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MTRasym and MRAPTR were obtained through the post-processing of APT data. The infarct volume, ADC, and ROI positions were also collected. McNemar\u2019s test was used to compare the pH sensitivity of two APT metrics. Spearman correlation analysis was used to compare the relationships between infarct volume, ADC, and ROI position with MTRasym and MRAPTR. One-way ANOVA was used to assess differences of both metrics across three ROI locations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      147 patients (mean age, 62.17 years \u00b1 0.92 [SD], 97 men) were evaluated. MRAPTR showed obviously better pH sensitivity than MTRasym for infarction (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). The pH sensitivity of MTRasym appeared compromised by larger infarct volume and elevated ADC values, even the ROIs position (\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.05). In contrast, MRAPTR effectively mitigated the impact of these confounding factors, resulting in higher pH sensitivity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MRAPTR demonstrated a higher sensitivity to tissue acidosis compared to MTRasym in APTw MRI. While MRAPTR effectively eliminates confounding influences from non-pH factors, but might still sensitive to the magnetic field inhomogeneities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00234-026-04142-1","type":"journal-article","created":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T07:06:50Z","timestamp":1786777610000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of acidosis in brain infarction with magnetization transfer ratio asymmetry (MTRasym) and magnetization transfer and relaxation-normalized amide proton transfer rate (MRAPTR) in amide proton transfer-weighted MRI and its influencing factors"],"prefix":"10.1007","author":[{"given":"Huan","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanoj Bahadur","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ting","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianhao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danni","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianzhong","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,15]]},"reference":[{"issue":"20_Supplement_2","key":"4142_CR1","doi-asserted-by":"publisher","first-page":"S6","DOI":"10.1212\/wnl.0000000000012781","volume":"97","author":"V Saini","year":"2021","unstructured":"Saini V, Guada L, Yavagal DR (2021) Global epidemiology of stroke and access to acute ischemic stroke interventions. 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