American Journal of Neuroradiology

Brain Tumor-Enhancement Visualization and Morphometric Assessment: A Comparison of MPRAGE, SPACE, and VIBE MRI Techniques
L. Danieli, G.C. Riccitelli, D. Distefano, E. Prodi, E. Ventura, A. Cianfoni, A. Kaelin-Lang, M. Reinert and E. Pravatà
American Journal of Neuroradiology July 2019, 40 (7) 1140-1148; DOI: https://doi.org/10.3174/ajnr.A6096
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Abstract
BACKGROUND AND PURPOSE: Postgadolinium MR imaging is crucial for brain tumor diagnosis and morphometric assessment. We compared brain tumor enhancement visualization and the “target” object morphometry obtained with the most commonly used 3D MR imaging technique, MPRAGE, with 2 other routinely available techniques: sampling perfection with application-optimized contrasts by using different flip angle evolutions (SPACE) and volumetric interpolated brain examination (VIBE).
MATERIALS AND METHODS: Fifty-four contrast-enhancing tumors (38 gliomas and 16 metastases) were assessed using MPRAGE, VIBE, and SPACE techniques randomly acquired after gadolinium-based contrast agent administration on a 3T scanner. Enhancement conspicuity was assessed quantitatively by calculating the contrast rate and contrast-to-noise ratio, and qualitatively, by consensus visual comparative ratings. The total enhancing tumor volume and between-sequence discrepancy in the margin delineation were assessed on the corresponding 3D target objects contoured with a computer-assisted software for neuronavigation. The Wilcoxon signed rank and Pearson χ2 nonparametric tests were used to investigate between-sequence discrepancies in the contrast rate, contrast-to-noise ratio, visual conspicuity ratings, tumor volume, and margin delineation estimates. Differences were also tested for 1D (Response Evaluation Criteria in Solid Tumors) and 2D (Response Assessment in Neuro-Oncology) measurements.
RESULTS: Compared with MPRAGE, both SPACE and VIBE obtained higher contrast rate, contrast-to-noise ratio, and visual conspicuity ratings in both gliomas and metastases (P range, <.001–.001). The between-sequence 3D target object margin discrepancy ranged between 3% and 19.9% of lesion tumor volume. Larger tumor volumes, 1D and 2D measurements were obtained with SPACE (P range, <.01–.007). CONCLUSIONS: Superior conspicuity for brain tumor enhancement can be achieved using SPACE and VIBE techniques, compared with MPRAGE. Discrepancies were also detected when assessing target object size and morphology, with SPACE providing more accurate estimates. ABBREVIATIONS: CEL contrast-enhancing lesion GBCA gadolinium-based contrast agent RANO Response Assessment in Neuro-Oncology RECIST Response Evaluation Criteria in Solid Tumors SPACE sampling perfection with application-optimized contrasts using different flip angle evolution TV tumor volume VIBE volumetric interpolated brain examination 




Association of Fractional Flow on 3D-TOF-MRA with Cerebral Perfusion in Patients with MCA Stenosis X. Ge, H. Zhao, Z. Zhou, X. Li, B. Sun, H. Wu, J. Wan, J. Xu, J.P. Villablanca and X. Liu American Journal of Neuroradiology July 2019, 40 (7) 1124-1131; DOI: https://doi.org/10.3174/ajnr.A6095 ArticleFigures & DataInfo & MetricsReferences PDF Abstract BACKGROUND AND PURPOSE: Fractional flow measured on 3D-TOF-MRA was proposed to quantify cerebral hemodynamic changes in patients with artery stenosis. We investigated the association between fractional flow and cerebral perfusion changes in patients with symptomatic MCA stenosis. MATERIALS AND METHODS: This prospective study was approved by the institutional review board, and all participants provided written informed consent. From June 2015 to May 2018, four hundred twenty-nine patients with symptomatic intracranial arterial stenosis were consecutively recruited and underwent conventional brain MR imaging, 3D-TOF-MRA, and brain CTP. A total of 91 patients with unilateral M1 segment stenosis of the MCA and a stenosis degree of 50%∼99% were included in the analysis. Fractional flow was measured by comparing distal and proximal signal intensity changes across the stenosis on 3D-TOF-MRA. The cutoff value for fractional flow for discriminating between normal perfusion and hypoperfusion was obtained from the receiver operating characteristic curve. Associations between fractional flow and hypoperfusion were assessed using univariate and multivariate analyses. RESULTS: The receiver operating characteristic curve showed a significant fractional flow threshold value at 0.90 (sensitivity, 70.1%; 95% CI, 55.9%–81.2%; specificity, 69.6%; 95% CI, 47.6%–84.1%). Participants with a fractional flow of ≤0.90 were independently associated with cerebral hypoperfusion downstream from the stenosis site (adjusted OR, 3.68; 95% CI, 1.63–11.62; P = .027). CONCLUSIONS: Fractional flow measured on 3D-TOF-MRA may serve as a noninvasive and practical tool for determining the cerebral hypoperfusion in patents with symptomatic MCA stenosis. ABBREVIATIONS: FF fractional flow ICAS intracranial arterial stenosis rMTT relative (affected side/contralateral side) MTT rTTP relative (affected side/contralateral side) TTP SAG-C stressed autoregulation compensated SAG-D stressed autoregulation decompensated SI signal intensity



 Wall Contrast Enhancement of Thrombosed Intracranial Aneurysms at 7T MRI T. Sato, T. Matsushige, B. Chen, O. Gembruch, P. Dammann, R. Jabbarli, M. Forsting, A. Junker, S. Maderwald, H.H. Quick, M.E. Ladd, U. Sure and K.H. Wrede American Journal of Neuroradiology July 2019, 40 (7) 1106-1111; DOI: https://doi.org/10.3174/ajnr.A6084 ArticleFigures & DataInfo & MetricsReferences PDF This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased. Abstract BACKGROUND AND PURPOSE: The pathophysiology of wall contrast enhancement in thrombosed intracranial aneurysms is incompletely understood. This in vivo study aimed to investigate wall microstructures with gadolinium-enhanced 7T MR imaging. MATERIALS AND METHODS: Thirteen patients with 14 thrombosed intracranial aneurysms were evaluated using a 7T whole-body MR imaging system with nonenhanced and gadolinium-enhanced high-resolution MPRAGE. Tissue samples were available in 5 cases, and histopathologic findings were correlated with 7T MR imaging to identify the gadolinium-enhancing microstructures. RESULTS: Partial or complete inner wall enhancement correlated with neovascularization of the inner wall layer and the adjacent thrombus. Additional partial or complete outer wall enhancement can be explained by formation of vasa vasorum in the outer aneurysm wall layer. The double-rim enhancement correlated with perifocal edema and wall histologic findings suggestive of instability. CONCLUSIONS: Two distinct aneurysm wall microstructures responsible for gadolinium enhancement not depictable at lower spatial resolutions can be visualized in vivo using high-resolution gadolinium-enhanced 7T MR imaging.


 Gadolinium Enhancement of the Aneurysm Wall in Unruptured Intracranial Aneurysms Is Associated with an Increased Risk of Aneurysm Instability: A Follow-Up Study M.D.I. Vergouwen, D. Backes, I.C. van der Schaaf, J. Hendrikse, R. Kleinloog, A. Algra and G.J.E. Rinkel American Journal of Neuroradiology July 2019, 40 (7) 1112-1116; DOI: https://doi.org/10.3174/ajnr.A6105 ArticleFigures & DataInfo & MetricsReferences PDF This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased. Abstract BACKGROUND AND PURPOSE: Previous studies have suggested that gadolinium enhancement of the wall of unruptured intracranial aneurysms on MR imaging may reflect aneurysm wall instability. However, all previous studies were cross-sectional. In this longitudinal study, we investigated whether aneurysm wall enhancement is associated with an increased risk of aneurysm instability. MATERIALS AND METHODS: We included all patients 18 years of age or older with ≥1 unruptured aneurysm from the University Medical Center Utrecht, the Netherlands, who were included in 2 previous studies with either 3T or 7T aneurysm wall MR imaging and for whom it was decided not to treat the aneurysm but to monitor it with follow-up imaging. We investigated the risk of growth or rupture during follow-up of aneurysms with and without gadolinium enhancement of the aneurysm wall at baseline and calculated the risk difference between the 2 groups with corresponding 95% confidence intervals. RESULTS: We included 57 patients with 65 unruptured intracranial aneurysms. After a median follow-up of 27 months (interquartile range, 20–31 months), growth (n = 2) or rupture (n = 2) was observed in 4 of 19 aneurysms (21%; 95% CI, 6%–54%) with wall enhancement and in zero of 46 aneurysms (0%; 95% CI, 0%–8%) without enhancement (risk difference, 21%; 95% CI, 3%–39%). CONCLUSIONS: Gadolinium enhancement of the aneurysm wall on MR imaging is associated with an increased risk of aneurysm instability. The absence of wall enhancement makes it unlikely that the aneurysm will grow or rupture in the short term. Larger studies are needed to investigate whether aneurysm wall enhancement is an independent predictor of aneurysm instability. ABBREVIATION: PHASES Population, Hypertension, Age, Size of Aneurysm, Earlier Subarachnoid Hemorrhage from Another Aneurysm, and Site of Aneurysm Assessment of Explicitly Stated Interval Change on Noncontrast Head CT Radiology Reports M. Braileanu, K. Crawford, S.R. Key and M.E. Mullins American Journal of Neuroradiology July 2019, 40 (7) 1091-1094; DOI: https://doi.org/10.3174/ajnr.A6081 ArticleFigures & DataInfo & MetricsReferences PDF This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased. Abstract BACKGROUND AND PURPOSE: Consistent and standardized reporting of interval change for certain diagnoses may improve the clinical utility of radiology reports. The purpose of this study was to assess explicitly stated interval change of various findings in noncontrast head CT reports. MATERIALS AND METHODS: A retrospective review was performed on successive noncontrast head CT radiology reports from the first 2 weeks of January 2014. Reports with at least 1 prior comparison CT scan were included. Reports with normal examination findings and those that made comparison with only other types of examinations (eg, MR imaging) were excluded. Descriptive and subgroup statistical analyses were performed. RESULTS: In total, 200 patients with 230 reports and 979 radiographic findings were identified. The average interval between reports was 344.9 ± 695.9 days (range, 0–3556 days). Interval change was mentioned 67.3% (n = 659) of the time for all findings (n = 979). Explicitly stated interval change was significantly associated with nonremote findings (P < .001) and generalized statements of interval change (P < .001). The proportion of interval change reported ranged from 95.3% of the time for hemorrhagic to 36.4% for soft-tissue/osseous categorizations. CONCLUSIONS: Interval change reporting was variable, mentioned for 67.3% of noncontrast head CT report findings with a prior comparison CT scan. Structured radiology reports may improve the consistent and clear reporting of interval change for certain findings. ABBREVIATION: IC interval change A Practical Review of Functional MRI Anatomy of the Language and Motor Systems V.B. Hill, C.Z. Cankurtaran, B.P. Liu, T.A. Hijaz, M. Naidich, A.J. Nemeth, J. Gastala, C. Krumpelman, E.N. McComb and A.W. Korutz American Journal of Neuroradiology July 2019, 40 (7) 1084-1090; DOI: https://doi.org/10.3174/ajnr.A6089 ArticleFigures & DataInfo & MetricsReferences PDF Abstract SUMMARY: Functional MR imaging is being performed with increasing frequency in the typical neuroradiology practice; however, many readers of these studies have only a limited knowledge of the functional anatomy of the brain. This text will delineate the locations, anatomic boundaries, and functions of the cortical regions of the brain most commonly encountered in clinical practice—specifically, the regions involved in movement and language. ABBREVIATIONS: FFA fusiform face area IPL inferior parietal lobule PPC posterior parietal cortex SMA supplementary motor area VOTC ventral occipitotemporal cortex

July 2019; Vol. 40, No. 7 Perspectives Eoin C. Kavanagh AJNR Am J Neuroradiol 2019; 40:1083 doi:10.3174/ajnr.P0078 http://www.ajnr.org/content/40/7/1083 Review Article A Practical Review of Functional MRI Anatomy of the Language and Motor Systems V.B. Hill, C.Z. Cankurtaran, B.P. Liu, T.A. Hijaz, M. Naidich, A.J. Nemeth, J. Gastala, C. Krumpelman, E.N. McComb and A.W. Korutz AJNR Am J Neuroradiol 2019; 40:1084-1090 doi:10.3174/ajnr.A6089 OPEN ACCESS ARTICLE http://www.ajnr.org/content/40/7/1084.abstract Practice Perspectives Assessment of Explicitly Stated Interval Change on Noncontrast Head CT Radiology Reports M. Braileanu, K. Crawford, S.R. Key and M.E. Mullins AJNR Am J Neuroradiol 2019; 40:1091-1094 doi:10.3174/ajnr.A6081 http://www.ajnr.org/content/40/7/1091.abstract General Contents 3T MRI Whole-Brain Microscopy Discrimination of Subcortical Anatomy, Part 2: Basal Forebrain M.J. Hoch, M.T. Bruno, A. Faustin, N. Cruz, A.Y. Mogilner, L. Crandall, T. Wisniewski, O. Devinsky and T.M. Shepherd AJNR Am J Neuroradiol 2019; 40:1095-1105 doi:10.3174/ajnr.A6088 OPEN ACCESS ARTICLE http://www.ajnr.org/content/40/7/1095.abstract The authors applied an optimized TSE T2 sequence to washed whole postmortem brain samples (n=13) to demonstrate and characterize the detailed anatomy of the basal forebrain using a clinical 3T MR imaging scanner. Theyidentified most basal ganglia and diencephalon structures using serial axial, coronal, and sagittal planes relative to the intercommissural plane. Specific oblique image orientations demonstrated the positions and anatomic relationships for selected structures of interest to functional neurosurgery. Wall Contrast Enhancement of Thrombosed Intracranial Aneurysms at 7T MRI T. Sato, T. Matsushige, B. Chen, O. Gembruch, P. Dammann, R. Jabbarli, M. Forsting, A. Junker, S. Maderwald, H.H. Quick, M.E. Ladd, U. Sure and K.H. Wrede AJNR Am J Neuroradiol 2019; 40:1106-1111 doi:10.3174/ajnr.A6084 http://www.ajnr.org/content/40/7/1106.abstract Gadolinium Enhancement of the Aneurysm Wall in Unruptured Intracranial Aneurysms Is Associated with an Increased Risk of Aneurysm Instability: A Follow-Up Study M.D.I. Vergouwen, D. Backes, I.C. van der Schaaf, J. Hendrikse, R. Kleinloog, A. Algra and G.J.E. Rinkel AJNR Am J Neuroradiol 2019; 40:1112-1116 doi:10.3174/ajnr.A6105 http://www.ajnr.org/content/40/7/1112.abstract Assessing Postconcussive Reaction Time Using Transport-Based Morphometry of Diffusion Tensor Images S. Kundu, A. Ghodadra, S. Fakhran, L.M. Alhilali and G.K. Rohde AJNR Am J Neuroradiol 2019; 40:1117-1123 doi:10.3174/ajnr.A6087 OPEN ACCESS ARTICLE http://www.ajnr.org/content/40/7/1117.abstract Association of Fractional Flow on 3D-TOF-MRA with Cerebral Perfusion in Patients with MCA Stenosis X. Ge, H. Zhao, Z. Zhou, X. Li, B. Sun, H. Wu, J. Wan, J. Xu, J.P. Villablanca and X. Liu AJNR Am J Neuroradiol 2019; 40:1124-1131 doi:10.3174/ajnr.A6095 OPEN ACCESS ARTICLE http://www.ajnr.org/content/40/7/1124.abstract Quantitative Delta T1 (dT1) as a Replacement for Adjudicated Central Reader Analysis of Contrast-Enhancing Tumor Burden: A Subanalysis of the American College of Radiology Imaging Network 6677/Radiation Therapy Oncology Group 0625 Multicenter Brain Tumor Trial K.M. Schmainda, M.A. Prah, Z. Zhang, B.S. Snyder, S.D. Rand, T.R. Jensen, D.P. Barboriak and J.L. Boxerman AJNR Am J Neuroradiol 2019; 40:1132-1139 doi:10.3174/ajnr.A6110 OPEN ACCESS ARTICLE http://www.ajnr.org/content/40/7/1132.abstract Brain Tumor-Enhancement Visualization and Morphometric Assessment: A Comparison of MPRAGE, SPACE, and VIBE MRI Techniques L. Danieli, G.C. Riccitelli, D. Distefano, E. Prodi, E. Ventura, A. Cianfoni, A. Kaelin-Lang, M. Reinert and E. Pravatà AJNR Am J Neuroradiol 2019; 40:1140-1148 doi:10.3174/ajnr.A6096 http://www.ajnr.org/content/40/7/1140.abstract Fifty-four contrast-enhancing tumors (38 gliomas and 16 metastases) were assessed using MPRAGE, VIBE, and SPACE techniques randomly acquired after gadolinium-based contrast agent administration on a 3T scanner. Enhancement conspicuity was assessed quantitatively by calculating the contrast rate and contrast-to-noise ratio, and qualitatively, by consensus visual comparative ratings. Compared with MPRAGE, both SPACE and VIBE obtained higher contrast rate, contrast-to-noise ratio, and visual conspicuity ratings in both gliomas and metastases. The authors conclude that superior conspicuity for brain tumor enhancement can be achieved using SPACE and VIBE techniques, compared with MPRAGE. Extent of Surgical Resection in Lower-Grade Gliomas: Differential Impact Based on Molecular Subtype S.H. Patel, A.G. Bansal, E.B. Young, P.P. Batchala, J.T. Patrie, M.B. Lopes, R. Jain, C.E. Fadul and D. Schiff AJNR Am J Neuroradiol 2019; 40:1149-1155 doi:10.3174/ajnr.A6102 http://www.ajnr.org/content/40/7/1149.abstract Normal-Appearing Cerebellar Damage in Neuromyelitis Optica Spectrum Disorder J. Sun, N. Zhang, Q. Wang, X. Zhang, W. Qin, L. Yang, F.-D. Shi and C. Yu AJNR Am J Neuroradiol 2019; 40:1156-1161 doi:10.3174/ajnr.A6098 OPEN ACCESS ARTICLE http://www.ajnr.org/content/40/7/1156.abstract Comparison of Multiple Sclerosis Cortical Lesion Types Detected by Multicontrast 3T and 7T MRI J. Maranzano, M. Dadar, D.A. Rudko, D. De Nigris, C. Elliott, J.S. Gati, S.A. Morrow, R.S. Menon, D.L. Collins, D.L. Arnold and S. Narayanan AJNR Am J Neuroradiol 2019; 40:1162-1169 doi:10.3174/ajnr.A6099 OPEN ACCESS ARTICLE http://www.ajnr.org/content/40/7/1162.abstract The aim of the authors was: 1) to compare multicontrast cortical lesion detection using 3T and 7T MR imaging, 2) to compare cortical lesion type frequency in relapsing-remitting and secondary-progressive MS, and 3) to assess whether detectability is related to the magnetization transfer ratio, an imaging marker sensitive to myelin content. Multicontrast 3T and 7T MR images from 10 patients with relapsing-remitting MS and 10 with secondary-progressive MS were evaluated with the following 3T contrasts: 3D-T1-weighted, quantitative T1, FLAIR and magnetization-transfer, and 2D proton density- and T2-weighted. The following 7T contrasts were used: 3D-T1-weighted, quantitative T1, and 2D-T2*-weighted. Cortical lesion counts at 7T were the following: 720 total cortical lesions, 420 leukocortical lesions (58%), 27 intracortical lesions (4%), and 273 subpial lesions (38%). Cortical lesion counts at 3T were the following: 424 total co rtical, 393 leukocortical (93%), 0intracortical, and 31 subpial (7%) lesions. Total, intracortical, and subpial 3T lesion counts were significantly lower than the 7Tcounts. The authors conclude that detection of leukocortical lesions at 3T is comparable with that at 7T MR imaging. Imaging at 3T is less sensitive to intracortical and subpial lesions. Improving Detection of Multiple Sclerosis Lesions in the Posterior Fossa Using an Optimized 3D-FLAIR Sequence at 3T A. Lecler, I. El Sanharawi, J. El Methni, O. Gout, P. Koskas and J. Savatovsky AJNR Am J Neuroradiol 2019; 40:1170-1176 doi:10.3174/ajnr.A6107 http://www.ajnr.org/content/40/7/1170.abstract Impact of Skull Defects on the Role of CTA for Brain Death Confirmation D.M. Nunes, A.C.M. Maia, Jr, R.C. Boni and A.J. da Rocha AJNR Am J Neuroradiol 2019; 40:1177-1183 doi:10.3174/ajnr.A6100 http://www.ajnr.org/content/40/7/1177.abstract Diagnosis and Prediction of Relapses in Susac Syndrome: A New Use for MR Postcontrast FLAIR Leptomeningeal Enhancement S. Coulette, A. Lecler, E. Saragoussi, K. Zuber, J. Savatovsky, R. Deschamps, O. Gout, C. Sabben, J. Aboab, A. Affortit, F. Charbonneau and M. Obadia AJNR Am J Neuroradiol 2019; 40:1184-1190 doi:10.3174/ajnr.A6103 http://www.ajnr.org/content/40/7/1184.abstract From January 2011 to December 2017, nine consecutive patients with Susac syndrome and a control group of 73 patients with multiple sclerosis or clinically isolated syndrome were included. Two neuroradiologists blinded to the clinical and ophthalmologic data independently reviewed MRIs and assessed leptomeningeal enhancement and parenchymal abnormalities. Follow-up MRIs of patients with Susac syndrome were reviewed and compared with clinical and retinal fluorescein angiographic data evaluated by an independent ophthalmologist. Patients with Susac syndrome were significantly more likely to present with leptomeningeal enhancement: 5/9 (56%) versus 6/73 (8%) in the control group. They had a significantly higher leptomeningeal enhancement burden with ≥3 lesions in 5/9 patients versus 0/73. Regions of leptomeningeal enhancement were significantly more likely to be located in the posterior fossa. The authors conclude that lep tomeningeal enhancement occurs frequently in Susac syndrome and could be helpful for diagnosis and prediction of clinical relapse. Long-Term Results and Follow-Up Examinations after Endovascular Embolization for Unruptured Cerebral Aneurysms T. Murakami, T. Nishida, K. Asai, Y. Kadono, H. Nakamura, T. Fujinaka and H. Kishima AJNR Am J Neuroradiol 2019; 40:1191-1196 doi:10.3174/ajnr.A6101 http://www.ajnr.org/content/40/7/1191.abstract The appropriate period of follow-up examinations after endovascular embolization for cerebral aneurysms using time-of-flight MR angiography is not well-known. Between April 2006 and March 2011, one hundred forty-eight unruptured aneurysms were treated with endovascular coil embolization. Among them, the authors investigated 116 unruptured aneurysms, which were followed up for >5 years. Time-of-flight MRA was performed at 1 day, 3–6 months, 1 year after the procedure, and every year thereafter. The mean follow-up period was 7.0 years. Recanalization was observed in 19 (16.3%) aneurysms within 2 years. Among them, retreatment was performed in 8 (6.8%) aneurysms. No recanalization was detected in any aneurysms that had been stable in the first 2 years after embolization. They conclude that aneurysms in which recanalization was not observed within 2 years after endovascular coil embolization were stable during a mean follo w-up of 7 years. This result may be helpful in considering the appropriate span or frequency of follow-up imaging for embolized cerebral aneurysms. Flow-Pattern Details in an Aneurysm Model Using High-Speed 1000-Frames-per-Second Angiography J.M. Krebs, A. Shankar, S.V. Setlur Nagesh, J.M. Davies, K.V. Snyder, E.I. Levy, L.N. Hopkins, M. Mokin, D.R. Bednarek, A.H. Siddiqui and S. Rudin AJNR Am J Neuroradiol 2019; 40:1197-1200 doi:10.3174/ajnr.A6090 http://www.ajnr.org/content/40/7/1197.abstract Antiplatelet Therapy in Patients with Aneurysmal SAH: Impact on Delayed Cerebral Ischemia and Clinical Outcome. A Meta-Analysis F. Cagnazzo, I. Derraz, P.-H. Lefevre, G. Gascou, C. Dargazanli, C. Riquelme, P. Perrini, D. di Carlo, A. Bonafe and V. Costalat AJNR Am J Neuroradiol 2019; 40:1201-1206 doi:10.3174/ajnr.A6086 http://www.ajnr.org/content/40/7/1201.abstract Comparison of Carotid Endarterectomy and Stenting for Symptomatic Internal Carotid Artery Near-Occlusion J. Kim, S. Male, D. Damania, B.S. Jahromi and R.P. Tummala AJNR Am J Neuroradiol 2019; 40:1207-1212 doi:10.3174/ajnr.A6085 http://www.ajnr.org/content/40/7/1207.abstract Functional Connectivity Associated with Health-Related Quality of Life in Children with Focal Epilepsy H. Nawani, M.L. Smith, A.L. Wheeler and E. Widjaja AJNR Am J Neuroradiol 2019; 40:1213-1220 doi:10.3174/ajnr.A6106 http://www.ajnr.org/content/40/7/1213.abstract Quantitative Analysis of Punctate White Matter Lesions in Neonates Using Quantitative Susceptibility Mapping and R2* Relaxation Y. Zhang, A. Rauscher, C. Kames and A.M. Weber AJNR Am J Neuroradiol 2019; 40:1221-1226 doi:10.3174/ajnr.A6114 http://www.ajnr.org/content/40/7/1221.abstract Predictive Value of MRI in Diagnosing Brain AVM Recurrence after Angiographically Documented Exclusion in Children A. Jhaveri, A. Amirabadi, P. Dirks, A.V. Kulkarni, M.M. Shroff, N. Shkumat, T. Krings, V.M. Pereira, V. Rea and P. Muthusami AJNR Am J Neuroradiol 2019; 40:1227-1235 doi:10.3174/ajnr.A6093 http://www.ajnr.org/content/40/7/1227.abstract The authors sought to determine the predictive values of contrast-enhanced MR imaging and TOF-MRA for brain AVM recurrence in children, compared with conventional angiography, in 39 patients (mean 10.8 years of age, mean Spetzler-Martin grade, 1.9). Features predictive of recurrence included a tuft of vessels on TOF-MRA and nodular juxtamural/linear enhancement with a draining vein on contrast-enhanced MR imaging. MR imaging is useful for surveillance after brain AVM treatment in children, but conventional angiography is required for definitive diagnosis of recurrence. TOF-MRA and contrast-enhanced MR imaging provide complementary information for determining brain AVM recurrence and should be interpreted in conjunction. Quantification of DTI in the Pediatric Spinal Cord: Application to Clinical Evaluation in a Healthy Patient Population B.B. Reynolds, S. By, Q.R. Weinberg, A.A. Witt, A.T. Newton, H.R. Feiler, B. Ramkorun, D.B. Clayton, P. Couture, J.E. Martus, M. Adams, J.C. Wellons III, S.A. Smith and A. Bhatia AJNR Am J Neuroradiol 2019; 40:1236-1241 doi:10.3174/ajnr.A6104 http://www.ajnr.org/content/40/7/1236.abstract Subject-Specific Studies of CSF Bulk Flow Patterns in the Spinal Canal: Implications for the Dispersion of Solute Particles in Intrathecal Drug Delivery W. Coenen, C. Gutiérrez-Montes, S. Sincomb, E. Criado-Hidalgo, K. Wei, K. King, V. Haughton, C. Martínez-Bazán, A.L. Sánchez and J. C. Lasheras AJNR Am J Neuroradiol 2019; 40:1242-1249 doi:10.3174/ajnr.A6097 http://www.ajnr.org/content/40/7/1242.abstract 35 Years Ago in AJNR Celebrating 35 Years of the AJNR: July 1984 edition AJNR Am J Neuroradiol 2019; 40:1250 doi:10.3174/ajnr.P0082 http://www.ajnr.org/content/40/7/1250 Online Features Letters Polymer Embolism from Bioactive and Hydrogel Coil Embolization Technology: Considerations for Product Development A.M. Chopra, J.P. Cruz and Y.C. Hu AJNR Am J Neuroradiol 2019; 40:E34-E35 doi:10.3174/ajnr.A6083 http://www.ajnr.org/content/40/7/E34 Optic Nerve Evaluation in Idiopathic Intracranial Hypertension M. De Bernardo, L. Vitiello and N. Rosa AJNR Am J Neuroradiol 2019; 40:E36 doi:10.3174/ajnr.A6091 http://www.ajnr.org/content/40/7/E36 Reply: T.A. Kennedy AJNR Am J Neuroradiol 2019; 40:E37 doi:10.3174/ajnr.A6094 http://www.ajnr.org/content/40/7/E37 Automated Segmentation of Hippocampal Volume: The Next Step in Neuroradiologic Diagnosis of Mesial Temporal Sclerosis N. Damodaran AJNR Am J Neuroradiol 2019; 40:E38 doi:10.3174/ajnr.A6092 http://www.ajnr.org/content/40/7/E38 Erratum Erratum AJNR Am J Neuroradiol 2019; 40:E39 doi:10.3174/ajnr.A6082 http://www.ajnr.org/content/40/7/E39 This message was sent to alsfakia@gmail.com. Unsubscribe from or edit your subscription for this service. Or by mail: Customer Service * 973 University Avenue * Los Gatos, CA 95032 * U.S.A. Copyright © 2019 by the American Society of Neuroradiology.