Background and Objectives: The objective of this research is to make a comparative evaluation of the correlation between the volumetric examination of subcortical cerebral regions and white matter hyperintensities classified according to the Fazekas scoring system. Materials and Methods: A total of 236 cases with cranial MRI studies were retrospectively analyzed. This study included patients aged over 45 years who had white matter hyperintensities and who did not have a prior stroke diagnosis. White matter hyperintensities were evaluated in axial FLAIR images according to Fazekas’s grading scale. Patients with Fazekas 0 and 1 were grouped in group 1 and the patients with Fazekas 2 and 3 were grouped in group 2. MRI data processing and subcortical volumetric analyses were performed using the volBrain MRI brain volumetry system. Results: There were statistically significant differences between groups 1 and 2 in terms of cerebrospinal fluid total brain white and gray matter (p < 0.001), total brain white and gray matter (p = 0.009), total cerebrum (p < 0.001), accumbens (p < 0.001), thalamus (p < 0.001), frontal lobe (p < 0.001), parietal lobe (p < 0.001), and lateral ventricle (p < 0.001) volumes. Conclusions: Our study finds a strong link between white matter hyperintensity burden and brain atrophy. This includes volume reductions in total brain white and gray matter, frontal and parietal lobe atrophy, increased cerebrospinal fluid (CSF), and atrophy in specific brain regions such as the accumbens and thalamus.

Background/Objectives: This study aimed to evaluate the ability of ChatGPT-5, a multimodal large language model, to perform automated ASPECTS assessment on non-contrast CT (NCCT) in patients with acute ischemic stroke. Methods: This retrospective, single-center study included 199 patients with anterior circulation AIS who underwent baseline NCCT before reperfusion therapy between November 2020 and February 2025. Each NCCT was evaluated by two human readers and by ChatGPT-5 using four representative images (two ganglionic and two supraganglionic). Interobserver agreement was measured with the intraclass correlation coefficient (ICC), and prognostic performance was analyzed using multivariable logistic regression and receiver operating characteristic (ROC) analysis for 3-month functional independence (mRS ≤ 2). Results: ChatGPT-5 demonstrated good-to-excellent agreement with expert consensus (ICC = 0.845; 95% CI, 0.792–0.884; κ = 0.79). ChatGPT-ASPECTS were independently associated with 3-month functional independence (OR = 1.28 per point; p = 0.004), comparable to consensus-ASPECTS (OR = 1.31; p = 0.003). Prognostic discrimination was similar between ChatGPT-5 and consensus scoring (AUC = 0.78 vs. 0.80; p = 0.41). Conclusions: ChatGPT-5 achieved high reliability and strong prognostic validity in automated ASPECTS assessment without task-specific training. These findings highlight the emerging potential of large language models for quantitative image interpretation, though clinical implementation will require multicenter validation and regulatory approval.

Aim: This study aims to evaluate the significance of puborectalis muscle and anal sphincter thickness in the context of anismus. Methods: We divided participants into three groups: patients with anismus (n=24), patients with pelvic floor dysfunction (PFD) (n=22), and a control group (n=24). On T2-weighted axial images, the thickness and circumference of both puborectalis muscles were measured at the level of the pubic symphysis, and the mean of these measurements was calculated. Additionally, the thicknesses of the external and internal anal sphincters were measured on T2-weighted axial magnetic resonance images at the level of the mid-anal canal, and the mean of these measurements was also calculated. Comparisons between groups were analyzed using ANOVA with post-hoc Tukey-HSD tests. ROC curve analysis was used to assess the diagnostic performance of key measurements, and interobserver agreement was evaluated using intraclass correlation coefficients (ICC). Results: A total of 70 participants were included in the study, consisting of 24 patients with anismus (41.6% male), 22 patients with PFD (31.8% male), and 24 controls (45.8% male). Puborectalis muscle thicknesses were significantly higher in the anismus group compared to the PFD group, while the mean puborectalis thickness was significantly greater than that of the PFD group but not significantly different from controls. Additionally, the circumference of the puborectalis muscle was lower in the anismus group compared to the PFD group. ROC curve analysis indicated that puborectalis muscle thickness may potentially serve as a predictive marker for anismus, with an area under the curve of 0.667 (p=0.022). Good to excellent interobserver agreement was noted for the various measurements, with ICC values ranging from 0.762 to 0.970. Conclusion: Our study suggests that puborectalis muscle and external anal sphincter measurements may aid in diagnosing anismus.

Aim: This study aims to evaluate the significance of puborectalis muscle and anal sphincter thickness in the context of anismus. Methods: We divided participants into three groups: patients with anismus (n=24), patients with pelvic floor dysfunction (PFD) (n=22), and a control group (n=24). On T2-weighted axial images, the thickness and circumference of both puborectalis muscles were measured at the level of the pubic symphysis, and the mean of these measurements was calculated. Additionally, the thicknesses of the external and internal anal sphincters were measured on T2-weighted axial magnetic resonance images at the level of the mid-anal canal, and the mean of these measurements was also calculated. Comparisons between groups were analyzed using ANOVA with post-hoc Tukey-HSD tests. ROC curve analysis was used to assess the diagnostic performance of key measurements, and interobserver agreement was evaluated using intraclass correlation coefficients (ICC). Results: A total of 70 participants were included in the study, consisting of 24 patients with anismus (41.6% male), 22 patients with PFD (31.8% male), and 24 controls (45.8% male). Puborectalis muscle thicknesses were significantly higher in the anismus group compared to the PFD group, while the mean puborectalis thickness was significantly greater than that of the PFD group but not significantly different from controls. Additionally, the circumference of the puborectalis muscle was lower in the anismus group compared to the PFD group. ROC curve analysis indicated that puborectalis muscle thickness may potentially serve as a predictive marker for anismus, with an area under the curve of 0.667 (p=0.022). Good to excellent interobserver agreement was noted for the various measurements, with ICC values ranging from 0.762 to 0.970. Conclusion: Our study suggests that puborectalis muscle and external anal sphincter measurements may aid in diagnosing anismus.