The American Journal of Neuroradiology

"Advancements in CT myelography (CTM) have improved visualization of CSF-venous fistulas (CVFs) but the relative impact of the timing of image acquisition and the contrast density in the subarachnoid space is unclear. This study compared effects of timing and contrast density in evaluation of CVFs."

"Maximizing the Conspicuity of CSF-Venous Fistulas on CT Myelography: Assessment of Contrast Density and Timing Effects"

@PeterGKranz @TimAmrheinMD @AjayMadhavanMD

doi.org/10.3174/ajnr...

"We performed a retrospective review of patients with dural tears diagnosed on photon-counting CT myelography, comparing Br56, Qr89 denoised with quantum iterative reconstruction, and Qr89 denoised with a trained convolutional neural network."

Enhancing the Characterization of Dural Tears on Photon-Counting CT Myelography: An Analysis of Reconstruction Techniques SUMMARY: Photon-counting detector CT myelography is an effective technique for the localization of spinal CSF leaks. The initial studies describing this technique used a relatively smooth Br56 kernel. However, subsequent studies have demonstrated that the use of the sharpest quantitative kernel on photon-counting CT (Qr89), particularly when denoised with techniques such as quantum iterative reconstruction or convolutional neural networks, enhances the detection of CSF-venous fistulas. In this clinical report, we sought to determine whether the Qr89 kernel has utility in patients with dural tears, the other main type of spinal CSF leak. We performed a retrospective review of patients with dural tears diagnosed on photon-counting CT myelography, comparing Br56, Qr89 denoised with quantum iterative reconstruction, and Qr89 denoised with a trained convolutional neural network. We specifically assessed spatial resolution, noise level, and diagnostic confidence in 8 such cases, finding that the sharper Qr89 kernel outperformed the smoother Br56 kernel. This finding was particularly true when Qr89 was denoised using a convolutional neural network. Furthermore, in 2 cases, the dural tear was only seen on the Qr89 reconstructions and missed on the Br56 kernel. Overall, our study demonstrates the potential value of further optimizing postprocessing techniques for photon-counting CT myelography aimed at localizing dural tears. CNN : convolutional neural network CTM : CT myelography CVF : CSF-venous fistula DSM : digital subtraction myelography EID : energy-integrating detector PCD : photon-counting detector QIR : quantum iterative reconstruction SIH : spontaneous intracranial hypotension UHR : ultra-high-resolution

"Enhancing the Characterization of Dural Tears on Photon-Counting CT Myelography: An Analysis of Reconstruction Techniques"

@AjayMadhavanMD

"This study describes 2 cases of spontaneous intracranial hypotension treated with fluoroscopically-guided, catheter-delivered Onyx to seal a spinal CSF leak, with significant improvement observed during a 2-year follow-up."

"Epidural Onyx Treatment for Spontaneous Intracranial Hypotension Caused by a Ventral Dural Tear"

doi.org/10.3174/ajnr...

"This study compares radiographic and anatomic intraoperative findings in patients with small lateral dural CSF collections who underwent surgical exploration."

"The Importance of Small Lateral Dural CSF Collections in Spontaneous Intracranial Hypotension: A Radiologic-Anatomic Study"

@WouterSchievink @marcelmaya

doi.org/10.3174/ajnr...

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"The resurgence in recreational misuse of nitrous oxide has consequently lead to a surge in cases of nitrous oxide–induced subacute combined degeneration of the cord (N2O-SACD). This study discusses characteristic features on MR imaging that may suggest a diagnosis of N2O-SACD."

"Increased Prevalence of Nitrous Oxide–Induced Subacute Combined Degeneration of the Spinal Cord: Clinical and Imaging Findings"

doi.org/10.3174/ajnr...

"CTA is a commonly used study in the setting of strangulation-related injuries due to the concern for blunt cerebrovascular injuries (BCVIs). This identified risk factors and rates of BCVIs in the setting of strangulation-related injuries to guide imaging strategies."

"Use of CTA in Strangulation Evaluation"

@vsyedavalli; @dhairyalakhani; @hamza_isleem

doi.org/10.3174/ajnr...

"SAH is a frequent intracranial finding in patients with trauma and poses significant diagnostic and prognostic challenges. This study evaluates the rate of posttraumatic subarachnoid hemorrhage enlargement, identifying predictors of hemorrhage progression and need for surgical intervention."

"Risk Stratification for Traumatic SAH Enlargement and Surgical Intervention: Guides to Follow-Up Imaging in Patients with Trauma"

@dyousem1

doi.org/10.3174/ajnr...

"Variability in the deep cerebral venous system is hypothesized to contribute to intraventricular hemorrhage (IVH) in preterm infants. This study adapts and expands current classification systems to provide a more comprehensive representation of subependymal vein anatomy in the preterm brain."

"Toward a Broader Classification of Deep Venous Cerebral Anatomy in Extremely Preterm Infants: A Literature-Based Approach and Its Relevance to Intraventricular Hemorrhage"

doi.org/10.3174/ajnr...

The March 2026 issue of AJNR is out now!

You can access the articles at www.ajnr.org/content....

@TheAJNR

"GM1 gangliosidosis is a rare lysosomal storage disorder caused by pathogenic variants in the GLB1 gene, leading to deficient β-galactosidase activity and accumulation of gangliosides. This study systematically characterizes neuroimaging features across all clinical subtypes of GM1 gangliosidosis."

"Neuroimaging Spectrum of GM1 Gangliosidosis with Description of Novel Imaging Signs"

@stikkman11

doi.org/10.3174/ajnr...

"Considerable socioeconomic disparities exist among pediatric patients with traumatic brain injury. This study analyzes effects of social determinants of health (SDoH) on head injury outcomes and creates a machine-learning algorithm (MLA) to predict the likelihood of head CT findings based on SDoH."

"Outcome Prediction in Pediatric Traumatic Brain Injury Utilizing Social Determinants of Health and Machine Learning Methods"

@artemka__crh

doi.org/10.3174/ajnr...

"Cerebral malaria (CM) is a leading cause of childhood mortality and neurologic morbidity in sub-Saharan Africa and South Asia. Our goal was to characterize patterns of cortical edema on brain MRI in children with CM and determine their association with patient outcomes."

"Peri-Rolandic and Occipital Sparing Cortical Edema: A Prevalent MRI Finding in Pediatric Patients with Cerebral Malaria"

doi.org/10.3174/ajnr...

"To elucidate biological mechanisms underlying the uptake of 68Ga-PSMA-11 in glioblastoma, this study investigates the relationship between 68Ga-PSMA-11 PET and arterial spin-labeling perfusion imaging, and the correlation between PSMA tracer uptake and immunohistochemical microvascular indices."

"Similarity of Biological Information Captured by [68]Ga-PSMA-11 PET and ASL Perfusion MRI in Glioblastoma"

doi.org/10.3174/ajnr...

"Motion artifacts remain a key limitation in brain MRI, particularly in cognitively impaired patients. Most deep learning (DL) reconstruction techniques improve SNR but lack mechanisms to correct for motion. This study aims to validate a DL reconstruction method for retrospective motion correction."

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

doi.org/10.3174/ajnr...

@FujitaMDPhD

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