Search

To report a rare case of severe oligoasthenoteratozoospermia which seems to be associated with long-term topical povidone-iodine (PVP-I) therapy. A 45-year-old man with secondary infertility was diagnosed with mild asthenospermia before undergoing in vitro fertilization (IVF). A repeat sperm analysis (SA) on June 30, 2022, after three months of using compound PVP-I liniment to treat fungal infection under a fingernail and toenail, revealed severe oligoasthenoteratozoospermia. After 77 days of drug withdrawal, sperm concentration, and normal morphology gradually returned to normal, but motility was only partially restored. It seems that the usage of PVP-I has a side effect of causing a decline in sperm quality. Although the exact mechanism of this adverse effect of PVP-I is unclear, men who are in fertility treatment should be informed of the potential risks. J Drugs Dermatol. 2025;24(3):e11-e13.  doi:10.36849/JDD.7342.

Background: Cerebrovascular hemodynamics are believed to play an important role in the development of ischemic stroke (IS). However, the relationships between hemodynamics and prognosis are not fully understood. Four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) enables comprehensive characteristics of cerebrovascular hemodynamics. This study aims to investigate the associations of the different hemodynamics derived from 4D flow CMR with IS functional outcomes., Methods: 91 patients (median age 64 years, 62 males) with unilateral IS in middle cerebral artery (MCA) territory were included. All subjects underwent a CMR scan, including 4D flow, three-dimensional (3D) time-of-flight (TOF) magnetic resonance angiography (MRA), 3D whole brain black-blood high-resolution vessel wall imaging (HR-VWI) of the MCA. Six hemodynamics, including flow rate, velocity, pulsatility index, time-averaged WSS (TAWSS), oscillatory shear index and relative residence time (RRT) were calculated for the lesion site, pre-bifurcation M1 (pM1) segment and the distal M1 and/or first branches of M2 (dM1/M2) segments. Vessel characteristics such as lumen area, vessel area, wall area, maximum wall thickness and the degree of stenosis were calculated at the most stenotic lesion site. The modified Rankin Scale (mRS) scores were assessed at 90 days and one year, and a mRS >2 was considered as a poor functional outcome., Results: Lower segment-level TAWSS (OR:0.24, P=0.006 and OR: 0.29, P=0.014), higher RRT (OR: 2.74, P=0.007 and OR: 2.40, P=0.011) of dM1/M2 segments and lower segment- and lesion-level velocity (OR: 0.40, P=0.019 and OR: 0.41, P=0.025; OR: 0.41, P=0.030 and OR: 0.42, P=0.040) of pM1 segment were observed to be associated with poor functional outcome at both 90 days and one year. Using the cut-off value of 3.58Pa and 0.29, respectively, TAWSS and RRT of dM1/M2 segments showed moderate estimate performance in distinguishing poor functional outcome from favorable outcome (AUCs range from 0.642-0.687) both at 90 days and one year., Conclusion: Distal segmental TAWSS and RRT of dM1/M2 segments were associated with poor functional outcomes. Such alterations of hemodynamics might help for the identification of patients with potential unfavorable prognosis., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 The Author(s). Published by Elsevier Inc. All rights reserved.)

Rationale and Objectives: To explore the value of diffusion tensor imaging (DTI), diffusion kurtosis imaging (DKI), neurite orientation dispersion and density imaging (NODDI), and mean apparent propagator (MAP) magnetic resonance imaging histogram analysis in evaluating the grade and proliferative activity of meningiomas., Materials and Methods: A total of 134 meningioma patients were prospectively included and underwent magnetic resonance diffusion imaging. The whole-tumor histogram parameters were extracted from multiple functional maps. Mann-Whitney U test was used to compare the histogram parameters of high- and low-grade meningiomas. The receiver operating characteristic (ROC) curve and multiple logistic regression analysis were used to evaluate the diagnostic efficacy. The correlation between histogram parameters and the Ki-67 index was analyzed. The diffusion model was further validated with an independently validation set (n = 33)., Results: Among single histogram parameters, the variance of NODDI-ISOVF (isotropic volume fraction) showed the highest AUC of 0.829 in grading meningiomas. For the combined models, the DKI model had the best performance in the diagnosis (AUC=0.925). Delong test showed the DKI combined model showed superior diagnostic performance to those of DTI, NODDI and MAP models (P < 0.05 for all). Moreover, moderate to weak correlations were found between various diffusion parameters and the Ki-67 labeling index (rho=0.20-0.45, P < 0.05 for all). In the validation set, the DKI model still showed higher performance (AUC, 0.85) than other diffusion models, thus demonstrating robustness., Conclusions: Whole-tumor histogram analyses of DTI, DKI, NODDI, and MAP are useful for evaluating the grade and cellular proliferation of meningiomas. DKI combined model has higher diagnostic accuracy than DTI, NODDI and MAP in meningioma grading., Competing Interests: Declaration of Competing Interest The authors have no relevant financial or non-financial interests to disclose., (Copyright © 2024 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.)

Objective: This study aimed to develop and validate machine learning models (MLMs) to diagnose Alzheimer's disease (AD) using cortical complexity indicated by fractal dimension (FD)., Methods: A total of 296 participants with normal cognitive (NC) function and 182 with AD from the AD Neuroimaging Initiative database were randomly divided into training and internal validation cohorts. Then, FDs, demographic characteristics, baseline global cognitive function scales [Montreal Cognitive Assessment (MoCA), Functional Activities Questionnaire (FAQ), Global Deterioration Scale (GDS), Neuropsychiatric Inventory (NPI)], phospho-tau (p-tau 181), amyloidβ-42/40, apolipoprotein E (APOE) and polygenic hazard score (PHS) were collected to establish multiple MLMs. Receiver operating characteristic curves were used to evaluate model performance. Participants from our institution ( n  = 66; 33 with NC and 33 with AD) served as external validation cohorts to validate the MLMs. Decision curve analysis was used to estimate the models' clinical values., Results: The FDs from 30 out of 69 regions showed significant alteration. All MLMs were conducted based on the 30 significantly different FDs. The FD model had good accuracy in predicting AD in three cohorts [area under the receiver operating characteristic (ROC) curve (AUC) = 0.842, 0.808, and 0.803]. There were no statistically significant differences in AUC values between the FD model and the other combined models in the training and internal validation cohorts except MoCA + FD and FAQ + FD models. Among MLMs, the MoCA + FD model showed the best predictive efficiency in three cohorts (AUC = 0.951, 0.931, and 0.955) and had the highest clinical net benefit., Conclusion: The FD model showed favorable diagnostic performance for AD. Among MLMs, the MoCA + FD model can predict AD with the highest efficiency and could be used as a non-invasive diagnostic method., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Jiang, Yang, Deng, Jiang and Xue.)

Background: In liver diffusion-weighted imaging (DWI), single-shot echo-planar imaging (SS-EPI) sequences are susceptible to motion artifacts, resulting in image blurring and decreased lesion detection rates. This study aimed to develop and optimize a motion-corrected (MOCO) technique for liver DWI at 3 Tesla (3T). The technique incorporates motion correction, complex averaging, and a combination of a reparametrized sinc fatsat pulse with an optimized water excitation pulse., Methods: This prospective cross-sectional study performed at Fujian Medical University Union Hospital included 42 healthy volunteers who underwent four SS-EPI DWI sequences on a 3T magnetic resonance imaging (MRI) system between January 2023 and March 2023. The sequences included a navigator-triggered (NT) MOCO-DWI, two free-breathing (FB) MOCO-DWI, and an FB conventional DWI (FB cDWI) sequence. Motion correction and complex averaging were performed for both MOCO-DWI sequences, and fat suppression was achieved using either a sinc fatsat pulse with optimized water excitation or a conventional spectral attenuated inversion recovery (SPAIR) pulse. Liver signal-to-noise ratio (SNR) was measured at b=1,000 s/mm 2 . Qualitative parameters were independently evaluated by three radiologists using 5-point Likert scales. Quantitative parameters were assessed using the Kolmogorov-Smirnov test, and variance homogeneity was assessed using Levene's test. Regarding the qualitative analysis, the Friedman test was used to compare subjective scores among the four techniques., Results: The SNRs of the liver were significantly higher with FB MOCO-DWI compared to the other EPI DWI sequences at b=1,000 s/mm 2 (P<0.05). In the superior-inferior direction, the SNRs of the inferior level of the liver were higher than those of the superior level in NT MOCO-DWI. The qualitative results showed significantly higher ratings for NT MOCO-DWI and FB MOCO-DWI compared to the other EPI DWI sequences at b=1,000 s/mm 2 (P<0.05). Regarding the apparent diffusion coefficient (ADC) quantification, the ADC values of the left lobe were higher than those of the right lobe in all four techniques., Conclusions: The proposed EPI DWI technique, incorporating motion correction, complex averaging, and a modified fat suppression scheme using spectral fat saturation and binomial water excitation, was found to be clinically feasible for liver MRI. The FB MOCO-DWI sequence, with its superior SNR and excellent image quality, is recommended for liver DW imaging at 3T in clinical routine., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-24-340/coif). C.F. is an employee of Siemens Shenzhen Magnetic Resonance Ltd. G.L. is an employee of Siemens Healthineers Ltd. T.B. is an employee of Siemens Healthineers AG. The other authors have no conflicts of interest to declare., (2024 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Objective: The general trend in meningioma treatment is shifting from surgery to active surveillance. However, the natural history of meningioma still needs to be clarified, and a simple, practical method is needed to identify fast-growing tumors. The authors aimed to determine whether diffusion-weighted imaging (DWI) could be a valuable imaging modality for predicting meningioma growth., Methods: Consecutive asymptomatic patients with a meningioma diagnosed on MRI and followed up at the authors' institution between July 2011 and July 2019 were eligible for inclusion in this retrospective study. Univariable and multivariable Cox regression analyses were used to explore whether the relative apparent diffusion coefficient (rADC) was an independent predictor of meningioma growth. Correlations between tumor growth rate (TGR), tumor volume doubling time (VDT), Ki-67, and rADC were assessed using the Pearson correlation coefficient. The predictive ability of rADC was evaluated using receiver operating characteristic (ROC) curves and validated with internal validation data., Results: Sixty-four patients (47 females, 17 males) with a mean age of 62.2 ± 1.4 years were included in this study. Univariable and multivariable analyses revealed that rADC was an independent predictor of meningioma growth (p < 0.05). ROC curve analysis showed that baseline rADC had good predictive power for growing meningiomas (AUC = 0.88, 95% CI 0.78-0.96), as well as slow- or fast-growing meningiomas (AUC = 0.83, 95% CI 0.59-0.98). Moreover, rADC still had a good ability to discriminate between growing and nongrowing meningiomas in the validation set (AUC = 0.85, 95% CI 0.64-1.00). In the 20 patients with tumor growth, baseline rADC was moderately negatively correlated with TGR (r = -0.50, p = 0.02) and strongly positively correlated with VDT (r = 0.63, p = 0.003). Moreover, Ki-67 was significantly associated with rADC in 8 patients who had undergone surgery (r = -0.75, p = 0.03)., Conclusions: In asymptomatic meningiomas, the lower the rADC at baseline, the faster the TGR and the shorter the VDT. DWI could be a valuable tool in predicting meningioma growth in asymptomatic patients.