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<meta name="DC.Title" content="MRI Detection of Carotid Intraplaque Hemorrhage and Postintervention Cognition" />
<meta name="DC.Identifier" content="10.3174/ajnr.A7701" />
<meta name="DC.Date" content="2022-12-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Cognitive improvement has been reported after carotid revascularization and attributed to treating stenosis and correcting hypoperfusion. This study investigated the effect of carotid intraplaque hemorrhage on postintervention cognition.

MATERIALS AND METHODS: In this institutional review board–approved single-center study, consecutive patients scheduled for carotid surgery were recruited for preoperative carotid MR imaging (MPRAGE) and pre- and postintervention cognitive testing using the Repeatable Battery for the Assessment of Neuropsychological Status. Pre- and postintervention scores were compared using t tests and multivariable linear regression.

RESULTS: Twenty-three participants were included, with endarterectomy performed in 20 (87%) and angioplasty/stent placement, in 3 (13%). Overall, statistically significant improvements occurred in the pre- versus postintervention mean Total Scale score (92.1 [SD, 15.5] versus 96.1 [SD, 15.8], P = .04), immediate memory index (89.4 [SD, 18.2] versus 97.7 [SD, 14.9], P  &lt; .001), and verbal index (96.1 [SD, 14.1] versus 103.0 [SD, 12.0], P = .002). Intraplaque hemorrhage (+) participants ( n = 11) had no significant improvement in any category, and the attention index significantly decreased (99.4 [SD, 18.0] versus 93.5 [SD, 19.4], P = .045). Intraplaque hemorrhage (−) participants ( n = 12) significantly improved in the Total Scale score (86.4 [SD, 11.8] versus 95.5 [SD, 12.4], P = .004), immediate memory index (82.3 [SD, 14.6] versus 96.2 [SD, 14.1], P = .002), delayed memory index (94.3 [SD, 14.9] versus 102.4 [SD, 8.0], P = .03), and verbal index (94.3 [SD, 13.2] versus 101.5 [SD, 107.4], P = .009). Postintervention minus preintervention scores for intraplaque hemorrhage (+) versus (−) groups showed statistically significant differences in the Total Scale score (−0.4 [SD, 6.8] versus 8.0 [SD, 8.5], P = .02), attention index (−5.9 [SD, 8.5] versus 4.3 [SD, 11.9], P = .03), and immediate memory index (4.2 [SD, 6.7] versus 12.2 [SD, 10.2], P = .04).

CONCLUSIONS: Cognitive improvement was observed after carotid intervention, and this was attributable to intraplaque hemorrhage (−) plaque. MR imaging detection of intraplaque hemorrhage status may be an important determinant of cognitive change after intervention.

ACA
:   anterior cerebral artery
BMI
:   body mass index
IPH
:   intraplaque hemorrhage
PCA
:   posterior cerebral artery
RBANS
:   Repeatable Battery for the Assessment of Neuropsychological Status" />
<meta name="DC.Contributor" content="S. Culleton" />
<meta name="DC.Contributor" content="H. Baradaran" />
<meta name="DC.Contributor" content="S.-E. Kim" />
<meta name="DC.Contributor" content="G. Stoddard" />
<meta name="DC.Contributor" content="J. Roberts" />
<meta name="DC.Contributor" content="G. Treiman" />
<meta name="DC.Contributor" content="D. Parker" />
<meta name="DC.Contributor" content="K. Duff" />
<meta name="DC.Contributor" content="J.S. McNally" />
<meta name="article:published_time" content="2022-12-01" />
<meta name="article:section" content="Extracranial Vascular" />
<meta name="citation_title" content="MRI Detection of Carotid Intraplaque Hemorrhage and Postintervention Cognition" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Cognitive improvement has been reported after carotid revascularization and attributed to treating stenosis and correcting hypoperfusion. This study investigated the effect of carotid intraplaque hemorrhage on postintervention cognition.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;In this institutional review board–approved single-center study, consecutive patients scheduled for carotid surgery were recruited for preoperative carotid MR imaging (MPRAGE) and pre- and postintervention cognitive testing using the Repeatable Battery for the Assessment of Neuropsychological Status. Pre- and postintervention scores were compared using &lt;i&gt;t&lt;/i&gt; tests and multivariable linear regression.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Twenty-three participants were included, with endarterectomy performed in 20 (87%) and angioplasty/stent placement, in 3 (13%). Overall, statistically significant improvements occurred in the pre- versus postintervention mean Total Scale score (92.1 [SD, 15.5] versus 96.1 [SD, 15.8], &lt;i&gt;P&lt;/i&gt; = .04), immediate memory index (89.4 [SD, 18.2] versus 97.7 [SD, 14.9], &lt;i&gt;P &lt;/i&gt;&amp;lt; .001), and verbal index (96.1 [SD, 14.1] versus 103.0 [SD, 12.0], &lt;i&gt;P&lt;/i&gt; = .002). Intraplaque hemorrhage (+) participants (&lt;i&gt;n&lt;/i&gt; = 11) had no significant improvement in any category, and the attention index significantly decreased (99.4 [SD, 18.0] versus 93.5 [SD, 19.4], &lt;i&gt;P&lt;/i&gt; = .045). Intraplaque hemorrhage (−) participants (&lt;i&gt;n&lt;/i&gt; = 12) significantly improved in the Total Scale score (86.4 [SD, 11.8] versus 95.5 [SD, 12.4], &lt;i&gt;P&lt;/i&gt; = .004), immediate memory index (82.3 [SD, 14.6] versus 96.2 [SD, 14.1], &lt;i&gt;P&lt;/i&gt; = .002), delayed memory index (94.3 [SD, 14.9] versus 102.4 [SD, 8.0], &lt;i&gt;P&lt;/i&gt; = .03), and verbal index (94.3 [SD, 13.2] versus 101.5 [SD, 107.4], &lt;i&gt;P&lt;/i&gt; = .009). Postintervention minus preintervention scores for intraplaque hemorrhage (+) versus (−) groups showed statistically significant differences in the Total Scale score (−0.4 [SD, 6.8] versus 8.0 [SD, 8.5], &lt;i&gt;P&lt;/i&gt; = .02), attention index (−5.9 [SD, 8.5] versus 4.3 [SD, 11.9], &lt;i&gt;P&lt;/i&gt; = .03), and immediate memory index (4.2 [SD, 6.7] versus 12.2 [SD, 10.2], &lt;i&gt;P&lt;/i&gt; = .04).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Cognitive improvement was observed after carotid intervention, and this was attributable to intraplaque hemorrhage (−) plaque. MR imaging detection of intraplaque hemorrhage status may be an important determinant of cognitive change after intervention.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
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<meta name="citation_publication_date" content="2022/12/01" />
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<meta name="citation_section" content="Extracranial Vascular" />
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<meta name="citation_author" content="S. Culleton" />
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<meta name="citation_author" content="H. Baradaran" />
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<meta name="citation_author" content="S.-E. Kim" />
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<meta name="citation_author_orcid" content="https://orcid.org/0000-0002-7232-3621" />
<meta name="citation_author" content="G. Stoddard" />
<meta name="citation_author_institution" content="bUtah Center for Advanced Imaging Research, Division of Epidemiology (G.S.)" />
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<meta name="citation_author" content="G. Treiman" />
<meta name="citation_author_institution" content="cDepartment of Internal Medicine, Department of Surgery (G.T.)" />
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<meta name="citation_author" content="D. Parker" />
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<meta name="citation_author" content="K. Duff" />
<meta name="citation_author_institution" content="dCenter for Alzheimer’s Care, Imaging and Research (K.D.), University of Utah, Salt Lake City, Utah" />
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<meta name="citation_author" content="J.S. McNally" />
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<meta name="twitter:title" content="MRI Detection of Carotid Intraplaque Hemorrhage and Postintervention Cognition" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Cognitive improvement has been reported after carotid revascularization and attributed to treating stenosis and correcting hypoperfusion. This study investigated the effect of carotid intraplaque hemorrhage on postintervention cognition.

MATERIALS AND METHODS: In this institutional review board–approved single-center study, consecutive patients scheduled for carotid surgery were recruited for preoperative carotid MR imaging (MPRAGE) and pre- and postintervention cognitive testing using the Repeatable Battery for the Assessment of Neuropsychological Status. Pre- and postintervention scores were compared using t tests and multivariable linear regression.

RESULTS: Twenty-three participants were included, with endarterectomy performed in 20 (87%) and angioplasty/stent placement, in 3 (13%). Overall, statistically significant improvements occurred in the pre- versus postintervention mean Total Scale score (92.1 [SD, 15.5] versus 96.1 [SD, 15.8], P = .04), immediate memory index (89.4 [SD, 18.2] versus 97.7 [SD, 14.9], P  &lt; .001), and verbal index (96.1 [SD, 14.1] versus 103.0 [SD, 12.0], P = .002). Intraplaque hemorrhage (+) participants ( n = 11) had no significant improvement in any category, and the attention index significantly decreased (99.4 [SD, 18.0] versus 93.5 [SD, 19.4], P = .045). Intraplaque hemorrhage (−) participants ( n = 12) significantly improved in the Total Scale score (86.4 [SD, 11.8] versus 95.5 [SD, 12.4], P = .004), immediate memory index (82.3 [SD, 14.6] versus 96.2 [SD, 14.1], P = .002), delayed memory index (94.3 [SD, 14.9] versus 102.4 [SD, 8.0], P = .03), and verbal index (94.3 [SD, 13.2] versus 101.5 [SD, 107.4], P = .009). Postintervention minus preintervention scores for intraplaque hemorrhage (+) versus (−) groups showed statistically significant differences in the Total Scale score (−0.4 [SD, 6.8] versus 8.0 [SD, 8.5], P = .02), attention index (−5.9 [SD, 8.5] versus 4.3 [SD, 11.9], P = .03), and immediate memory index (4.2 [SD, 6.7] versus 12.2 [SD, 10.2], P = .04).

CONCLUSIONS: Cognitive improvement was observed after carotid intervention, and this was attributable to intraplaque hemorrhage (−) plaque. MR imaging detection of intraplaque hemorrhage status may be an important determinant of cognitive change after intervention.

ACA
:   anterior cerebral artery
BMI
:   body mass index
IPH
:   intraplaque hemorrhage
PCA
:   posterior cerebral artery
RBANS
:   Repeatable Battery for the Assessment of Neuropsychological Status" />
<meta name="og-title" property="og:title" content="MRI Detection of Carotid Intraplaque Hemorrhage and Postintervention Cognition" />
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<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Cognitive improvement has been reported after carotid revascularization and attributed to treating stenosis and correcting hypoperfusion. This study investigated the effect of carotid intraplaque hemorrhage on postintervention cognition.

MATERIALS AND METHODS: In this institutional review board–approved single-center study, consecutive patients scheduled for carotid surgery were recruited for preoperative carotid MR imaging (MPRAGE) and pre- and postintervention cognitive testing using the Repeatable Battery for the Assessment of Neuropsychological Status. Pre- and postintervention scores were compared using t tests and multivariable linear regression.

RESULTS: Twenty-three participants were included, with endarterectomy performed in 20 (87%) and angioplasty/stent placement, in 3 (13%). Overall, statistically significant improvements occurred in the pre- versus postintervention mean Total Scale score (92.1 [SD, 15.5] versus 96.1 [SD, 15.8], P = .04), immediate memory index (89.4 [SD, 18.2] versus 97.7 [SD, 14.9], P  &lt; .001), and verbal index (96.1 [SD, 14.1] versus 103.0 [SD, 12.0], P = .002). Intraplaque hemorrhage (+) participants ( n = 11) had no significant improvement in any category, and the attention index significantly decreased (99.4 [SD, 18.0] versus 93.5 [SD, 19.4], P = .045). Intraplaque hemorrhage (−) participants ( n = 12) significantly improved in the Total Scale score (86.4 [SD, 11.8] versus 95.5 [SD, 12.4], P = .004), immediate memory index (82.3 [SD, 14.6] versus 96.2 [SD, 14.1], P = .002), delayed memory index (94.3 [SD, 14.9] versus 102.4 [SD, 8.0], P = .03), and verbal index (94.3 [SD, 13.2] versus 101.5 [SD, 107.4], P = .009). Postintervention minus preintervention scores for intraplaque hemorrhage (+) versus (−) groups showed statistically significant differences in the Total Scale score (−0.4 [SD, 6.8] versus 8.0 [SD, 8.5], P = .02), attention index (−5.9 [SD, 8.5] versus 4.3 [SD, 11.9], P = .03), and immediate memory index (4.2 [SD, 6.7] versus 12.2 [SD, 10.2], P = .04).

CONCLUSIONS: Cognitive improvement was observed after carotid intervention, and this was attributable to intraplaque hemorrhage (−) plaque. MR imaging detection of intraplaque hemorrhage status may be an important determinant of cognitive change after intervention.

ACA
:   anterior cerebral artery
BMI
:   body mass index
IPH
:   intraplaque hemorrhage
PCA
:   posterior cerebral artery
RBANS
:   Repeatable Battery for the Assessment of Neuropsychological Status" />
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">December 2022,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">43 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1762-1769; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A7701 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-100169--61806459394" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S. Culleton </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (S.C., H.B., S.-E.K., J.R., D.P., J.S.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BCulleton%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Culleton%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.%2BCulleton%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-8394-045X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S. Culleton</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">H. Baradaran </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (S.C., H.B., S.-E.K., J.R., D.P., J.S.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.%2BBaradaran%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Baradaran%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.%2BBaradaran%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6251-5769" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H. Baradaran</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">S.-E. Kim </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (S.C., H.B., S.-E.K., J.R., D.P., J.S.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.-E.%2BKim%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Kim%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.-E.%2BKim%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7232-3621" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.-E. Kim</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">G. Stoddard </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Utah Center for Advanced Imaging Research, Division of Epidemiology (G.S.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.%2BStoddard%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Stoddard%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.%2BStoddard%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6292-276X" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G. Stoddard</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">J. Roberts </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (S.C., H.B., S.-E.K., J.R., D.P., J.S.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BRoberts%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Roberts%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.%2BRoberts%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1786-0969" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J. Roberts</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">G. Treiman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Internal Medicine, Department of Surgery (G.T.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=G.%2BTreiman%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Treiman%20G&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AG.%2BTreiman%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1376-2536" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for G. Treiman</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">D. Parker </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Radiology (S.C., H.B., S.-E.K., J.R., D.P., J.S.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BParker%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Parker%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AD.%2BParker%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2557-8952" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for D. 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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Culleton</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">H.</span> <span class="nlm-surname">Baradaran</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">S.-E.</span> <span class="nlm-surname">Kim</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Stoddard</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">J.</span> <span class="nlm-surname">Roberts</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Treiman</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Parker</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Duff</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">J.S.</span> <span class="nlm-surname">McNally</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Dec 2022, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">43 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(12) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1762-1769; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A7701 </span></div>
  
  
  
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