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•The reproducibility assessment of magnetic resonance spectroscopy was explored.•CV and ICC showed good reliability of within- and between- scanning sessions.•Bland-Altman plots indicated strong agreement in the repeated measurements.•Pearson correlation coefficients showed great reproducibility across three machines.•It revealed higher reproducibility for the intra-vendor than the inter-vendor. Proton magnetic resonance spectroscopy (1H-MRS) has potential in clinical diagnosis and understanding the mechanism of illnesses. However, its application is limited by the lack of standardization in data acquisition and processing across time points and between different magnetic resonance imaging (MRI) system vendors. This study examines whether metabolite concentrations obtained from different sessions, scanner models, and vendors can be reliably reproduced and combined for diagnostic analysis-an important consideration for rare disease research. Participants underwent magnetic resonance scanning once on two separate days within one week (one session per day, each including two 1H-MRS scans without subject movement) on each machine. Absolute metabolite concentrations were analyzed for reliability of within- and between- session using the coefficient of variation (CV), intraclass correlation coefficient (ICC) and Bland-Altman (BA) plot, and for reproducibility across the machines using the Pearson correlation coefficient. As for within- and between- session, most of the CV values for a group of all the first or second scans of a session, and from each session were below 20 %, and most of ICCs ranged from moderate (0.4≤ICC<0.59) to excellent (ICC≥0.75), which indicated high reliability. Most of the BA plots had the line of equality between 95 % confidence interval of bias (mean difference), therefore the differences over scanning time could be negligible. Majority of the Pearson correlation coefficients approached 1 with statistical significance (P < 0.001), showing high reproducibility across the three scanners. Additionally, the intra-vendor reproducibility was greater than the inter-vendor ones. [Display omitted]

Our study aimed to explore the calcification patterns of culprit lesions associated with artery-to-artery embolism (AAE) infarction in patients with vertebrobasilar artery atherosclerosis, using vessel wall magnetic resonance imaging (VW-MRI) and computed tomography (CT). We retrospectively analyzed data from patients undergoing VW-MRI and CT scans at two institutions. Patients with ≥ 50% vertebrobasilar atherosclerotic stenosis were categorized based on their stroke mechanisms as AAE (+) and AAE (-). Calcification profiles of the culprit lesion, including the morphology, location, quantity, and VW-MRI characteristics were compared among stroke patients. Multivariate logistic regression model was used to evaluate the relationship between vertebrobasilar artery calcification characteristics and the presence of AAE (+). Among the 151 stroke patients included, 56 (37.09%) were classified as AAE (+), while 95 (62.91%) as AAE (-). Multivariate regression analysis revealed the odds ratio of AAE (+) was 2.69 and 2.15 for the presence and count of spotty calcification, 3.33 for intimal-predominant calcification, and 3.65 for multiple calcifications. Calcification characteristics observed at the culprit lesion were associated with posterior circulation infarction in patients exhibiting AAE infarction. Understanding the relationship between intracranial artery calcification and stroke mechanisms may help clinicians improve stroke prevention and treatment.

Purpose To assess the role of body composition mediating the association between MRI-quantified adrenal gland volume (AGV) and type 2 diabetes mellitus (T2DM) and to clarify the underlying mechanisms involved. Methods This retrospective study analyzed 239 hospitalized patients (54 T2DM, 185 non-T2DM) with abdominal MRI. AGV was manually segmented on T1-weighted images. Body composition parameters, including subcutaneous adipose tissue (SAT) area and fat fraction (FF), visceral adipose tissue (VAT) area and FF, hepatic FF (HFF), pancreatic FF (PFF), and abdominal muscle (AM) area and FF, were quantified using MRI fat fraction mapping. Results After adjusting for age, sex, hypertension, and BMI, mediation analysis showed that PFF partially mediated the association between AGV and T2DM (OR = 1.036, 95% CI: 1.009–1.101), accounting for 8.7% of the total effect. Multivariate analysis identified both AGV (OR: 1.475, 95% CI: 1.235–1.762) and PFF (OR: 1.069, 95% CI: 1.023–1.116) as independent factors associated with T2DM. ROC analysis showed AUCs of 0.792 for AGV and 0.803 for PFF in differentiating T2DM. The combined AGV + PFF model achieved an AUC of 0.836 (95% CI: 0.779–0.894). Conclusion MRI-quantified AGV and PFF demonstrate potential as biomarkers for T2DM. Pancreatic fat deposition partially mediates the link between adrenal enlargement and T2DM, suggesting a novel pathway involving HPA axis dysregulation and ectopic fat deposition.

Background and purpose: Executive function impairment, a slight but noticeable cognitive deficit in mild cognitive impairment (MCI) patients, is influenced by gamma-aminobutyric acid (GABA) levels. Reduced cognitive function is accompanied by thinning of the cerebral cortex, which has higher GABA levels than white matter. However, the relationships among GABA levels, cortical thickness, and executive function in MCI patients have not yet been elucidated. We investigated the relationships among GABA levels, cortical thickness, and executive function in MCI patients. Methods: In this study, a total of 36 MCI patients and 36 sex-, age-, and education-matched healthy controls (HC) were recruited. But 33 MCI patients and 35 HC were included because of head motion or poor data quality for three MCI patients and one HC. The levels of gamma-aminobutyric acid plus relative to creatine (GABA+/Cr) and glutamate-glutamine relative to creatine (Glx/Cr) in the anterior cingulate cortex (ACC) and posterior cingulate cortex (PCC) were measured using the Meshcher-Garwood point resolved spectroscopy (MEGA-PRESS) sequence. Metabolite ratios, cortical thickness, and executive function and their interrelationships were determined in the MCI and HC groups. Results: Patients with MCI showed lower GABA+/Cr levels in the ACC and PCC. Combined levels of GABA+ and Glx in the ACC and GABA+ in the PCC showed good diagnostic efficacy for MCI (AUC: 0.82). But no differences in cortical thickness were found between the two groups. In the MCI group, lower GABA+/Cr level was correlated to worse performance on the digit span test backward, and the shape trail test-B. The cortical thickness was not associated with GABA+ levels and executive function in patients. Conclusion: These results implied that decreased GABA levels in the ACC and PCC had a critical role in the early diagnosis of impaired executive function of MCI. Therefore, GABA in the ACC and PCC could be a potential diagnostic marker of the executive function decline of MCI.

Objective To explore the efficacy of quantitative measurements of temporal changes in CT-based spatial habitat to predict pathological responses after neoadjuvant chemotherapy (NAC) in patients with locally advanced gastric cancer (LAGC). Methods This retrospective study included 68 LAGC patients who underwent NAC followed by radical gastrectomy. Patients were stratified into a good response (GR) group or a poor response (PR) group based on tumor regression grading (TRG). Baseline and restaging portal venous-phase CT images, along with CT-based texture entropy maps, were grouped into three spatial habitats using K-means clustering. The voxel number and fraction (f i ) of each habitat and their changing trends (delta) at the baseline (pre) and restaging (post) stages were quantified. Differences between the GR and PR groups were compared. The spatiotemporal habitat (SH), clinical-radiological (CR) and laboratory (Lab) models and their model scores were generated through multivariate logistic regression. A combined nomogram integrating SH, CR, and Lab scores was developed. Diagnostic accuracy was assessed using the area under receiver operating characteristic curves (AUCs). Results Compared to the PR group, the GR group exhibited significantly higher post-f 1 and delta-f 1 values, and lower post-f 3 and post-voxel number 3 values ( p  < 0.01). The GR group showed lower incidences of Borrmann III-IV, reduced post-tumor thickness, lower post-CA724 levels, and smaller delta-CEA values ( p  < 0.05). The combined nomogram exhibited the highest diagnostic efficacy (AUC = 0.893), significantly outperforming the CR (0.711), Lab (0.766), and SH (0.833) models ( p  < 0.05). Conclusions CT-based spatiotemporal habitat imaging demonstrates clinical utility in predicting pathological response to NAC in LAGC.

To investigate potential alterations of white matter hyperintensities (WMHs) on J -edited MR spectroscopy (MRS) measures of the primary inhibitory neurotransmitter γ-aminobutyric acid (GABA). Twenty-four WMHs patients and 20 healthy controls (HCs) were recruited to undergo magnetic resonance spectroscopy (MRS) scan at 3T from voxels in left centrum semiovale white matter, using the MEGA point resolved spectroscopy (MEGA-PRESS) technique with the MATLAB-based Gannet tool to estimate GABA+ co-edited macromolecule (GABA+) levels and using Tarquin software to estimate levels of glutamate + glutamine (Glx), total N-acetylaspartate (tNAA), total choline (tCho), and total creatine (tCr). Independent t -tests or Mann-Whitney U -tests were used to test group differences between WMHs and HCs. Additionally, WMHs patients were divided into mild and moderate-severe WMHs subgroup according to the Fazekas scale. Analysis of variance (ANOVA) and post-hoc tests were used among WMHs subgroups and HCs. We found there was a significant reduction in GABA+ levels ( p = 0.018) in WMHs patients compared with healthy controls. In subgroup analyses, there was also a significant reduction of GABA+ levels in moderate-severe WMHs subgroup ( p = 0.037) and mild WMHs subgroup ( p = 0.047) when compared to HCs. Besides, the moderate-severe WMHs subgroup had significantly higher levels of tCho compared with healthy controls ( p = 0.019). In conclusion, reduced GABA+ levels in WMHs patients and elevated tCho levels in moderate-severe WMHs were observed when compared with HCs. These results demonstrate that abnormalities of the GABAergic system and choline metabolism may contribute to the pathogenesis of WMHs.

The neurotransmitter excitation/inhibition (E/I) balance is critical for maintaining normal brain function, and the contribution of nicotine signaling to homeostasis regulation and maintenance of E/I ratios is only beginning to be understood. Advanced -edited H magnetic resonance spectroscopy ( H MRS) enables reliable detection of overlapped brain metabolite, including the neurotransmitters of glutamate (Glu) and N-acetylaspartyl glutamate (NAAG) and gamma-aminobutyric acid (GABA), etc. The purpose of this study was to explore the changes of neurotransmitters in the medial prefrontal cortex (mPFC) of smokers, so as to understand the potential metabolic mechanism of smoking addiction and make a contribution to the cause of smoking cessation. In 2022, 45 males aged 40-60 years old were recruited. All subjects underwent routine magnetic resonance imaging (MRI) and the -edited H MRS scans on a 3.0T MRI scanner. The edited spectra were post-processed and quantitatively analyzed using the Gannet tools. Two independent samples -test was used to analyze the differences in GABA, glutamine/glutamic acid (Glx) and NAAG levels between nicotine addicts and control group; Finally, the spearman standard was used to analyze the correlation between metabolite levels and clinical characteristics assessment scales. All measured metabolite levels in the brain mPFC region of smokers showed no significant difference to those of the control subjects. While the NAAG levels with reference to total creatine or water signals in smokers was significantly correlated with daily smoking volume, and the level of NAAG/Cr was potentially correlated with the FTND score. In this study, we observed that the level of medial prefrontal NAAG in smokers was associated with daily smoking volume. This suggests that the metabolism of NAAG in the brain is related to nicotine, and the balance of glutaminergic system in the brain of smokers may be disrupted.

To explore the correlation between the number of lenticulostriate arteries (LSAs) and the white matter features in cerebral small vessel diseases (CSVD) by 3T magnetic resonance imaging (MRI). Seventy-one patients with diagnoses of CSVD were prospectively enrolled to undergo 3T MRI examination, including high-resolution vascular wall imaging (VWI) and diffusion tensor imaging (DTI). The LSAs were observed and counted on VWI, and the patients were divided into three groups according to the LSA counts. The presence of white matter hyperintensities (WMHs), lacunes, cerebral microbleeds (CMBs), and enlarged perivascular spaces (EPVS) was assessed in each patient, and a composite CSVD score was calculated. Periventricular and deep white matter hyperintensity (PVWMH, DWMH) volume ratios were obtained based on automatic segmentation. Fractional anisotropy (FA) and mean diffusivity (MD) were processed by using tract-based spatial statistics (TBSS) analysis. These parameters were compared among the three groups. Correlations between the LSA counts and white matter features were also analyzed. There were differences in WMHs ( P = 0.001), CMBs ( P < 0.001), EPVS ( P = 0.017), composite CSVD scores ( P < 0.001), PVWMH volume ratios ( P = 0.001), DWMH volume ratios ( P < 0.001), global FA ( P = 0.001), and global MD ( P = 0.002) among the three groups. There were correlations between the LSA counts and WMHs ( r = −0.45, P < 0.001), CMBs ( r = −0.44, P < 0.001), EPVS ( r = −0.28, P = 0.020), the composite CSVD score ( r = −0.52, P < 0.001), DWMH volume ratio ( r = −0.47, P < 0.001), PWMH volume ratio ( r = −0.34, P = 0.004), global FA ( r = 0.36, P = 0.002), and global MD ( r = −0.33, P = 0.005). Diabetes mellitus (OR 3.36, 95% CI 1.06–10.63; P = 0.039) and increased DWMH volume ratios (OR 1.04, 95% CI 1.00–1.08; P = 0.048) were independent risk factors for a decrease in LSA counts. TBSS analysis showed differences among the three groups in global FA and MD after adjusting for age and sex ( P < 0.05). The LSA counts was associated with white matter microstructure changes in CSVD and has the potential to represent the extent of subcortical microvascular damage in CSVD patients.