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Background and purposeIntracranial vessel wall MR imaging is an emerging technique for intracranial vasculopathy assessment. Our aim was to investigate intracranial vessel wall MR imaging use by the American Society of Neuroradiology (ASNR) members at their home institutions, including indications and barriers to implementation.Materials and methodsThe ASNR Vessel Wall Imaging Study Group survey on vessel wall MR imaging use, frequency, applications, MR imaging systems and field strength used, protocol development approaches, vendor engagement, reasons for not using vessel wall MR imaging, ordering-provider interest, and impact on clinical care, was distributed to the ASNR membership between April 2 and August 30, 2019.ResultsThere were 532 responses; 79 were excluded due to nonresponse and 42 due to redundant institutional responses, leaving 411 responses. Fifty-two percent indicated that their institution performs vessel wall MR imaging, with 71.5% performed at least 1-2 times/month, most frequently on 3T MR imaging, and 87.7% using 3D sequences. Protocols most commonly included were T1-weighted pre- and postcontrast and TOF-MRA; 60.6% had limited contributions from vendors or were still in protocol development. Vasculopathy differentiation (94.4%), cryptogenic stroke (41.3%), aneurysm (38.0%), and atherosclerosis (37.6%) evaluation were the most common indications. For those not performing vessel wall MR imaging, interpretation (53.1%) or technical (46.4%) expertise, knowledge of applications (50.5%), or limitations of clinician (56.7%) or radiologist (49.0%) interest were the most common reasons. If technical/expertise obstacles were overcome, 56.4% of those not performing vessel wall MR imaging indicated that they would perform it. Ordering providers most frequently inquiring about vessel wall MR imaging were from stroke neurology (56.5%) and neurosurgery (25.1%), while 34.3% indicated that no providers had inquired.ConclusionsMore than 50% of neuroradiology groups use vessel wall MR imaging for intracranial vasculopathy characterization and differentiation, emphasizing the need for additional technical and educational support, especially as clinical vessel wall MR imaging implementation continues to grow.

BACKGROUND AND PURPOSE: 3D intracranial vessel wall MRI techniques are time consuming and prone to artifacts, especially flow artifacts. Our aim was to compare the image quality of accelerated and flow-suppressed 3D intracranial vessel wall MR imaging techniques relative to conventional acquisitions. MATERIALS AND METHODS: Consecutive patients undergoing MR imaging had conventional postcontrast 3D T1-sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE) and either postcontrast delay alternating with nutation for tailored excitation (DANTE) flow-suppressed or DANTE–controlled aliasing in parallel imaging results in higher acceleration (CAIPI) flow-suppressed and accelerated T1-SPACE sequences performed. The sequences were evaluated using 4- or 5-point Likert scales for overall image quality, SNR, extent/severity of artifacts, motion, blood suppression, sharpness, and lesion assessment. Quantitative assessment of lumen and wall-to-lumen contrast ratios was performed. RESULTS: Eighty-nine patients were included. T1-DANTE-SPACE had significantly better qualitative ratings relative to T1-SPACE for image quality, SNR, artifact impact, arterial and venous suppression, and lesion assessment (P < .001 for each, respectively), with the exception of motion (P = .16). T1-DANTE-CAIPI-SPACE had significantly better image quality, lesion assessment, arterial and venous blood suppression, less artifact impact, and less motion compared with T1-SPACE (P < .001 for each, respectively). The SNR was higher with T1-SPACE compared with T1-DANTE-CAIPI-SPACE (P < .001). T1-DANTE-CAIPI-SPACE showed significantly worse lumen (P = .005) and wall-to-lumen contrast ratios (P = .001) compared with T1-SPACE, without a significant difference between T1-SPACE and T1-DANTE-SPACE. T1-DANTE-CAIPI-SPACE scan time was 5:11 minutes compared with 8:08 and 8:41 minutes for conventional T1-SPACE and T1-DANTE-SPACE, respectively. CONCLUSIONS: Accelerated postcontrast T1-DANTE-CAIPI-SPACE had fewer image artifacts, less motion, improved blood suppression, and a shorter scan time, but lower qualitative and quantitative SNR ratings relative to conventional T1-SPACE intracranial vessel wall MR imaging. Postcontrast T1-DANTE-SPACE had superior SNR, blood suppression, higher image quality, and fewer image artifacts, but slightly longer scan times relative to T1-SPACE.

Genetic analysis of high-grade glial tumors in children has revealed the presence of the ETV6-NTRK3 gene fusion in a small number of highly aggressive‐appearing neoplasms. Identification of this gene fusion is important in that these patients may benefit from new, targeted therapies. Clinical presentation, imaging, and pathologic confirmation were obtained from 5 patients with confirmed ETV6-NTRK3 gene fusion. This case series may raise awareness of this entity and prompt genetic evaluation.

BACKGROUND AND PURPOSE: Contrast curve truncation in CTP protocols may introduce errors. We sought to identify risk factors and design a protocol to avoid truncation while limiting radiation. MATERIALS AND METHODS: In an initial fixed-timing cohort, patients underwent a 65-second CTP with 2-second delay postcontrast injection. Multivariable analysis identified factors associated with truncation. A later case-specific cohort underwent either the original protocol or a low cardiac output protocol with a 7-second delay and 75-second scanning window, with selection determined by CTA test-dose enhancement upswing delay. Time-density curves were assessed for truncation and compared between the 2 groups, and the radiation dose was evaluated. RESULTS: From September 2017 through May 2018, one hundred fifty-three patients underwent the standard fixed-timing protocol. Age (OR, 1.82/10-year increase; P = .019), reduced left ventricle ejection fraction (OR, 9.23; P = .001), and hypertension (OR, 0.32; P = .06) were independently associated with truncation in an exploratory multivariable model. From May 2018 through April 2019, one hundred fifty-seven patients underwent either the standard (72 patients) or low cardiac output protocol (85 patients). The fixed-timing cohort had 15 truncations (9.8%) versus 4 in the case-specific cohort (2.5%; P = .009). If the low cardiac output protocol were applied to those with >10.6% predicted risk of truncation based on age, left ventricle ejection fraction, and hypertension, the number of truncations would have decreased from 15 to 4 in the fixed-timing cohort. CONCLUSIONS: Older age, left ventricle ejection fraction, and the absence of hypertension increase the risk of time-density curve truncation. However, a CTA test-dose-directed case-specific protocol can reduce truncation to ensure accurate data while mitigating radiation dose increases.

This paper investigates fractional-order partial differential equations analytically by applying a modified technique called the Laplace residual power series method. The analytical solution was utilized to test the accuracy and precision of the proposed methodologies and shown by tables and graphs. The solution is a convergent series established on Taylor's new form. When determining the series coefficients like RPSM, the fractional derivatives must be calculated every time. We only need to perform a few computations to obtain the coefficients because LRPSM only requires the concept of an infinite limit. The advantage of this method is that it does not require Adomian polynomials or he's polynomials to solve nonlinear problems. As a result, the method's reduced computation size is a strength. The outcome we got supports the idea that the suggested method is the best one for handling any non-linear models that appear in technology and science.

With effective techniques like the homotopy perturbation approach and the Adomian decomposition method via the Yang transform, the time-fractional vibration equation's solution is found for large membranes. In Caputo's sense, the fractional derivative is taken. Numerical experiments with various initial conditions are carried out through a few test examples. The findings are described using various wave velocity values. The outcomes demonstrate the competence and reliability of this analytical framework. Figures are used to discuss the solution of the fractional vibration equation using the suggested strategies for different orders of memory-dependent derivative. The suggested approaches reduce computation size and time even when the accurate solution of a nonlinear differential equation is unknown. It is helpful for both small and large parameters. The results show that the suggested techniques are trustworthy, accurate, appealing and effective strategies.

The two approaches to solving nonlinear Caputo time-fractional wave-like equations with variable coefficients are examined in this study. The Homotopy perturbation transform method and the Yang transform decomposition method are the names of these two techniques. Three separate numerical examples are provided to demonstrate the effectiveness and precision of the suggested methods. The results were acquired to demonstrate the effectiveness and power of the two approaches, providing estimates with better precision and closed form solutions. The solutions to these kinds of equations can be found using the suggested methods as infinite series, and when these series are in closed form, they provide the exact solution. The suggested techniques have been demonstrated to be effective and efficient in their application. Three numerical examples are used to examine the methods accuracy and effectiveness.

The approximate solution of the Kersten-Krasil'shchik coupled Korteweg-de Vries-modified Korteweg-de Vries system is obtained in this study by employing a natural decomposition method in association with the newly established Atangana-Baleanu derivative and Caputo-Fabrizio derivative of fractional order. The Korteweg-de Vries equation is considered a classical super-extension in this system. This nonlinear model scheme is commonly used to describe waves in traffic flow, electromagnetism, electrodynamics, elastic media, multi-component plasmas, shallow water waves and other phenomena. The acquired results are compared to exact solutions to demonstrate the suggested method's effectiveness and reliability. Graphs and tables are used to display the numerical results. The results show that the natural decomposition technique is a very user-friendly and reliable method for dealing with fractional order nonlinear problems.

In this article, we solved pantograph delay differential equations by utilizing an efficient numerical technique known as Chebyshev pseudospectral method. In Caputo manner fractional derivatives are taken. These types of problems are reduced to linear or nonlinear algebraic equations using the suggested approach. The proposed method's convergence is being studied with particular care. The suggested technique is effective, simple, and easy to implement as compared to other numerical approaches. To prove the validity and accuracy of the presented approach, we take two examples. The solutions we obtained show greater accuracy as compared to other methods. Furthermore, the current approach can be implemented for solving other linear and nonlinear fractional delay differential equations, owing to its innovation and scientific significance.

Background Inflammatory Bowel Disease (IBD) and endometriosis are chronic inflammatory diseases occurring in young women, sharing some clinical manifestations. We aimed to investigate, in a multidisciplinary approach, symptoms, type and site of pelvic endometriosis in IBD patients versus non-IBD Controls with endometriosis. Methods In a prospective nested, case-control study, all female premenopausal IBD patients showing symptoms compatible with endometriosis were enrolled. Patients were referred to dedicated gynecologists for assessing pelvic endometriosis by transvaginal sonography (TVS). Each IBD patient with endometriosis (Cases) was retrospectively matched for age (±5 years) and body mass index (±1) with 4 patients with endometriosis at TVS, but no-IBD (Controls). Data were expressed as median [range], the Mann-Whitney or Student-t and χ2 tests were used for comparisons. Results Endometriosis was diagnosed in 25 (71%) out of 35 IBD patients with compatible symptoms including 12 (52.6%) Crohn’s Disease and 13 (47.4%) Ulcerative Colitis patients. Dyspareunia and dyschezia were significantly more frequent in Cases vs Controls (25 [73.7%] vs 26 [45.6%]; p=0.03). At TVS, deep infiltrating endometriosis (DIE) and posterior adenomyosis were significantly more frequent in Cases vs Controls (25 [100%] vs 80 [80%]; p=0.03 and (19 [76%] vs 48 [48%]; p=0.02). Conclusion Endometriosis was detected in two/thirds of IBD patients with compatible symptoms. The frequency of DIE and posterior adenomyosis was higher in IBD than in Controls. A diagnosis of endometriosis, often mimicking IBD activity, should be considered in subgroups of female patients with IBD.

Extracranial vessel wall MRI (EC-VWI) contributes to vasculopathy characterization. This survey study investigated EC-VWI adoption by American Society of Neuroradiology (ASNR) members and indications and barriers to implementation.The ASNR Vessel Wall Imaging Study Group survey on EC-VWI use, frequency, applications, MR imaging systems and field strength used, protocol development approaches, vendor engagement, reasons for not using EC-VWI, ordering provider interest, and impact on clinical care was distributed to the ASNR membership between April 2, 2019, to August 30, 2019.There were 532 responses; 79 were excluded due to minimal, incomplete response and 42 due to redundant institutional responses, leaving 411 responses. Twenty-six percent indicated that their institution performed EC-VWI, with 66.3% performing it ≤1-2 times per month, most frequently on 3T MR imaging, with most using combined 3D and 2D protocols. Protocols most commonly included pre- and postcontrast T1-weighted imaging, TOF-MRA, and contrast-enhanced MRA. Inflammatory vasculopathy (63.3%), plaque vulnerability assessments (61.1%), intraplaque hemorrhage (61.1%), and dissection-detection/characterization (51.1%) were the most frequent applications. For those not performing EC-VWI, the reasons were a lack of ordering provider interest (63.9%), lack of radiologist time/interest (47.5%) or technical support (41.4%) for protocol development, and limited interpretation experience (44.9%) and knowledge of clinical applications (43.7%). Reasons given by 46.9% were that no providers approached radiology with interest in EC-VWI. If barriers were overcome, 51.1% of those not performing EC-VWI indicated they would perform it, and 40.6% were unsure; 48.6% did not think that EC-VWI had impacted patient management at their institution.Only 26% of neuroradiology groups performed EC-VWI, most commonly due to limited clinician interest. Improved provider and radiologist education, protocols, processing techniques, technical support, and validation trials could increase adoption.

In a prospective study, SARS-CoV-2 IgG seroprevalence was assessed during the second pandemic wave (W2) in a cohort of Inflammatory Bowel Disease (IBD) patients using biologics. The secondary aim was to compare, in the same cohort, the frequency of seropositivity and of COVID-19 during the second vs. the first (W1) wave.From November 2020 to March 2021, SARS-CoV-2 IgG seropositivity and the prevalence of COVID-19 were assessed in a cohort of IBD patients using biologics already studied at W1.age ≥ 18 years; diagnosis of IBD; follow-up; written consent.SARS-CoV-2 vaccination. Risk factors for infection, compatible symptoms, history of infection or COVID-19, nasopharyngeal swab test were recorded. Data were expressed as median [range]. The χ2 test, Student's t-test, logistic regression analysis was used.IBD cohort at W1 and W2 included 85 patients: 45 CD (52.9%), 40 UC (47.1%). When comparing the same 85 patients at W2 vs. W1, a higher SARS-CoV-2 seroprevalence at W2 was at the limit of the statistical significance (9.4% vs. 2.3%; p=0.05). The prevalence of COVID-19 at W2 vs. W1 was 3.5% (3/85) vs. 0% (0/85) (p=0.08). Contacts with COVID-19 patients and symptoms compatible with COVID-19 were more frequent at W2 vs. W1 (18.8 % vs. 0%; p=0.0001; 34.1% vs. 15.3%; p=0.004). At W2, history of contacts and new onset diarrhea were more frequent in seropositive patients [4/8 (50%) vs. 12/77 (15.6%); p=0.01 and 4/8 (50%) vs. 2/77 (2.6%); p=0.0001]. At W2, the risk factors for seropositivity included cough, fever, new onset diarrhea, rhinitis, arthromyalgia, dysgeusia/anosmia at univariate (p0.05), but not at multivariate analysis. History of contacts was the only risk factor for seropositivity at univariate (p=0.03), but not at multivariate analysis (p=0.1).During W2, characterized by a high viral spread, IBD and biologics appeared not to increase the prevalence of SARS-CoV-2 infection or COVID-19 disease. New onset diarrhea mimicking IBD relapse may be observed in patients with SARS-CoV-2 infection.

Background Colorectal cancer (CRC) risk is increased in patients (pts) with long-standing colitis related to Inflammatory Bowel Disease (IBD). A higher frequency mucinous and signet-ring colonic adenocarcinoma has been suggested in IBD, but data regarding risk factors for these aggressive CRC are currently lacking. Primary aim was to assess the frequency of mucinous and signet-ring adenocarcinoma in IBD pts with CRC. Secondary aim was to assess risk factors for these histotypes of CRC. Methods From January 2002 to July 2022, all IBD pts with concomitant CRC were retrospectively enrolled. Inclusion criteria: 1) age ≥18; 2) well-defined diagnosis of IBD and CRC; 3) available histological and surgical report. Exclusion criteria: Missing data. Characteristics of IBD were reported according to standard criteria. Data were expressed as median [range]. Student-t Test and χ2 test were used for comparisons. Univariate logistic regression model was applied for assessing risk factors for mucinous and signet-ring adenocarcinoma (OR [95%CI]). Results The study population included 40 IBD pts with concomitant CRC: 24 (60%) with Ulcerative Colitis (UC) and 16 (40%) with Crohn’s Disease (CD). CRC included standard adenocarcinoma in 23 (57.5%) and mucinous or signet-ring in 17 (42.5%) pts. CD was more frequently stricturing in pts with standard adenocarcinoma (7 [77.8%] vs 1 [14.4%], p=0.04). CRC most frequently involved the rectum in pts with mucinous or signet-ring adenocarcinoma vs standard adenocarcinoma (4 [17.4%] vs 8 [47.1%]; p=0.04). Other IBD characteristics did not differ between standard and mucinous or signet-ring adenocarcinoma, including: age at CRC diagnosis (61 [30-80] vs 53 [29.80]; p=0.61), gender (F): 8 [34.8%] vs 5 [29.4%]; p=0.98), IBD duration at CRC diagnosis (14 [1-45] vs 17 [1-36]; p=0.74), smoking status (p=0.78), IBD type (UC: 14 [60.9%] vs 9 [56.3%]; p=0.84), UC extent and CD localization, frequency of perianal disease (p=0.37), thiopurine (p=0.55) or biologic (p=0.55) use. The proportion of pts surgically treated for CRC (20 [86.9%] vs 17 [100%], p=0.34) and the frequency of CRC-related death (3 [13.1%] vs 5 [29.4%]; p=0.37) were also comparable between groups. At diagnosis, CRC stage was comparable between pts with standard vs mucinous or signet-ring adenocarcinoma (stage I: 6 [26.1%] vs 1 [5.9%]; p=0.21; II: 9 [39.1%] vs 4 [23.5%]; p=0.48; III: 5 [21.7%] vs 7 [41.2%]; p=0.34); IV: 3 [13.1%] vs 2 [11.8%]; p=0.71). At univariate analysis, no specific risk factors for mucinous and signet-ring colonic adenocarcinoma were detected. Conclusion In the tested cohort of IBD patients with CRC, mucinous and signet-ring adenocarcinomas were observed in almost half of cases, although no specific risk factors were identified.