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Background and Purpose: Prediction of aneurysm instability is crucial to guide treatment decisions and to select appropriate patients with unruptured intracranial aneurysms (IAs) for preventive treatment. High-resolution 4D MR flow imaging and 3D quantification of aneurysm morphology could offer insights and new imaging markers for aneurysm instability. In this cross-sectional study, we aim to identify 4D MR flow imaging markers for aneurysm instability by relating hemodynamics in the aneurysm sac to 3D morphologic proxy parameters for aneurysm instability., Materials and Methods: In 35 patients with 37 unruptured IAs, a 3T MRA and a 7T 4D MRI flow scan were performed. Five hemodynamic parameters-peak-systolic wall shear stress (WSS MAX ) and time-averaged wall shear stress (WSS MEAN ), oscillatory shear index (OSI), mean velocity, and velocity pulsatility index-were correlated to 6 3D morphology proxy parameters of aneurysm instability-major axis length, volume, surface area (all 3 size parameters), flatness, shape index, and curvedness-by Pearson correlation with 95% CI. Scatterplots of hemodynamic parameters that correlated with IA size (major axis length) were created., Results: WSS MAX and WSS MEAN correlated negatively with all 3 size parameters (strongest for WSS MEAN with volume ( r = -0.70, 95% CI -0.83 to -0.49) and OSI positively (strongest with major axis length [ r = 0.87, 95% CI 0.76-0.93]). WSS MAX and WSS MEAN correlated positively with shape index ( r = 0.61, 95% CI 0.36-0.78 and r = 0.49, 95% CI 0.20-0.70, respectively) and OSI negatively ( r = -0.82, 95% CI -0.9 to -0.68). WSS MEAN and mean velocity correlated negatively with flatness ( r = -0.35, 95% CI -0.61 to -0.029 and r = -0.33, 95% CI -0.59 to 0.007, respectively) and OSI positively ( r = 0.54, 95% CI 0.26-0.74). Velocity pulsatility index did not show any statistically relevant correlation., Conclusions: Out of the 5 included hemodynamic parameters, WSS MAX , WSS MEAN , and OSI showed the strongest correlation with morphologic 3D proxy parameters of aneurysm instability. Future studies should assess these promising new imaging marker parameters for predicting aneurysm instability in longitudinal cohorts of patients with IA., (© 2024 by American Journal of Neuroradiology.)

Background: Asymmetry in diameter between pre-communicating (A1) segments of the anterior cerebral arteries is related to anterior communicating artery aneurysm formation. Diameter asymmetry definitions vary and have not been related to blood flow measurements using the same imaging modality. We aimed to evaluate the relationship between A1-diameter asymmetry and blood flow asymmetry and to define a hemodynamically significant cut-off value for A1-diameter asymmetry. We assessed sex differences between different groups of A1-asymmetry., Materials and Methods: 3-Tesla time-of-flight MRA and 4D-phase-contrast MRI were performed in 122 healthy participants. Diameter and blood flow measurements were performed halfway in both A1-segments. Participants were subdivided based on A1-diameter asymmetry: ≤10% (symmetric); 11-20%; 21-30%; 31-40%; and >40% (increasing asymmetry) groups. We studied the relationship between A1-diameter asymmetry and corresponding flow asymmetry (scatterplot and correlation). A hemodynamic-based cutoff value for A1-asymmetry was determined by comparing dominant A1 blood flow in the asymmetry groups to the mean blood flow of the symmetric A1-group (linear mixed-effects model). Sex-related differences in A1-diameter, blood flow and asymmetry were assessed with t-tests., Results: A1-diameter asymmetry was linearly related to blood flow asymmetry between dominant and non-dominant sides. A1-diameter asymmetry >30% yielded statistically significant increased blood flow in the dominant A1 compared to symmetric A1s. Men had statistically significant larger A1-diameters, higher blood flow and a similar degree of A1-diameter asymmetry compared to women., Conclusion: A1-diameter asymmetry is linearly related to blood flow asymmetry. A >30% A1-asymmetry can be used as hemodynamically significant cut-off value. There were no sex-related differences in A1-diameter asymmetry., Competing Interests: Declaration of Competing Interest We have no conflict of interest., (Copyright © 2022 The Author(s). Published by Elsevier Masson SAS.. All rights reserved.)

Purpose: To investigate gender differences in diagnostic radiology practice, specifically, the differences in scope of practice, the frequency of consultations to other colleagues, and the error rates., Material and Methods: A retrospective observational study was performed including radiologists working for a European teleradiology provider between 2013 and 2019. Main outcome measures included the adjusted odds ratio of female gender for reporting cases in more than one subspecialty, the adjusted incidence rate ratio (IRR) of female gender for the count of second opinion requests to other colleagues, and the adjusted IRR of female gender for the count of radiologic errors. Multivariable adjustment was performed for covariates associated with experience, type of cases reported, part- or full-time employment, and reporting speed., Results: A total of 213 radiologists (36% female) were included in the analysis of gender differences in scope of practice. Female gender was associated with a lower odds of reporting cases in more than one subspecialty with an odds ratio of 0.46 (95% confidence interval, 0.22-0.96). A total of 204 radiologists (36% female) were included in the analysis of gender differences in the count of second opinion requests to colleagues. There was a trend toward an association between female gender and higher odds of requesting a second opinion with an adjusted IRR of 1.6 compared with male gender, but it was not statistically significant (P = .08). A total of 199 radiologists were included (37% female) in the analysis of gender differences in the number of radiologic errors. Female gender was associated with a decrease in the odds of error with an IRR of 0.8 (95% confidence interval, 0.64-0.995)., Conclusions: Female radiologists tend to have a narrower scope of practice and make fewer mistakes than their male counterparts, even after detailed adjustment for factors that might explain gender differences in scope of practice and errors., (Copyright © 2021 American College of Radiology. Published by Elsevier Inc. All rights reserved.)

We compared velocity pulsatility, distensibility, and pulsatility attenuation along the intracranial ICA and MCA between 50 patients with pseudoxanthoma elasticum and 40 controls. Patients with pseudoxanthoma elasticum had higher pulsatility and lower distensibility at all measured locations, except for a similar distensibility at C4. The pulsatility attenuation over the siphon was similar between patients with pseudoxanthoma elasticum and controls. This finding suggests that other disease mechanisms are the main contributors to increased intracranial pulsatility in pseudoxanthoma elasticum., (© 2021 by American Journal of Neuroradiology.)

Attention deficit hyperactivity disorder (ADHD) is a common neuropsychiatric disorder. Genetics has an important role in the aetiology of this disease. In this study, we describe the clinical findings in a Dutch family with eight patients suffering from ADHD, in whom five had at least one other psychiatric disorder. We performed a genome-wide (parametric and nonparametric) affected-only linkage analysis. Two genomic regions on chromosomes 7 and 14 showed an excess of allele sharing among the definitely affected members of the family with suggestive LOD scores (2.1 and 2.08). Nonparametric linkage analyses (NPL) yielded a maxNPL of 2.92 (P=0.001) for marker D7S502 and a maxNPL score of 2.56 (P=0.003) for marker D14S275. We confirmed that all patients share the same haplotype in each region of 7p15.1-q31.33 and 14q11.2-q22.3. Interestingly, both loci have been reported before in Dutch (affected sib pairs) and German (extended families) ADHD linkage studies. Hopefully, the genome-wide association studies in ADHD will help to highlight specific polymorphisms and genes within the broad areas detected by our, as well as other, linkage studies.