evidence supporting the concept of glaucoma as a neurodegenerative disease involving the central nervous system.

The cerebral cortex is organized along hierarchical gradients that integrate sensory and cognitive functions, yet whether this organization is disrupted in primary angle-closure glaucoma and contributes to cognitive impairment remains unclear. Here we examine cortical functional gradients in individuals with primary angle-closure glaucoma using resting-state functional magnetic resonance imaging and transcriptomic analyses. We show that patients exhibit compression and reorganization of cortical gradients, particularly within visual and default mode networks, and that these alterations are associated with visual performance and cognitive decline. Genes related to gradient disruption are enriched in synaptic signaling, neurodevelopmental pathways, and astrocyte-associated processes. These findings identify cortical hierarchical remodeling and its molecular correlates in primary angle-closure glaucoma, providing insight into the neural basis of cognitive impairment in this disease.

OBJECTIVE:To investigate the relationship between intravascular enhancement sign (IVES) on high-resolution magnetic resonance vessel wall imaging (HR-VWI) and cerebral perfusion indicators and stroke events in patients with moyamoya disease (MMD). METHOD:Retrospective analysis of clinical and imaging data of patients diagnosed with MMD by digital subtraction angiography from May 2021 to November 2024, all patients completed HR-VWI examination. Paired comparisons, correlation analysis, and logistic regression analysis were performed to explore the relationship between IVES with cerebral perfusion and infarction. RESULTS:A total of 47 cases with MMD were analyzed, comprising 20 females and 27 males with an average age of 53.4 years. The IVES was visible in 74 hemispheres, 91.9 % showed severe stenosis or occlusion of the internal carotid artery or middle cerebral artery among them, and cerebral infarction lesions were found in 10 of these cases. IVES score (odd ratio, 1.11; 95 % CI, 1.01 to 1.24; p = 0.042) was independently associated with ipsilateral infarction events after controlling for the stenosis degree, enhanced grade, posterior cerebral artery diameter, integrity of the posterior communicating artery, and MRA score. Among 33 cases underwent CT perfusion, it was found that the hemisphere with a higher score had significantly higher values in cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and T-max. And IVES score was moderately positively correlated with MTT, TTP, T-max, Suzuki stage, and Houkin's MRA score. Furthermore, the higher the IVES score, the decreasing tendency the perfusion status of the corresponding brain region. CONCLUSION:The IVES score is related to the cerebral perfusion level in MMD patients, and an increased IVES score may indicate an increased risk of cerebral infarction.

Background/Objectives: Patients with glaucoma often exhibit cognitive dysfunction. Identifying imaging markers of glaucoma-related cognitive dysfunction can guide early clinical interventions. Method: This study included 44 primary angle-closure glaucoma patients (PACG) with cognitive dysfunction, and 46 healthy controls (HCs). Participants underwent 3D high-resolution T1 structural imaging and BOLD fMRI scanning. Seven hippocampus subregions were selected as seed regions to explore changes in functional connectivity (FC) between the bilateral hippocampal subregions and the whole brain in PACG patients with cognitive dysfunction. Results: Compared with the HCs group, the PACG group showed decreased FC between multiple hippocampus subregions and the cerebellum, precentral gyrus, postcentral gyrus, supplementary motor area, supramarginal gyrus, inferior frontal gyrus, opercular part, lenticular nucleus, pallidum, rolandic operculum, and inferior parietal, supramarginal, and angular gyri. However, increased FC was found between the bilateral hippocampal subregions and the calcarine fissure and the surrounding cortex, lingual gyrus, anterior cingulate, and paracingulate gyri. We also found that FC between the hippocampal subregion and some brain regions was associated with visual acuity, average cup-to-disc ratio, and retinal nerve fibre layer thickness. Conclusion: Extensive FC abnormalities between the hippocampal subregion and cerebellum, sensorimotor network, default mode network, visual network, and other brain areas were found in PACG patients with cognitive dysfunction, providing new insights into the neuropathological mechanisms and potential neuroimaging biomarkers for early diagnosis and intervention.

BACKGROUND:Cognitive dysfunction has been reported in patients with glaucoma, but the underlying neural mechanisms remain unclear. This study aimed to explore functional connectivity (FC) alterations in hippocampal subregions in primary angle-closure glaucoma (PACG) patients with cognitive impairment. METHOD:This study included forty-four PACG patients with cognitive dysfunction, and forty-six healthy controls (HCs). Participants underwent 3D high-resolution T1 structural imaging and BOLD fMRI scanning. Seven hippocampal subregions were selected as seed regions to explore changes in FC between the bilateral hippocampal subregions (Cornu Ammonis 1, Cornu Ammonis 2, Cornu Ammonis 3, Dentate gyrus, Entorhinal cortex, HATA, Subiculu) and the whole brain in PACG patients with cognitive dysfunction. RESULTS:Compared with the HCs group, the PACG group showed decreased FC between multiple hippocampal subregions and the cerebellum, precentral gyrus, postcentral gyrus, supplementary motor area, supramarginal gyrus, inferior frontal gyrus, opercular part, lenticular nucleus, pallidum, rolandic operculum, inferior parietal, supramarginal, and angular gyri. However, increased FC was found between the bilateral hippocampal subregions and the calcarine fissure and surrounding cortex, lingual gyrus, anterior cingulate, and paracingulate gyri. We also found that FC between hippocampal subregions and some brain regions were associated with visual acuity, average cup-to-disc ratio, and retinal nerve fibre layer thickness. CONCLUSION:These findings reveal widespread hippocampal FC alterations involving the cerebellum, sensorimotor, default mode, and visual network (VN) in PACG patients with cognitive dysfunction, contributing to a better understanding of the underlying neural mechanisms.

Purpose This study aims to explore the relationships between neural activity, neurovascular coupling (NVC), and neurotransmitter receptors, and to investigate their association with emotion and cognition in COVID-19 survivors. Materials and methods A total of 42 COVID-19 survivors and 30 matched healthy controls (HCs) were recruited. Regional homogeneity (ReHo) and functional connectivity strength (FCS) were calculated -to assess local and global neural activity, respectively. Cerebral blood flow (CBF) was characterized as brain perfusion. Regional NVC was evaluated using CBF/ReHo and CBF/FCS ratios at the voxel level. Neurotransmitter receptor maps were derived from the JuSpace toolbox, which integrates positron emission tomography (PET) and single-photon emission computed tomography (SPECT) data from healthy populations. These maps included 16 receptor/transporters, such as dopamine, serotonin, norepinephrine and glutamate receptors, among others. Spatial correlations between neural activity, NVC and neurotransmitter receptor maps were subsequently analyzed in COVID-19 survivors. Results Whether examining neural activity or NVC, COVID-19 survivors primariily exhibiteddecreased ReHo or CBF/ReHo pattern compared to HC. Moreover, the neurotransmitter receptor distributions showed strong associations exclusively with local neural activity (e.g., ReHo) and NVC (e.g., CBF/ReHo) in COVID-19 survivors. Specifically, the spatial pattern of ReHo correlated with dopamine receptors, glutamate receptors, and noradrenaline transporters, but the CBF/ReHo correlated only with dopamine receptors. Importantly, the correlation coefficients between ReHo and dopamine receptors or noradrenaline transporters were associated with cognitive performance in COVID-19 survivors. Conversely, the correlation coefficients between CBF/ReHo and dopamine were correlated with depression in COVID-19 survivors. Conclusion COVID-19 survivors exhibit disruptions in local neural activity and NVC related to dopamine receptors and noradrenaline transporters. These alterations are associated with depression and cognitive impairment, suggesting a potential molecular basis for impaired neural and neurovascular function.

ObjectiveTo investigate the value of routine T2-weighted magnetic resonance imaging (MRI) and contrast-enhanced magnetic resonance angiography (CE-MRA) sequences in locating the fistula level of spinal arteriovenous fistula (SAVF).MethodsRetrospectively analyzed the radiological findings of patients with SAVF diagnosed by surgery from May 2018 to September 2024. All patients completed spinal CE-MRA and routine T2-weighted MRI. The imaging manifestations of SAVF lesions on CE-MRA and MRI were summarized and analyzed.ResultsWe enrolled 40 cases with SAVF (average age 58.1 years old, 85.0% male). The majority of fistulas were located in the thoracic (60.0%), followed by the lumbar (27.5%), and cervical (12.5%). Based on CE-MRA images, the fistula of 33 cases (82.5%) with SAVF can be accurately located, the perimedullary varicose vessels of 34 cases (89.47%) can be shown, and the feeding arteries of 27 cases (71.05%) can be identified. Based on T2-weighted MRI, the perimedullary flow voids and T2 hyperintensity were seen in 36 (90.0%) of SAVF cases, the fistula level in 88.9% (32/36) of cases was located at one end of the flow voids within 1 vertebral level, and the flow voids of 72.2% (26/36) cases near the fistula to be more tension. There is no significant difference in the accuracy of routine T2-weighted MRI in locating the fistula level compared to CE-MRA and digital subtraction angiography (DSA).ConclusionBoth routine T2-weighted MRI and CE-MRA sequences are valuable in the detection of SAVF fistula, we can locate the fistula level by the clues of the perimedullary varicose vessels.

OBJECTIVE:This study aimed to explore alterations in brain network characteristics among patients with moyamoya disease (MMD) before and after combined revascularization surgery (CRS). METHODS:This investigation enrolled 20 MMD patients alongside 20 age- and sex-matched healthy controls (HCs). All participants underwent MRI scans. Additionally, MMD patients were subjected to comprehensive clinical assessments. Degree centrality (DC) analysis was utilized to assess the connectivity features of the entire brain network. The study also examined correlations between DC values in MMD patients before- (pre-CRS) and after-CRS (post-CRS) and various clinical indicators. RESULTS:Compared with HCs, pre-CRS MMD patients showed abnormal DC values in multiple brain regions, mainly including the cerebellum, frontal lobe, temporal lobe, and cingulate gyrus. One year after CRS treatment, the DC values of the bilateral cerebellum posterior lobe showed a reverse increase. In addition, the DC value of the right cerebellum posterior lobe in pre-CRS MMD patients was positively correlated with the Montreal cognitive assessment scores. CONCLUSIONS:CRS treatment can effectively improve the functional network damage of the bilateral cerebellum posterior lobes caused by MMD, and it is expected to provide a new neuroimaging marker for the evaluation of CRS treatment efficacy.