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Pixels in a digital image have spatial relationships where they are neighbors based on their location. Pixels that are horizontally, vertically, or diagonally adjacent are considered 8-neighbors of a pixel. Connectivity between pixels is important for determining boundaries and regions in an image, with adjacency defined based on similar pixel values. There are three types of pixel adjacency: 4-adjacency for horizontal and vertical neighbors only, 8-adjacency including diagonal neighbors, and mixed adjacency which can consider farther pixel relationships.