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Najdenovska E, Tuleasca C, Jorge J, Maeder P, Marques JP, Roine T, Gallichan D, Thiran JP, Levivier M, Bach Cuadra M. Comparison of MRI-based automated segmentation methods and functional neurosurgery targeting with direct visualization of the Ventro-intermediate thalamic nucleus at 7T. Sci Rep 2019; 9:1119. [PMID: 30718634 PMCID: PMC6361927 DOI: 10.1038/s41598-018-37825-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 12/13/2018] [Indexed: 12/22/2022] Open
Abstract
The ventro-intermediate nucleus (Vim), as part of the motor thalamic nuclei, is a commonly used target in functional stereotactic neurosurgery for treatment of drug-resistant tremor. As it cannot be directly visualized on routinely used magnetic resonance imaging (MRI), its clinical targeting is performed using indirect methods. Recent literature suggests that the Vim can be directly visualized on susceptibility-weighted imaging (SWI) acquired at 7 T. Our work aims to assess the distinguishable Vim on 7 T SWI in both healthy-population and patients and, using it as a reference, to compare it with: (1) The clinical targeting, (2) The automated parcellation of thalamic subparts based on 3 T diffusion MRI (dMRI), and (3) The multi-atlas segmentation techniques. In 95.2% of the data, the manual outline was adjacent to the inferior lateral border of the dMRI-based motor-nuclei group, while in 77.8% of the involved cases, its ventral part enclosed the Guiot points. Moreover, the late MRI signature in the patients was always observed in the anterior part of the manual delineation and it overlapped with the multi-atlas outline. Overall, our study provides new insight on Vim discrimination through MRI and imply novel strategies for its automated segmentation, thereby opening new perspectives for standardizing the clinical targeting.
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Affiliation(s)
- Elena Najdenovska
- Centre d'Imagerie BioMédicale (CIBM), University of Lausanne (UNIL), Lausanne, Switzerland. .,Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
| | - Constantin Tuleasca
- Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland.,Sorbonne Université, Faculté de Médecine, Paris, France.,Assistance Publique - Hôpitaux de Paris, Hôpitaux Universitaires Paris-Sud, Hôpital Bicêtre, Service de Neurochirurgie, Le Kremlin Bicêtre, France
| | - João Jorge
- Centre d'Imagerie BioMédicale (CIBM), University of Lausanne (UNIL), Lausanne, Switzerland.,Laboratory for Functional and Metabolic Imaging, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Philippe Maeder
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - José P Marques
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Timo Roine
- Centre d'Imagerie BioMédicale (CIBM), University of Lausanne (UNIL), Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Turku Brain and Mind Center, University of Turku, Turku, Finland
| | - Daniel Gallichan
- Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, UK
| | - Jean-Philippe Thiran
- Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - Marc Levivier
- Department of Clinical Neurosciences, Neurosurgery Service and Gamma Knife Center, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne (UNIL), Lausanne, Switzerland
| | - Meritxell Bach Cuadra
- Centre d'Imagerie BioMédicale (CIBM), University of Lausanne (UNIL), Lausanne, Switzerland.,Department of Radiology, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Signal Processing Laboratory (LTS5), Ecole Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
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152
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Farhat NS, Theiss R, Santini T, Ibrahim TS, Aizenstein HJ. Neuroimaging of Small Vessel Disease in Late-Life Depression. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1192:95-115. [PMID: 31705491 PMCID: PMC6939470 DOI: 10.1007/978-981-32-9721-0_5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Cerebral small vessel disease is associated with late-life depression, cognitive impairment, executive dysfunction, distress, and loss of life for older adults. Late-life depression is becoming a substantial public health burden, and a considerable number of older adults presenting to primary care have significant clinical depression. Even though white matter hyperintensities are linked with small vessel disease, white matter hyperintensities are nonspecific to small vessel disease and can co-occur with other brain diseases. Advanced neuroimaging techniques at the ultrahigh field magnetic resonance imaging are enabling improved characterization, identification of cerebral small vessel disease and are elucidating some of the mechanisms that associate small vessel disease with late-life depression.
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Affiliation(s)
- Nadim S Farhat
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Robert Theiss
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tales Santini
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tamer S Ibrahim
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Radiology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Howard J Aizenstein
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA.
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153
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Chen L, Wei X, Liu C, Li C, Zhou Z. Brain iron deposition in primary insomnia-An in vivo susceptibility-weighted imaging study. Brain Behav 2019; 9:e01138. [PMID: 30548431 PMCID: PMC6346654 DOI: 10.1002/brb3.1138] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 06/25/2018] [Accepted: 07/01/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND To study the brain iron deposition and its relationships with cognitive impairment and sleep quality in primary insomnia (PI). METHODS Thirty-five patients with PI and 35 volunteers underwent MRI scanning using high-resolution susceptibility-weighted imaging sequence. Bilateral anterior cingulate cortices, posterior cingulate cortex, hippocampus, caudate nucleus, globus pallidus, putamen, thalamus, red nucleus, substantia nigra, parietal cortex, and frontal white matter were selected as regions of interest. The phase shift values of the above areas were compared between the two groups. Partial correlations between phase shifts values and neuropsychological scale scores including Pittsburgh Sleep Quality Index, Insomnia Severity Index, Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Activities of Daily Living Scale, and Clinical Dementia Rating of the PI patients were analyzed. RESULTS Compared with the normal controls, the PI patients showed significant lower MMSE and MoCA scores and increased phase shift values in the left caudate nucleus, left putamen, left hippocampus, and bilateral thalamus (p < 0.05). Close correlation was found between the phase shift value of the left hippocampus and the MMSE scores of the PI patients (R = -0.447, p < 0.01). CONCLUSION The PI patients exhibited significant cognitive impairment and increased iron deposition in several brain regions. The iron concentration of the left hippocampus is a biomarker of cognitive impairment and may play an important role in the pathophysiological mechanism.
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Affiliation(s)
- Lin Chen
- Department of Psychology, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xin Wei
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chen Liu
- Department of Radiology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chuanming Li
- Department of Radiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Zhenhua Zhou
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
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154
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Ruuth R, Kuusela L, Mäkelä T, Melkas S, Korvenoja A. Comparison of reconstruction and acquisition choices for quantitative T2* maps and synthetic contrasts. Eur J Radiol Open 2019; 6:42-48. [PMID: 30619919 PMCID: PMC6314103 DOI: 10.1016/j.ejro.2018.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 11/23/2022] Open
Abstract
Phase images have artifacts if reconstructed with a vendor’s sum of squares mode. Quantitative T2* values can be obtained from DICOM data instead of k-space data. Reconstruction from DICOM data does not reduce white matter/gray matter contrast.
Aim and scope A Gradient Echo Plural Contrast Imaging technique (GEPCI) is a post-processing method, which can be used to obtain quantitative T2* values and generate multiple synthetic contrasts from a single acquisition. However, scan duration and image reconstruction from k-space data present challenges in a clinical workflow. This study aimed at optimizing image reconstruction and acquisition duration to facilitate a post-processing method for synthetic image contrast creation in clinical settings. Materials and methods This study consists of tests using the American College of Radiology (ACR) image quality phantom, two healthy volunteers, four mild traumatic brain injury patients and four small vessel disease patients. The measurements were carried out on a 3.0 T scanner with multiple echo times. Reconstruction from k-space data and DICOM data with two different coil-channel combination modes were investigated. Partial Fourier techniques were tested to optimize the scanning time. Conclusions Sum of squares coil-channel combination produced artifacts in phase images, but images created with adaptive combination were artifact-free. The voxel-wise median signed difference of T2* between the vendor’s adaptive channel combination and k-space reconstruction modes was 2.9 ± 0.7 ms for white matter and 4.5 ± 0.6 ms for gray matter. Relative white matter/gray matter contrast of all synthetic images and contrast-to-noise ratio of synthetic T1-weighted images were almost equal between reconstruction modes. Our results indicate that synthetic contrasts can be generated from the vendor’s DICOM data with the adaptive combination mode without affecting the quantitative T2* values or white matter/gray matter contrast.
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Affiliation(s)
- Riikka Ruuth
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, P.O. Box 340, FI-00029, HUS, Finland
- Department of Physics, Faculty of Science, University of Helsinki, P.O. Box 64, FI-00014, Helsinki, Finland
- Corresponding author at: HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, P.O. Box 340, FI-00029, HUS, Finland.
| | - Linda Kuusela
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, P.O. Box 340, FI-00029, HUS, Finland
- Department of Physics, Faculty of Science, University of Helsinki, P.O. Box 64, FI-00014, Helsinki, Finland
| | - Teemu Mäkelä
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, P.O. Box 340, FI-00029, HUS, Finland
- Department of Physics, Faculty of Science, University of Helsinki, P.O. Box 64, FI-00014, Helsinki, Finland
| | - Susanna Melkas
- Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, P.O. Box 302, FI-00029, HUS, Finland
| | - Antti Korvenoja
- HUS Medical Imaging Center, Radiology, University of Helsinki and Helsinki University Hospital, P.O. Box 340, FI-00029, HUS, Finland
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155
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Superficial Siderosis of the Central Nervous System: Neurotological Findings Related to Magnetic Resonance Imaging. Otol Neurotol 2018; 40:31-37. [PMID: 30516591 DOI: 10.1097/mao.0000000000002071] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare the neurotological results of five patients suffering from progressive hearing loss and ataxia due to superficial siderosis (SS) with the magnetic resonance imaging (MRI) findings. STUDY DESIGN Retrospective case review. SETTING Primary and hospital care center. PARTICIPANTS Five adult patients with neurotological symptoms of SS underwent MRI with acquisition of our temporal bone protocol including 3D-constructive interference in steady state (3D-CISS) and susceptibility-weighted imaging (SWI). All patients underwent a complete neurotological examination, the results of which were compared with the imaging findings. MAIN OUTCOME MEASURES Cochleovestibular deficits were present in all five patients as determined by uni- or bilateral bithermal caloric testing and/or video head impulse tests. Sacculocollic reflex was present with increased P1 and N1 latencies on both sides in all patients. MRI revealed an extensive hypointense SWI signal outlining the surface of the brain and the VIIIth cranial nerve in all five patients. Desynchronization of the brainstem auditory evoked potentials (BAEP) and partial or complete absence of the visual suppression of vestibulo-ocular reflex during the pendular rotatory test was particularly consistent with the lesions of the cochleovestibular nerves as well as the cerebellar atrophy seen on MRI. CONCLUSION The MRI results with SWI were related to neurotological findings in patients suffering from sensorineural deafness with ataxia due to SS. Our findings support the integration of the SWI and 3D-CISS sequences into the MRI protocol for all patients referred for evaluation of the extent of SS.
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156
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Hashimoto T, Koge J, Tanaka E, Kawajiri M, Yamada T. Diagnostic utility of magnetic resonance imaging in isolated cortical venous thrombosis presenting with seizures and a hypercoagulable state. INTERDISCIPLINARY NEUROSURGERY 2018. [DOI: 10.1016/j.inat.2018.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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157
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Acosta-Cabronero J, Milovic C, Mattern H, Tejos C, Speck O, Callaghan MF. A robust multi-scale approach to quantitative susceptibility mapping. Neuroimage 2018; 183:7-24. [PMID: 30075277 PMCID: PMC6215336 DOI: 10.1016/j.neuroimage.2018.07.065] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 06/29/2018] [Accepted: 07/29/2018] [Indexed: 12/11/2022] Open
Abstract
Quantitative Susceptibility Mapping (QSM), best known as a surrogate for tissue iron content, is becoming a highly relevant MRI contrast for monitoring cellular and vascular status in aging, addiction, traumatic brain injury and, in general, a wide range of neurological disorders. In this study we present a new Bayesian QSM algorithm, named Multi-Scale Dipole Inversion (MSDI), which builds on the nonlinear Morphology-Enabled Dipole Inversion (nMEDI) framework, incorporating three additional features: (i) improved implementation of Laplace's equation to reduce the influence of background fields through variable harmonic filtering and subsequent deconvolution, (ii) improved error control through dynamic phase-reliability compensation across spatial scales, and (iii) scalewise use of the morphological prior. More generally, this new pre-conditioned QSM formalism aims to reduce the impact of dipole-incompatible fields and measurement errors such as flow effects, poor signal-to-noise ratio or other data inconsistencies that can lead to streaking and shadowing artefacts. In terms of performance, MSDI is the first algorithm to rank in the top-10 for all metrics evaluated in the 2016 QSM Reconstruction Challenge. It also demonstrated lower variance than nMEDI and more stable behaviour in scan-rescan reproducibility experiments for different MRI acquisitions at 3 and 7 Tesla. In the present work, we also explored new forms of susceptibility MRI contrast making explicit use of the differential information across spatial scales. Specifically, we show MSDI-derived examples of: (i) enhanced anatomical detail with susceptibility inversions from short-range dipole fields (hereby referred to as High-Pass Susceptibility Mapping or HPSM), (ii) high specificity to venous-blood susceptibilities for highly regularised HPSM (making a case for MSDI-based Venography or VenoMSDI), (iii) improved tissue specificity (and possibly statistical conditioning) for Macroscopic-Vessel Suppressed Susceptibility Mapping (MVSSM), and (iv) high spatial specificity and definition for HPSM-based Susceptibility-Weighted Imaging (HPSM-SWI) and related intensity projections.
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Affiliation(s)
- Julio Acosta-Cabronero
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, London, United Kingdom; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
| | - Carlos Milovic
- Department of Electrical Engineering, Pontificia Universidad Catolica de Chile, Santiago, Chile; Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Hendrik Mattern
- Department of Biomedical Magnetic Resonance, Institute of Experimental Physics, Otto von Guericke University, Magdeburg, Germany
| | - Cristian Tejos
- Department of Electrical Engineering, Pontificia Universidad Catolica de Chile, Santiago, Chile; Biomedical Imaging Center, Pontificia Universidad Catolica de Chile, Santiago, Chile
| | - Oliver Speck
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Department of Biomedical Magnetic Resonance, Institute of Experimental Physics, Otto von Guericke University, Magdeburg, Germany; Center for Behavioural Brain Sciences, Magdeburg, Germany; Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Martina F Callaghan
- Wellcome Centre for Human Neuroimaging, UCL Institute of Neurology, University College London, London, United Kingdom
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158
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Rodríguez-López C, Garzo Caldas N, Uriarte Pérez de Urabayen D, Sánchez Tornero M, Hilario Barrio A, Saiz Díaz R, González de la Aleja J. A new MR radiological sign in HaNDL syndrome. A case report. J Clin Neurosci 2018; 61:274-276. [PMID: 30449590 DOI: 10.1016/j.jocn.2018.11.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 11/05/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND One of the classical diagnostic criteria of the syndrome of transient headache and neurologic deficits with cerebrospinal fluid lymphocytosis (HaNDL syndrome) is the normality of imaging studies except from some reversible alterations as leptomeningeal enhancement or focal hypoperfusion. CASE We present a 41 year-old man who abruptly started with a set of right parietal symptoms, meeting the diagnostic criteria for HaNDL syndrome. An electroencephalographic record showed a slowing of the right hemisphere. MR susceptibility weighted sequences demonstrated a reduced venous signal in the symptomatic hemisphere, unlike other transient disorders as migraine aura where an opposite pattern with prominence of the venous structures in the symptomatic hemisphere has been reported. This sign could reflect a decrease in metabolic demands or a fail in oxygen employment by the affected tissue. CONCLUSION To our knowledge, this finding has not been described yet, and it may provide a new insight on the pathogenesis of HaNDL syndrome.
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Affiliation(s)
| | | | | | | | | | - Rosana Saiz Díaz
- Department of Neurology, 12 de Octubre University Hospital, Madrid, Spain
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159
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Kau T, Hametner S, Endmayr V, Deistung A, Prihoda M, Haimburger E, Menard C, Haider T, Höftberger R, Robinson S, Reichenbach JR, Lassmann H, Traxler H, Trattnig S, Grabner G. Microvessels may Confound the “Swallow Tail Sign” in Normal Aged Midbrains: A Postmortem 7 T SW-MRI Study. J Neuroimaging 2018; 29:65-69. [DOI: 10.1111/jon.12576] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 10/21/2018] [Accepted: 10/22/2018] [Indexed: 12/25/2022] Open
Affiliation(s)
- Thomas Kau
- Department of Radiologic Technology; Carinthia University of Applied Sciences; Klagenfurt Austria
- Institute of Radiology; Villach General Hospital; Villach Austria
| | - Simon Hametner
- Center for Brain Research; Medical University of Vienna; Vienna Austria
| | - Verena Endmayr
- Center for Brain Research; Medical University of Vienna; Vienna Austria
| | - Andreas Deistung
- Medical Physics Group, Institute for Diagnostic and Interventional Radiology; Jena University Hospital-Friedrich Schiller-University; Jena Germany
- Section of Experimental Neurology, Department of Neurology; Essen University Hospital; Essen Germany
| | - Max Prihoda
- Department of Radiologic Technology; Carinthia University of Applied Sciences; Klagenfurt Austria
| | - Evelin Haimburger
- Department of Radiologic Technology; Carinthia University of Applied Sciences; Klagenfurt Austria
| | - Christian Menard
- Department of Medical Engineering; Carinthia University of Applied Sciences; Klagenfurt Austria
| | - Thomas Haider
- Department of Orthopedics and Trauma Surgery; Medical University of Vienna; Vienna Austria
| | - Romana Höftberger
- Institute of Neurology; Medical University of Vienna; Vienna Austria
| | - Simon Robinson
- Department of Biomedical Imaging and Image-guided Therapy, High Field Magnetic Resonance Centre; Medical University of Vienna; Vienna Austria
| | - Jürgen R. Reichenbach
- Medical Physics Group, Institute for Diagnostic and Interventional Radiology; Jena University Hospital-Friedrich Schiller-University; Jena Germany
| | - Hans Lassmann
- Center for Brain Research; Medical University of Vienna; Vienna Austria
| | - Hannes Traxler
- Center of Anatomy and Cell Biology; Medical University of Vienna; Vienna Austria
| | - Siegfried Trattnig
- Department of Biomedical Imaging and Image-guided Therapy, High Field Magnetic Resonance Centre; Medical University of Vienna; Vienna Austria
| | - Günther Grabner
- Department of Biomedical Imaging and Image-guided Therapy, High Field Magnetic Resonance Centre; Medical University of Vienna; Vienna Austria
- Institute for Applied Research on Ageing; Carinthia University of Applied Sciences; Klagenfurt Austria
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160
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Böker SM, Adams LC, Bender YY, Fahlenkamp UL, Wagner M, Hamm B, Makowski MR. Differentiation of Predominantly Osteoblastic and Osteolytic Spine Metastases by Using Susceptibility-weighted MRI. Radiology 2018; 290:146-154. [PMID: 30375926 DOI: 10.1148/radiol.2018172727] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To evaluate the use of susceptibility-weighted MRI for the differentiation of predominantly osteoblastic and osteolytic spine metastases. Materials and Methods For this prospective study, 53 study participants (mean age, 54.5 years ± 14.3 [range, 22-88 years]; 27 men with a mean age of 55.3 years ± 12.7 [range, 22-72 years] and 26 women with a mean age of 53.8 years ± 15.7 [range, 23-88 years]) with clinically suspected spine metastases underwent imaging with standard MRI sequences, susceptibility-weighted MRI, and CT. Sensitivities and specificities of MRI sequences for the detection of predominantly osteoblastic and osteolytic metastases were determined by using CT as the reference standard. The metastases-to-vertebral body signal intensity ratio (MVR) was calculated to compare modalities. Phantom measurements were obtained to correlate bone densities between MRI sequences and CT. Results A total of 64 metastases (38 predominantly osteoblastic, 26 predominantly osteolytic) were detected. Susceptibility-weighted MRI achieved a sensitivity of 100% (38 of 38) and specificity of 96% (25 of 26) for predominantly osteoblastic metastases and a sensitivity of 96% (25 of 26) and specificity of 100% (38 of 38) for predominantly osteolytic metastases. Standard MRI sequences achieved a sensitivity of 89% (34 of 38) and specificity of 73% (19 of 26) for predominantly osteoblastic metastases and a sensitivity of 73% (19 of 26) and specificity of 92% (35 of 38) for predominantly osteolytic metastases. MVR measurements obtained with susceptibility-weighted MRI demonstrated a strong correlation with those obtained with CT (R2 = 0.75), whereas those obtained with T1-weighted MRI, T2-weighted MRI, and turbo inversion-recovery magnitude MRI showed a weak to moderate correlation (R2 = 0.00, R2 = 0.35, and R2 = 0.39, respectively). Susceptibility-weighted MRI showed a strong correlation with CT with regard to metastases size (R2 = 0.91). In phantom measurements, susceptibility-weighted MRI enabled the reliable differentiation of different degrees of mineralization (R2 = 0.92 compared with CT). Conclusion Susceptibility-weighted MRI enables the reliable differentiation between predominantly osteoblastic and osteolytic spine metastases with a higher accuracy than standard MRI sequences. © RSNA, 2018 Online supplemental material is available for this article. See also the editorial by Schweitzer in this issue.
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Affiliation(s)
- Sarah M Böker
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Lisa C Adams
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Yvonne Y Bender
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Ute L Fahlenkamp
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Moritz Wagner
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Bernd Hamm
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Marcus R Makowski
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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161
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Engel G, Bender YY, Adams LC, Boker SM, Fahlenkamp UL, Wagner M, Diederichs G, Hamm B, Makowski MR. Evaluation of osseous cervical foraminal stenosis in spinal radiculopathy using susceptibility-weighted magnetic resonance imaging. Eur Radiol 2018; 29:1855-1862. [DOI: 10.1007/s00330-018-5769-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/23/2018] [Accepted: 09/14/2018] [Indexed: 02/04/2023]
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162
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Tateishi M, Kitajima M, Hirai T, Yoneda T, Hashimoto M, Kurehana N, Uetani H, Fukuhara R, Azuma M, Yamashita Y. Differentiating between Alzheimer Disease Patients and Controls with Phase-difference-enhanced Imaging at 3T: A Feasibility Study. Magn Reson Med Sci 2018; 17:283-292. [PMID: 29332926 PMCID: PMC6196300 DOI: 10.2463/mrms.mp.2017-0134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: To test the feasibility of the phase difference enhanced (PADRE) imaging for differentiation between Alzheimer disease (AD) patients and control subjects on 3T MR imaging. Materials and Methods: Fifteen patients with AD and 10 age-matched control subjects underwent two-dimensional fast field echo imaging to obtain PADRE images on a 3T MR scanner. A double Gaussian distribution model was used to determine the threshold phase value for differentiation between the physiologic and non-physiologic iron in the cerebral cortices, and PADRE images were processed with the threshold. Using a 4-point grading system, two readers independently assessed the signal of the four cerebral cortices on PADRE images: the cuneus, precuneus, superior frontal gyrus, and superior temporal gyrus. The difference in the signals in each cortex between the AD patients and age-matched control subjects was determined by using Mann–Whitney U test. Inter-rater reliability was determined by Kappa analysis. We also evaluated the correlation between Mini-Mental State Examination (MMSE) score and the hypointense grade, and between disease duration and the hypointense grade using the Spearman rank correlation test. Results: The threshold phase value for differentiation between the physiologic and non-physiologic iron was −4.6% π (radian). The mean grades of the cuneus, precuneus, and superior temporal gyrus were significantly higher for the AD patients than for the control subjects (P = 0.002). Excellent inter-rater reliability was seen in the precuneus (kappa = 0.93), superior temporal gyrus (kappa = 0.94), and superior frontal gyrus (kappa = 0.93); good inter-rater reliability was observed in the cuneus (kappa = 0.75). We found a statistical correlation between MMSE score and the hypointense grade in superior temporal gyrus (STG) (P = 0.008), and no correlation between disease duration and the hypointense grade in any gyrus. Conclusion: Our results suggest the feasibility of PADRE imaging at 3T for differentiation between AD patients and control subjects.
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Affiliation(s)
- Machiko Tateishi
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| | - Mika Kitajima
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| | - Toshinori Hirai
- Department of Radiology, Faculty of Medicine, University of Miyazaki
| | - Tetsuya Yoneda
- Department of Medical Physics in Advanced Biomedical Sciences, Faculty of Life Sciences, Kumamoto University
| | - Mamoru Hashimoto
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University
| | - Nan Kurehana
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| | - Hiroyuki Uetani
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
| | - Ryuji Fukuhara
- Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University
| | - Minako Azuma
- Department of Radiology, Faculty of Medicine, University of Miyazaki
| | - Yasuyuki Yamashita
- Department of Diagnostic Radiology, Faculty of Life Sciences, Kumamoto University
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Doishita S, Sakamoto S, Yoneda T, Uda T, Tsukamoto T, Yamada E, Yoneyama M, Kimura D, Katayama Y, Tatekawa H, Shimono T, Ohata K, Miki Y. Differentiation of Brain Metastases and Gliomas Based on Color Map of Phase Difference Enhanced Imaging. Front Neurol 2018; 9:788. [PMID: 30298047 PMCID: PMC6160550 DOI: 10.3389/fneur.2018.00788] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 08/31/2018] [Indexed: 12/14/2022] Open
Abstract
Background and objective: Phase difference enhanced imaging (PADRE), a new phase-related MRI technique, can enhance both paramagnetic and diamagnetic substances, and select which phases to be enhanced. Utilizing these characteristics, we developed color map of PADRE (Color PADRE), which enables simultaneous visualization of myelin-rich structures and veins. Our aim was to determine whether Color PADRE is sufficient to delineate the characteristics of non-gadolinium-enhancing T2-hyperintense regions related with metastatic tumors (MTs), diffuse astrocytomas (DAs) and glioblastomas (GBs), and whether it can contribute to the differentiation of MTs from GBs. Methods: Color PADRE images of 11 patients with MTs, nine with DAs and 17 with GBs were created by combining tissue-enhanced, vessel-enhanced and magnitude images of PADRE, and then retrospectively reviewed. First, predominant visibility of superficial white matter and deep medullary veins within non-gadolinium-enhancing T2-hyperintense regions were compared among the three groups. Then, the discriminatory power to differentiate MTs from GBs was assessed using receiver operating characteristic analysis. Results: The degree of visibility of superficial white matter was significantly better in MTs than in GBs (p = 0.017), better in GBs than in DAs (p = 0.014), and better in MTs than in DAs (p = 0.0021). On the contrary, the difference in the visibility of deep medullary veins was not significant (p = 0.065). The area under the receiver operating characteristic curve to discriminate MTs from GBs was 0.76 with a sensitivity of 80% and specificity of 64%. Conclusion: Visibility of superficial white matter on Color PADRE reflects inferred differences in the proportion of vasogenic edema and tumoral infiltration within non-gadolinium-enhancing T2-hyperintense regions of MTs, DAs and GBs. Evaluation of peritumoral areas on Color PADRE can help to distinguish MTs from GBs.
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Affiliation(s)
- Satoshi Doishita
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shinichi Sakamoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Tetsuya Yoneda
- Department of Medical Physics in Advanced Biomedical Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Takehiro Uda
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Taro Tsukamoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Eiji Yamada
- Department of Radiological Technology, Osaka City University Hospital, Osaka, Japan
| | | | - Daisuke Kimura
- Department of Radiological Technology, Osaka City University Hospital, Osaka, Japan
| | - Yutaka Katayama
- Department of Radiological Technology, Osaka City University Hospital, Osaka, Japan
| | - Hiroyuki Tatekawa
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Taro Shimono
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kenji Ohata
- Department of Neurosurgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
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164
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Zamora C, Hung SC, Tomingas C, Atkinson C, Castillo M. Engorgement of Deep Medullary Veins in Neurosarcoidosis: A Common-Yet-Underrecognized Cerebrovascular Finding on SWI. AJNR Am J Neuroradiol 2018; 39:2045-2050. [PMID: 30237298 DOI: 10.3174/ajnr.a5783] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 06/18/2018] [Indexed: 12/25/2022]
Abstract
We describe the prevalence and potential significance of deep medullary vein engorgement on SWI in patients with neurosarcoidosis, a finding that has not been described previously. Engorgement was evaluated for possible associations with meningeal or perivascular disease, intracranial hemorrhage, and venous thrombosis, as well as with modified Rankin Scale scores at the time of MR imaging and at follow-up. Deep medullary vein engorgement was seen in 7 of 21 patients and was more common in men. Patients with venous engorgement had a significantly increased incidence of microhemorrhages, perivascular disease, and hydrocephalus. There was no association with the degree of leptomeningeal disease, venous dural sinus thrombosis, or modified Rankin Scale scores. In conclusion, deep medullary vein engorgement was common in our patients with neurosarcoidosis. Although its pathophysiology remains uncertain, it could be related to venous or perivenous abnormalities and may represent a useful secondary finding of cerebrovascular disease.
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Affiliation(s)
- C Zamora
- From the Division of Neuroradiology, Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
| | - S-C Hung
- From the Division of Neuroradiology, Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - C Tomingas
- From the Division of Neuroradiology, Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - C Atkinson
- From the Division of Neuroradiology, Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - M Castillo
- From the Division of Neuroradiology, Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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165
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Dar NZ, Ain QU, Nazir R, Ahmad A. Cerebral Microbleeds in an Acute Ischemic Stroke as a Predictor of Hemorrhagic Transformation. Cureus 2018; 10:e3308. [PMID: 32175198 PMCID: PMC7053796 DOI: 10.7759/cureus.3308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Cerebral microbleeds are small, round hypointensities of <10 mm in diameter, evident on T2* gradient-recall echo (GRE) or susceptibility-weighted (SWI) magnetic resonance imaging (MRI) sequences. Objective In this study, our objective was to determine the number and location of cerebral microbleeds in ischemic stroke and to identify the predictive role of microbleeds for hemorrhagic transformation. Materials and methods This was a retrospective cohort study. Microbleeds were visually rated on SWI scans of patients who presented with an ischemic stroke and had an SWI scan within 24 hours of onset and a computed tomography (CT)/MRI scan during follow up. Microbleeds were graded as Grades I-IV. Results Out of 575 stroke patients, 121 did not have an SWI scan and 336 had no follow-up scan. A total of 118 patients were included for a final analysis (75 males, 43 females) out of which 30 had a hemorrhagic transformation. Most microbleeds were in the parietal region (n=46) with 50% transformation (p-value <0.001). The size and grade of microbleeds had a statistical association with hemorrhagic transformation with p-value 0.001 and p-value <0.001, respectively; 33% of patients with Grade 3 microbleeds aging 55-65 years had transformations. Of the patients, 93.3% with Grade 4 microbleeds had a hemorrhagic transformation. 30% of transformations were detected in the first 24 hours while 30% were detected during the first week. Age, gender, comorbidity, and anticoagulant use had no statistical association of conversion of microbleeds into hemorrhagic transformation. Conclusion Microbleeds detected on an SWI scan is a relevant and accurate predictor of hemorrhagic transformations in acute ischemic infarcts and should be added to MRI stroke protocols.
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Affiliation(s)
- Nayab Z Dar
- Radiology, Shifa International Hospital, Islamabad, PAK
| | - Qurat Ul Ain
- Medical Officer, Shifa College of Medicine, Shifa International Hospital, Islamabad, PAK
| | - Rashed Nazir
- Radiology, Shifa International Hospital, Islamabad, PAK
| | - Arsalan Ahmad
- Neurology, Shifa International Hospital, Islamabad, PAK
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166
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Bandt SK, de Rochefort L, Chen W, Dimov AV, Spincemaille P, Kopell BH, Gupta A, Wang Y. Clinical Integration of Quantitative Susceptibility Mapping Magnetic Resonance Imaging into Neurosurgical Practice. World Neurosurg 2018; 122:e10-e19. [PMID: 30201583 DOI: 10.1016/j.wneu.2018.08.213] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 08/27/2018] [Accepted: 08/29/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To introduce quantitative susceptibility mapping (QSM), a novel magnetic resonance imaging sequence, to the field of neurosurgery. METHODS QSM is introduced both in its historical context and by providing a brief overview of the physics behind the technique tailored to a neurosurgical audience. Its application to clinical neurosurgery is then highlighted using case examples. RESULTS QSM offers a quantitative assessment of susceptibility (previously considered as an artifact) via a single, straightforward gradient echo acquisition. QSM differs from standard susceptibility weighted imaging in its ability to both quantify and precisely localize susceptibility effects. Clinical applications of QSM are wide reaching and include precise localization of the deep nuclei for deep brain stimulation electrode placement, differentiation between blood products and calcification within brain lesions, and enhanced sensitivity of cerebral micrometastasis identification. CONCLUSIONS We present this diverse range of QSM's clinical applications to neurosurgical care via case examples. QSM can be obtained in all patients able to undergo magnetic resonance imaging and is easily integratable into busy neuroradiology programs because of its short acquisition time and straightforward, automated offline postprocessing workflow. Clinical integration of QSM may help clinicians better identify and characterize neurosurgical lesions, thereby improving patient care.
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Affiliation(s)
- S Kathleen Bandt
- Aix Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France; APHM, Hôpital de la Timone, CEMEREM, Marseille, France; Department of Neurological Surgery, Northwestern University, Chicago, Illinois, USA.
| | | | - Weiwei Chen
- Department of Radiology, Tongji Hospital, Wuhan, China
| | - Alexey V Dimov
- Department of Biomedical Engineering, Cornell University, Ithaca, New York, USA
| | - Pascal Spincemaille
- Department of Radiology, Weill Cornell Medical College, New York, New York, USA
| | - Brian H Kopell
- Department of Neurosurgery, the Mount Sinai Hospital, New York, New York, USA
| | - Ajay Gupta
- Department of Radiology, Weill Cornell Medical College, New York, New York, USA
| | - Yi Wang
- Aix Marseille Université, CNRS, CRMBM UMR 7339, Marseille, France; Department of Biomedical Engineering, Cornell University, Ithaca, New York, USA; Department of Radiology, Weill Cornell Medical College, New York, New York, USA
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167
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Skalski KA, Kessler AT, Bhatt AA. Hemorrhagic and non-hemorrhagic causes of signal loss on susceptibility-weighted imaging. Emerg Radiol 2018; 25:691-701. [PMID: 30136160 DOI: 10.1007/s10140-018-1634-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 08/15/2018] [Indexed: 01/14/2023]
Abstract
Susceptibility-weighted imaging (SWI) plays a key role in an emergency setting. SWI takes the intrinsic properties of materials being scanned and creates a visual representation of their effects on the magnetic field, thereby differentiating a number of pathologies. Magnetic resonance imaging (MRI) is now more often used, especially when computed tomography (CT) is inconclusive or even negative. Often, clinicians prefer to obtain an MRI first. This article will review the various hemorrhagic and non-hemorrhagic causes of low signal on SWI. There will be a focus on the distribution patterns of low signal on SWI in pathologies such as diffuse axonal injury, cerebral amyloid angiopathy, and cerebral fat embolism. It is important to recognize these patterns of susceptibility, as the radiologist may be the first to give an accurate diagnosis and therefore, directly impact clinical management.
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Affiliation(s)
- Kamila A Skalski
- Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, PO Box 648, Rochester, NY, 14642, USA
| | - Alexander T Kessler
- Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, PO Box 648, Rochester, NY, 14642, USA
| | - Alok A Bhatt
- Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, PO Box 648, Rochester, NY, 14642, USA.
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Havsteen I, Willer L, Ovesen C, Nybing JD, Ægidius K, Marstrand J, Meden P, Rosenbaum S, Folke MN, Christensen H, Christensen A. Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort study. BMC Med Imaging 2018; 18:24. [PMID: 30126352 PMCID: PMC6102826 DOI: 10.1186/s12880-018-0264-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 07/30/2018] [Indexed: 11/10/2022] Open
Abstract
Background In a prospective cohort of patients with transient ischemic attack (TIA), we investigated usefulness and feasibility of arterial spin labeling (ASL) perfusion and susceptibility weighted imaging (SWI) alone and in combination with standard diffusion weighted (DWI) imaging in subacute diagnostic work-up. We investigated rates of ASL and SWI changes and their potential correlation to lasting infarction 8 weeks after ictus. Methods Patients with TIA underwent 3T-MRI including DWI, ASL and SWI within 72 h of symptom onset. We defined lasting infarction as presence of 8-week MRI T2-fluid attenuated inversion recovery (FLAIR) hyperintensity or atrophy in the area of initial DWI-lesion. Results We included 116 patients. Diffusion and perfusion together identified more patients with ischemia than either alone (59% vs. 40%, p < 0.0001). The presence of both diffusion and perfusion lesions had the highest rate of 8-week gliosis scars, 65% (p < 0.0001). In white matter, DWI-restriction was the determinant factor for scar development. However, in cortical gray matter half of lesions with perfusion deficit left a scar, while lesions without perfusion change rarely resulted in scars (56% versus 21%, p = 0.03). SWI lesions were rare (6%) and a subset of perfusion lesions. SWI-lesions with DWI-lesions were all located in cortical gray matter and showed high scar rate. Conclusions ASL perfusion increased ischemia detection in patients with TIA, and was most useful in conjunction with DWI. ASL was fast, robust and useful in a subacute clinical diagnostic setting. SWI had few positive findings and did not add information. Trial Registration. http://www.clinicaltrials.gov. Unique Identifier NCT01531946, prospectively registered February 9, 2012. Electronic supplementary material The online version of this article (10.1186/s12880-018-0264-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Inger Havsteen
- Department of Radiology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark.
| | - Lasse Willer
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Christian Ovesen
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Janus Damm Nybing
- Department of Radiology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Karen Ægidius
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Jacob Marstrand
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Per Meden
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Sverre Rosenbaum
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Marie Norsker Folke
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Hanne Christensen
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
| | - Anders Christensen
- Department of Radiology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark
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Mayer AR, Kaushal M, Dodd AB, Hanlon FM, Shaff NA, Mannix R, Master CL, Leddy JJ, Stephenson D, Wertz CJ, Suelzer EM, Arbogast KB, Meier TB. Advanced biomarkers of pediatric mild traumatic brain injury: Progress and perils. Neurosci Biobehav Rev 2018; 94:149-165. [PMID: 30098989 DOI: 10.1016/j.neubiorev.2018.08.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 07/27/2018] [Accepted: 08/03/2018] [Indexed: 12/20/2022]
Abstract
There is growing public concern about neurodegenerative changes (e.g., Chronic Traumatic Encephalopathy) that may occur chronically following clinically apparent and clinically silent (i.e., sub-concussive blows) pediatric mild traumatic brain injury (pmTBI). However, there are currently no biomarkers that clinicians can use to objectively diagnose patients or predict those who may struggle to recover. Non-invasive neuroimaging, electrophysiological and neuromodulation biomarkers have promise for providing evidence of the so-called "invisible wounds" of pmTBI. Our systematic review, however, belies that notion, identifying a relative paucity of high-quality, clinically impactful, diagnostic or prognostic biomarker studies in the sub-acute injury phase (36 studies on unique samples in 28 years), with the majority focusing on adolescent pmTBI. Ultimately, well-powered longitudinal studies with appropriate control groups, as well as standardized and clearly-defined inclusion criteria (time post-injury, injury severity and past history) are needed to truly understand the complex pathophysiology that is hypothesized (i.e., still needs to be determined) to exist during the acute and sub-acute stages of pmTBI and may underlie post-concussive symptoms.
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Affiliation(s)
- Andrew R Mayer
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States; Neurology Department, University of New Mexico School of Medicine, Albuquerque, NM, 87131, United States; Psychiatry Department, University of New Mexico School of Medicine, Albuquerque, NM, 87131, United States; Psychology Department, University of New Mexico, Albuquerque, NM, 87131, United States.
| | - Mayank Kaushal
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
| | - Andrew B Dodd
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Faith M Hanlon
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Nicholas A Shaff
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Rebekah Mannix
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, 02115, United States
| | - Christina L Master
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, PA, 19104, United States; Division of Orthopedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, United States
| | - John J Leddy
- UBMD Department of Orthopaedics and Sports Medicine, University at Buffalo, Buffalo, NY, 14214, United States
| | - David Stephenson
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Christopher J Wertz
- The Mind Research Network/Lovelace Biomedical and Environmental Research Institute, Pete & Nancy Domenici Hall, 1011 Yale Blvd. NE, Albuquerque, NM, 87106, United States
| | - Elizabeth M Suelzer
- Medical College of Wisconsin Libraries, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
| | - Kristy B Arbogast
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, PA, 19104, United States
| | - Timothy B Meier
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, 53226, United States; Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, 53226, United States
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170
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Scheffler M, Maturana E, Salomir R, Haller S, Kövari E. Air bubble artifact reduction in post-mortem whole-brain MRI: the influence of receiver bandwidth. Neuroradiology 2018; 60:1089-1092. [PMID: 30090981 DOI: 10.1007/s00234-018-2071-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 07/30/2018] [Indexed: 11/26/2022]
Abstract
Air bubble artifacts on SWI post-mortem MRI studies may interfere with the detection of cerebral microbleeds. We investigated whether the utilization of a higher receiver bandwidth of 500 Hz/pixel could reduce cortical air bubble artifacts without compromising the detection of cerebral microbleeds in high-field MRI. All microbleeds remained clearly visible whereas a reduction of 17% of the long axis of the "halo" magnitude artifacts was achieved. On corresponding phase images, air bubble artifacts appeared identical.
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Affiliation(s)
- Max Scheffler
- Department of Radiology, Geneva University Hospitals, Ch. du Pont-Bochet 3, 1226, Thonex, Switzerland.
| | - Enrique Maturana
- Department of Radiology, Geneva University Hospitals, Ch. du Pont-Bochet 3, 1226, Thonex, Switzerland
| | - Rares Salomir
- Department of Radiology, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland
- Image Guided Interventions Laboratory, Faculty of Medicine, University of Geneva, Rue du Général-Dufour 24, 1211, Geneva, Switzerland
| | - Sven Haller
- Centre d'Imagerie Rive Droite (CIRD), 21 rue Chantepoulet, 1201, Geneva, Switzerland
| | - Enikö Kövari
- Department of Psychiatry, Geneva University Hospitals, Ch. du Petit-Bel-Air 2, 1225, Chêne-Bourg, Switzerland
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Warne RR, Carney OM, Wang G, Bhattacharya D, Chong WK, Aylett SE, Mankad K. The Bone Does Not Predict the Brain in Sturge-Weber Syndrome. AJNR Am J Neuroradiol 2018; 39:1543-1549. [PMID: 30026385 DOI: 10.3174/ajnr.a5722] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/18/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE It has been hypothesized that skull marrow signal alteration may represent an early disease manifestation of Sturge-Weber syndrome before development of its intracranial manifestations. We alternatively hypothesized that intraosseous changes are associated with the overlying port-wine stain rather than the intracranial stigmata of Sturge-Weber syndrome and hence are not a predictor of brain involvement. MATERIALS AND METHODS MR imaging of children presenting with port-wine stain and/or Sturge-Weber syndrome between 1998 and 2017 was evaluated by 2 pediatric neuroradiologists for marrow signal abnormality and pial angioma and other Sturge-Weber syndrome features: ocular hemangioma, atrophy, and white matter changes (advanced myelination). Groups were divided into port-wine stain-only (without intracranial Sturge-Weber syndrome features) and Sturge-Weber syndrome (the presence of cerebral pial angioma). The χ2 test was performed to evaluate the association between port-wine stain and bone marrow changes and between osseous change and pial angioma. RESULTS We reviewed 139 cases: 40 with port-wine stain-only and 99 with Sturge-Weber syndrome with pial angioma. Fifteen of 99 cases of Sturge-Weber syndrome had no port-wine stain. In the port-wine stain-only cohort, 78% had ipsilateral bony changes and 17% had no intraosseous changes. In the Sturge-Weber syndrome cohort, 84/99 had associated port-wine stain, 91% (P < .01) had bony changes ipsilateral to the port-wine stain or had no bone changes in the absence of port-wine stain, and 77% (P = .27) had bony changes ipsilateral to a cerebral pial angioma. Eighty percent of patients with Sturge-Weber syndrome who lacked a port-wine stain also lacked marrow changes. Five patients with bilateral port-wine stain and bilateral marrow changes had only a unilateral pial angioma. CONCLUSIONS Intraosseous marrow changes are strongly associated with facial port-wine stain; no significant association was found between pial angioma and bone marrow changes.
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Affiliation(s)
- R R Warne
- From the Department of Paediatric Neuroradiology (R.R.W., O.M.C., D.B., W.K.C., K.M.), Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - O M Carney
- From the Department of Paediatric Neuroradiology (R.R.W., O.M.C., D.B., W.K.C., K.M.), Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - G Wang
- Department of Biostatistics (G.W.), University of Sydney School of Public Health, Sydney, New South Wales, Australia 2006
| | - D Bhattacharya
- From the Department of Paediatric Neuroradiology (R.R.W., O.M.C., D.B., W.K.C., K.M.), Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - W K Chong
- From the Department of Paediatric Neuroradiology (R.R.W., O.M.C., D.B., W.K.C., K.M.), Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - S E Aylett
- Neurosciences (S.E.A.), Great Ormond Street Hospital for Children and Developmental Neurosciences University College London, NHS Foundation Trust, London UK
| | - K Mankad
- From the Department of Paediatric Neuroradiology (R.R.W., O.M.C., D.B., W.K.C., K.M.), Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
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Protti A, Jones KL, Bonal DM, Qin L, Politi LS, Kravets S, Nguyen QD, Van den Abbeele AD. Development and validation of a new MRI simulation technique that can reliably estimate optimal in vivo scanning parameters in a glioblastoma murine model. PLoS One 2018; 13:e0200611. [PMID: 30036367 PMCID: PMC6056046 DOI: 10.1371/journal.pone.0200611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 06/29/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Magnetic Resonance Imaging (MRI) relies on optimal scanning parameters to achieve maximal signal-to-noise ratio (SNR) and high contrast-to-noise ratio (CNR) between tissues resulting in high quality images. The optimization of such parameters is often laborious, time consuming, and user-dependent, making harmonization of imaging parameters a difficult task. In this report, we aim to develop and validate a computer simulation technique that can reliably provide "optimal in vivo scanning parameters" ready to be used for in vivo evaluation of disease models. METHODS A glioblastoma murine model was investigated using several MRI imaging methods. Such MRI methods underwent a simulated and an in vivo scanning parameter optimization in pre- and post-contrast conditions that involved the investigation of tumor, brain parenchyma and cerebrospinal fluid (CSF) CNR values in addition to the time relaxation values of the related tissues. The CNR tissues information were analyzed and the derived scanning parameters compared in order to validate the simulated methodology as a reliable technique for "optimal in vivo scanning parameters" estimation. RESULTS The CNRs and the related scanning parameters were better correlated when spin-echo-based sequences were used rather than the gradient-echo-based sequences due to augmented inhomogeneity artifacts affecting the latter methods. "Optimal in vivo scanning parameters" were generated successfully by the simulations after initial scanning parameter adjustments that conformed to some of the parameters derived from the in vivo experiment. CONCLUSION Scanning parameter optimization using the computer simulation was shown to be a valid surrogate to the in vivo approach in a glioblastoma murine model yielding in a better delineation and differentiation of the tumor from the contralateral hemisphere. In addition to drastically reducing the time invested in choosing optimal scanning parameters when compared to an in vivo approach, this simulation program could also be used to harmonize MRI acquisition parameters across scanners from different vendors.
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Affiliation(s)
- Andrea Protti
- Department of Imaging, Lurie Family Imaging Center, Center for Biomedical Imaging in Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| | - Kristen L. Jones
- Department of Imaging, Lurie Family Imaging Center, Center for Biomedical Imaging in Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Dennis M. Bonal
- Department of Imaging, Lurie Family Imaging Center, Center for Biomedical Imaging in Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Lei Qin
- Department of Imaging, Lurie Family Imaging Center, Center for Biomedical Imaging in Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Letterio S. Politi
- Neuroimaging Research, Radiology Department, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Radiology Department, University of Massachusetts Medical School, Worcester, MA, United States of America
- University of Massachusetts Memorial Medical Center, Worcester, MA, United States of America
| | - Sasha Kravets
- Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, Massachusetts, United States of America
| | - Quang-Dé Nguyen
- Department of Imaging, Lurie Family Imaging Center, Center for Biomedical Imaging in Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Annick D. Van den Abbeele
- Department of Imaging, Lurie Family Imaging Center, Center for Biomedical Imaging in Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
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173
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Zhang W, Zuo Z, Huang X, Jin G, Su D. Value of Diffusion-Weighted Imaging Combined with Susceptibility-Weighted Imaging in Differentiating Benign from Malignant Parotid Gland Lesions. Med Sci Monit 2018; 24:4610-4616. [PMID: 29972148 PMCID: PMC6064192 DOI: 10.12659/msm.911185] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the diagnostic value of diffusion-weighted imaging (DWI) in combination with susceptibility-weighted imaging (SWI) for differentiating benign parotid gland lesions from malignant ones. MATERIAL AND METHODS This retrospective study was approved by the Ethics Committee of our hospital. A total of 36 patients (26 benign cases and 10 malignant cases) were confirmed by surgical pathology. The apparent diffusion coefficient (ADC), normalized ADC (ADCNormalized), intratumoral susceptibility signals (ITSS), and morphological characteristics were analyzed with SPSS 19.0 software. RESULTS The mean ADC values of parotid gland lesions was not different between malignant and benign lesions (P=0.07), while the differences between ADCNormalized (P=0.026) and ITSS grading (P=0.014) were statistically significant. Logistic regression analysis identified use of ADCNormalized and ITSS as the only independent predictor of malignant lesions (odds ratio 0.038; 95% confidence interval 0.001~0.988; P=0.011) and (odds ratio 4.867; 95% confidence interval 1.442~16.423; P=0.049), respectively. The optimum threshold of the ADCNormalized values was -0.45%, ITSS grade was 2, the corresponding areas under the receiver operating characteristic curve (AUC) were 0.750 and 0.787 respectively, and the combination of the 2 was 0.846. CONCLUSIONS DWI integrated with SWI can significantly improve the diagnostic efficacy in distinguishing benign from malignant parotid lesions.
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Affiliation(s)
- Wei Zhang
- Department of Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Zhichao Zuo
- Department of Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Xiangyang Huang
- Department of Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Guanqiao Jin
- Department of Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
| | - Danke Su
- Department of Radiology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, Guangxi, China (mainland)
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174
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Li L, Liu MS, Li GQ, Zheng Y, Guo TL, Kang X, Yuan MT. Susceptibility-weighted Imaging in Thrombolytic Therapy of Acute Ischemic Stroke. Chin Med J (Engl) 2018; 130:2489-2497. [PMID: 29052571 PMCID: PMC5684633 DOI: 10.4103/0366-6999.216401] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Objective: To provide a comprehensive and latest overview of susceptibility-weighted imaging (SWI) in the application of thrombolysis in acute ischemic stroke, and to update the decision-making effect and clinical value of SWI on identifying stroke patients suitable for thrombolytic therapy and possible benefits and risks followed. Data Sources: Literatures referred to this review were collected from PubMed, Medline, and EMBASE published till May 2017, using the search terms including susceptibility-weighted imaging, gradient-echo, T2*, thrombolysis, recombinant tissue plasminogen activator (rt-PA), thrombolytic therapy, and stroke. Study Selection: Papers in English or with available English abstracts were considered, with no limitation of study design. References were also identified from the bibliographies of identified articles and the authors’ files. Results: SWI is of guiding significance for thrombolytic therapy in stroke patients, it can predict the location and length of thrombus and ischemic penumbra. It is worthy of noting that susceptibility vessel sign (SVS) on SWI can be used to predict recanalization after thrombolytic therapy and whether it is better to implement endovascular thrombolectomy in combination or alone. SWI is sensitive in detecting cerebral microbleed (CMB), and CMB might not be a contraindication for thrombolytic therapy, yet CMBs in multiple foci could possibly be related to intracranial hemorrhage (ICH) after thrombolysis. SVS and CMB on SWI sequence are of instructive value in performing antiplatelet therapy after thrombolytic therapy. Cerebral venous change on SWI is related to lower recanalization rate and poor outcome after thrombolysis. Conclusions: It seems that SWI can be applied to guide individualized thrombolytic therapies and assist clinicians in making better decisions by weighing benefits and risks. However, there still exist controversies about the relationship between signs on SWI and thrombolytic therapy.
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Affiliation(s)
- Lin Li
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Ming-Su Liu
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Guang-Qin Li
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Yang Zheng
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Tong-Li Guo
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Xin Kang
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
| | - Mao-Ting Yuan
- Department of Neurology, The First Affiliated Hospital, Chongqing Medical University, Chongqing 400016, China
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175
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Koch KM, Meier TB, Karr R, Nencka AS, Muftuler LT, McCrea M. Quantitative Susceptibility Mapping after Sports-Related Concussion. AJNR Am J Neuroradiol 2018; 39:1215-1221. [PMID: 29880474 DOI: 10.3174/ajnr.a5692] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 04/08/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Quantitative susceptibility mapping using MR imaging can assess changes in brain tissue structure and composition. This report presents preliminary results demonstrating changes in tissue magnetic susceptibility after sports-related concussion. MATERIALS AND METHODS Longitudinal quantitative susceptibility mapping metrics were produced from imaging data acquired from cohorts of concussed and control football athletes. One hundred thirty-six quantitative susceptibility mapping datasets were analyzed across 3 separate visits (24 hours after injury, 8 days postinjury, and 6 months postinjury). Longitudinal quantitative susceptibility mapping group analyses were performed on stability-thresholded brain tissue compartments and selected subregions. Clinical concussion metrics were also measured longitudinally in both cohorts and compared with the measured quantitative susceptibility mapping. RESULTS Statistically significant increases in white matter susceptibility were identified in the concussed athlete group during the acute (24 hour) and subacute (day 8) period. These effects were most prominent at the 8-day visit but recovered and showed no significant difference from controls at the 6-month visit. The subcortical gray matter showed no statistically significant group differences. Observed susceptibility changes after concussion appeared to outlast self-reported clinical recovery metrics at a group level. At an individual subject level, susceptibility increases within the white matter showed statistically significant correlations with return-to-play durations. CONCLUSIONS The results of this preliminary investigation suggest that sports-related concussion can induce physiologic changes to brain tissue that can be detected using MR imaging-based magnetic susceptibility estimates. In group analyses, the observed tissue changes appear to persist beyond those detected on clinical outcome assessments and were associated with return-to-play duration after sports-related concussion.
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Affiliation(s)
- K M Koch
- From the Departments of Radiology (K.M.K., R.K., A.S.N.)
| | - T B Meier
- Neurosurgery (T.B.M., L.T.M., M.M.), Medical College of Wisconsin, Milwaukee, Wisconsin
| | - R Karr
- From the Departments of Radiology (K.M.K., R.K., A.S.N.)
| | - A S Nencka
- From the Departments of Radiology (K.M.K., R.K., A.S.N.)
| | - L T Muftuler
- Neurosurgery (T.B.M., L.T.M., M.M.), Medical College of Wisconsin, Milwaukee, Wisconsin
| | - M McCrea
- Neurosurgery (T.B.M., L.T.M., M.M.), Medical College of Wisconsin, Milwaukee, Wisconsin
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Irimia A, Van Horn JD, Vespa PM. Cerebral microhemorrhages due to traumatic brain injury and their effects on the aging human brain. Neurobiol Aging 2018; 66:158-164. [PMID: 29579686 PMCID: PMC5924627 DOI: 10.1016/j.neurobiolaging.2018.02.026] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 02/24/2018] [Accepted: 02/27/2018] [Indexed: 01/08/2023]
Abstract
Although cerebral microbleeds (CMBs) are frequently associated with traumatic brain injury (TBI), their effects on clinical outcome after TBI remain controversial and poorly understood, particularly in older adults. Here we (1) highlight major challenges and opportunities associated with studying the effects of TBI-mediated CMBs; (2) review the evidence on their potential effects on cognitive and neural outcome as a function of age at injury; and (3) suggest priorities for future research on understanding the clinical implications of CMBs. Although TBI-mediated CMBs are likely distinct from those due to cerebral amyloid angiopathy or other neurodegenerative diseases, the effects of these 2 CMB types on brain function may share common features. Furthermore, in older TBI victims, the incidence of TBI-mediated CMBs may approximate that of cerebral amyloid angiopathy-related CMBs, and thus warrants detailed study. Because the alterations effected by CMBs on brain structure and function are both unique and age-dependent, it seems likely that novel, age-tailored therapeutic approaches are necessary for the adequate clinical interpretation and treatment of these ubiquitous and underappreciated TBI sequelae.
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Affiliation(s)
- Andrei Irimia
- Ethel Percy Andrus Gerontology Center, USC Leonard Davis School of Gerontology, University of Southern California, Los Angeles CA, USA.
| | - John D Van Horn
- USC Mark & Mary Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, Los Angeles, CA, USA
| | - Paul M Vespa
- Departments of Neurosurgery and Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Wu CX, Ma L, Chen XZ, Chen XL, Chen Y, Zhao YL, Hess C, Kim H, Jin HW, Ma J. Evaluation of Angioarchitectural Features of Unruptured Brain Arteriovenous Malformation by Susceptibility Weighted Imaging. World Neurosurg 2018; 116:e1015-e1022. [PMID: 29859363 DOI: 10.1016/j.wneu.2018.05.151] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 05/20/2018] [Accepted: 05/22/2018] [Indexed: 01/14/2023]
Abstract
OBJECTIVES A precise assessment of angioarchitectural characteristics using noninvasive imaging is helpful for serial follow-up and weighting risk of natural history in unruptured brain arteriovenous malformation (bAVM). This study aimed to test the hypothesis that susceptibility weighted imaging (SWI) would provide an accurate evaluation of angioarchitectural features of unruptured bAVM. METHODS A total of 81 consecutive patients with unruptured bAVM were examined. Image quality of SWI for the assessment of bAVM angioarchitectural features was determined by a 5-point scale. The accuracy of SWI for detection of angioarchitectural features was evaluated using digital subtraction angiography as a standard reference and further compared among unruptured bAVMs with or without silent intralesional microhemorrhage on SWI to examine the potential confounding effect of microhemorrhage on image analysis. RESULTS All lesions were identified on SWI. Image quality of SWI was judged to be at least adequate for diagnosis (range, 3-5) in all patients by both readers. Using digital subtraction angiography as a reference standard, the area under the receiver operating curve of detection of deep or posterior fossa location, exclusively deep venous drainage, venous ectasia, venous varices, and the presence of associated aneurysm on SWI was 1, 0.93, 0.94, 0.95, and 0.83, respectively. Silent intralesional microhemorrhage were detected in 39 patients (48.15%) on SWI and no significant difference (P > 0.05) was found in angioarchitectural features between patients with and without silent microhemorrhage. CONCLUSIONS SWI might be a noninvasive alternative technique for angiography in the angioarchitectural assessment of unruptured bAVM.
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Affiliation(s)
- Chun-Xue Wu
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, People's Republic of China
| | - Li Ma
- Department of NeurosurgeryBeijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China
| | - Xu-Zhu Chen
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, People's Republic of China
| | - Xiao-Lin Chen
- Department of NeurosurgeryBeijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China
| | - Yu Chen
- Department of NeurosurgeryBeijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China
| | - Yuan-Li Zhao
- Department of NeurosurgeryBeijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, People's Republic of China; China National Clinical Research Center for Neurological Diseases, Beijing, People's Republic of China; Stroke Center, Beijing Institute for Brain Disorders, Beijing, People's Republic of China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, People's Republic of China
| | - Christopher Hess
- Center for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, USA
| | - Helen Kim
- Center for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California San Francisco, San Francisco, California, USA
| | - Heng-Wei Jin
- Interventional Neuroradiology Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, People's Republic of China
| | - Jun Ma
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Dongcheng District, Beijing, People's Republic of China.
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Pittau F, Baud MO, Jorge J, Xin L, Grouiller F, Iannotti GR, Seeck M, Lazeyras F, Vulliémoz S, Vargas MI. MP2RAGE and Susceptibility-Weighted Imaging in Lesional Epilepsy at 7T. J Neuroimaging 2018; 28:365-369. [DOI: 10.1111/jon.12523] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 04/27/2018] [Indexed: 01/22/2023] Open
Affiliation(s)
- Francesca Pittau
- Division of Neurology; Geneva University Hospitals; Geneva Switzerland
| | - Maxime O. Baud
- Division of Neurology; Geneva University Hospitals; Geneva Switzerland
| | - João Jorge
- Laboratory for Functional and Metabolic Imaging; École Polytechnique Fédérale de Lausanne; Lausanne Switzerland
| | - Lijing Xin
- Animal Imaging and Technology Core; Center for Biomedical Imaging; École Polytechnique Fédérale de Lausanne; Lausanne Switzerland
| | - Frédéric Grouiller
- Swiss Center for Affective Sciences; University of Geneva; Geneva Switzerland
| | | | - Margitta Seeck
- Division of Neurology; Geneva University Hospitals; Geneva Switzerland
| | - François Lazeyras
- Division of Radiology of Geneva University Hospitals and CIBM; Geneva Switzerland
| | - Serge Vulliémoz
- Division of Neurology; Geneva University Hospitals; Geneva Switzerland
| | - Maria Isabel Vargas
- Division of Neuroradiology of Geneva University Hospitals and Geneva University; Geneva Switzerland
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179
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Dmytriw AA, Song JSA, Yu E, Poon CS. Cerebral venous thrombosis: state of the art diagnosis and management. Neuroradiology 2018; 60:669-685. [PMID: 29752489 DOI: 10.1007/s00234-018-2032-2] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 05/03/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE This review article aims to discuss the pathophysiology, clinical presentation, and neuroimaging of cerebral venous thrombosis (CVT). Different approaches for diagnosis of CVT, including CT/CTV, MRI/MRV, and US will be discussed and the reader will become acquainted with imaging findings as well as limitations of each modality. Lastly, this exhibit will review the standard of care for CVT treatment and emerging endovascular options. METHODS A literature search using PubMed and the MEDLINE subengine was completed using the terms "cerebral venous thrombosis," "stroke," and "imaging." Studies reporting on the workup, imaging characteristics, clinical history, and management of patients with CVT were included. RESULTS The presentation of CVT is often non-specific and requires a high index of clinical suspicion. Signs of CVT on NECT can be divided into indirect signs (edema, parenchymal hemorrhage, subarachnoid hemorrhage, and rarely subdural hematomas) and less commonly direct signs (visualization of dense thrombus within a vein or within the cerebral venous sinuses). Confirmation is performed with CTV, directly demonstrating the thrombus as a filling defect, or MRI/MRV, which also provides superior characterization of parenchymal abnormalities. General pitfalls and anatomic variants will also be discussed. Lastly, endovascular management options including thrombolysis and mechanical thrombectomy are discussed. CONCLUSIONS CVT is a relatively uncommon phenomenon and frequently overlooked at initial presentation. Familiarity with imaging features and diagnostic work-up of CVT will help in providing timely diagnosis and therapy which can significantly improve outcome and diminish the risk of acute and long-term complications, optimizing patient care.
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Affiliation(s)
- Adam A Dmytriw
- Department of Medical Imaging, University of Toronto, 263 McCaul St, 4th Floor, Toronto, ON, M5T 1W7, Canada.
| | - Jin Soo A Song
- Department of Medical Imaging, University of Toronto, 263 McCaul St, 4th Floor, Toronto, ON, M5T 1W7, Canada
| | - Eugene Yu
- Department of Medical Imaging, University of Toronto, 263 McCaul St, 4th Floor, Toronto, ON, M5T 1W7, Canada
| | - Colin S Poon
- Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA
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180
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Haller S, Vernooij MW, Kuijer JPA, Larsson EM, Jäger HR, Barkhof F. Cerebral Microbleeds: Imaging and Clinical Significance. Radiology 2018; 287:11-28. [PMID: 29558307 DOI: 10.1148/radiol.2018170803] [Citation(s) in RCA: 182] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Cerebral microbleeds (CMBs), also referred to as microhemorrhages, appear on magnetic resonance (MR) images as hypointense foci notably at T2*-weighted or susceptibility-weighted (SW) imaging. CMBs are detected with increasing frequency because of the more widespread use of high magnetic field strength and of newer dedicated MR imaging techniques such as three-dimensional gradient-echo T2*-weighted and SW imaging. The imaging appearance of CMBs is mainly because of changes in local magnetic susceptibility and reflects the pathologic iron accumulation, most often in perivascular macrophages, because of vasculopathy. CMBs are depicted with a true-positive rate of 48%-89% at 1.5 T or 3.0 T and T2*-weighted or SW imaging across a wide range of diseases. False-positive "mimics" of CMBs occur at a rate of 11%-24% and include microdissections, microaneurysms, and microcalcifications; the latter can be differentiated by using phase images. Compared with postmortem histopathologic analysis, at least half of CMBs are missed with premortem clinical MR imaging. In general, CMB detection rate increases with field strength, with the use of three-dimensional sequences, and with postprocessing methods that use local perturbations of the MR phase to enhance T2* contrast. Because of the more widespread availability of high-field-strength MR imaging systems and growing use of SW imaging, CMBs are increasingly recognized in normal aging, and are even more common in various disorders such as Alzheimer dementia, cerebral amyloid angiopathy, stroke, and trauma. Rare causes include endocarditis, cerebral autosomal dominant arteriopathy with subcortical infarcts, leukoencephalopathy, and radiation therapy. The presence of CMBs in patients with stroke is increasingly recognized as a marker of worse outcome. Finally, guidelines for adjustment of anticoagulant therapy in patients with CMBs are under development. © RSNA, 2018.
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Affiliation(s)
- Sven Haller
- From the Affidea Centre de Diagnostic Radiologique de Carouge (CDRC), Geneva, Switzerland (S.H.); Faculty of Medicine, University of Geneva, Geneva, Switzerland (S.H.); Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H., E.M.L.); Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany (S.H.); Department of Radiology and Nuclear Medicine and Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (M.W.V.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands (J.P.A.K., F.B.); Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, England (H.R.J., F.B.)
| | - Meike W Vernooij
- From the Affidea Centre de Diagnostic Radiologique de Carouge (CDRC), Geneva, Switzerland (S.H.); Faculty of Medicine, University of Geneva, Geneva, Switzerland (S.H.); Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H., E.M.L.); Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany (S.H.); Department of Radiology and Nuclear Medicine and Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (M.W.V.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands (J.P.A.K., F.B.); Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, England (H.R.J., F.B.)
| | - Joost P A Kuijer
- From the Affidea Centre de Diagnostic Radiologique de Carouge (CDRC), Geneva, Switzerland (S.H.); Faculty of Medicine, University of Geneva, Geneva, Switzerland (S.H.); Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H., E.M.L.); Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany (S.H.); Department of Radiology and Nuclear Medicine and Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (M.W.V.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands (J.P.A.K., F.B.); Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, England (H.R.J., F.B.)
| | - Elna-Marie Larsson
- From the Affidea Centre de Diagnostic Radiologique de Carouge (CDRC), Geneva, Switzerland (S.H.); Faculty of Medicine, University of Geneva, Geneva, Switzerland (S.H.); Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H., E.M.L.); Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany (S.H.); Department of Radiology and Nuclear Medicine and Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (M.W.V.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands (J.P.A.K., F.B.); Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, England (H.R.J., F.B.)
| | - Hans Rolf Jäger
- From the Affidea Centre de Diagnostic Radiologique de Carouge (CDRC), Geneva, Switzerland (S.H.); Faculty of Medicine, University of Geneva, Geneva, Switzerland (S.H.); Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H., E.M.L.); Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany (S.H.); Department of Radiology and Nuclear Medicine and Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (M.W.V.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands (J.P.A.K., F.B.); Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, England (H.R.J., F.B.)
| | - Frederik Barkhof
- From the Affidea Centre de Diagnostic Radiologique de Carouge (CDRC), Geneva, Switzerland (S.H.); Faculty of Medicine, University of Geneva, Geneva, Switzerland (S.H.); Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H., E.M.L.); Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany (S.H.); Department of Radiology and Nuclear Medicine and Department of Epidemiology, Erasmus Medical Center, Rotterdam, the Netherlands (M.W.V.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, the Netherlands (J.P.A.K., F.B.); Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, England (H.R.J., F.B.)
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Duan Y, Xu Z, Li H, Cai X, Chang C, Yang B. Prominent deep medullary veins: a predictive biomarker for stroke risk from transient ischemic attack? Acta Radiol 2018; 59:606-611. [PMID: 28814097 DOI: 10.1177/0284185117726813] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Deep medullary veins (DMVs) are a biomarker of severity and prognosis in patients with acute cerebral infarction. However, their clinical significance remains unclear in patients with transient ischemic attack (TIA). Purpose To determine whether prominent deep medullary veins (PDMVs) are a predictive biomarker for stroke risk after TIA. Material and Methods Clinical and imaging data of 49 patients with TIA and 49 sex- and age-matched controls were studied. PDMVs were defined as DMVs with a score of 3 (TDMVs) or asymmetric DMVs (ADMVs), and the relationship between PDMVs and clinical features was analyzed. The DMV score based on susceptibility weighted imaging (SWI) ranged from 0 (not visible) to 3 (very prominent) and was calculated for both hemispheres separately. A different score in each hemisphere was defined as ADMVs and an equal score was defined as symmetric DMVs. The asymmetry and score of DMVs were compared between the two groups and with respect to the time from TIA onset to imaging analysis. Results Agreement between neuroradiologists for the DMV asymmetry/score on SWI was excellent. The frequency of ADMVs and TDMVs was significantly higher in patients with TIA than controls ( P < 0.05). The patients showed no correlation between the time from TIA onset to imaging and the DMV asymmetry/score ( P > 0.05); PDMVs were not correlated with age, blood pressure, or diabetes. However, PDMVs were associated with the ABCD2 score (≥4), clinical symptoms, and duration of TIA (≥10 min). Conclusion Prominent deep medullary veins is a predictive biomarker for the risk of stroke in many patients having suffered from TIA.
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Affiliation(s)
- Yang Duan
- Department of Radiology, General Hospital of Shenyang Military Area Command, Shenyang, PR China
| | - Zhihua Xu
- Jinzhou Medical University, General Hospital of Shenyang Military Area Command Training Base for Graduate, Shenyang, PR China
| | - Hongyi Li
- Department of Radiology, General Hospital of Shenyang Military Area Command, Shenyang, PR China
| | - Xiaonan Cai
- Dalian Medical University, General Hospital of Shenyang Military Area Command Training Base for Graduate, Shenyang, PR China
| | - Cancan Chang
- Department of Radiology, General Hospital of Shenyang Military Area Command, Shenyang, PR China
| | - Benqiang Yang
- Department of Radiology, General Hospital of Shenyang Military Area Command, Shenyang, PR China
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182
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Ozbek D, Ozturk Tan O, Ekinci G, Midi I. Risk of hemorrhage in ischemic stroke and its relationship with cerebral microbleeds. Clin Neurol Neurosurg 2018; 168:112-117. [DOI: 10.1016/j.clineuro.2018.03.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 02/26/2018] [Accepted: 03/06/2018] [Indexed: 11/25/2022]
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183
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Sato R, Shirai T, Taniguchi Y, Murase T, Bito Y, Soutome Y, Ochi H. Susceptibility difference weighted imaging in vertical-field MRI. Radiol Phys Technol 2018; 11:255-261. [PMID: 29700796 DOI: 10.1007/s12194-018-0458-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/13/2018] [Accepted: 04/17/2018] [Indexed: 12/30/2022]
Abstract
To realize susceptibility-weighted imaging in vertical-field magnetic resonance imaging (MRI), we developed an image-processing method called "susceptibility difference weighted imaging" (SDWI). In SDWI, contrasts are enhanced using a susceptibility map calculated by using a weighted least-square algorithm with a small iteration number. Experiments were performed on human volunteers to compare image contrast obtained from the conventional method (SWI) and SDWI. In horizontal-field MRI, SDWI results show that veins and deep-gray-matter nuclei were visualized as well as those with SWI. In vertical-field MRI, SDWI visualized veins and deep-gray-matter nuclei without severe streaking artifacts, while SWI did not. In our experiments, the time taken to calculate the susceptibility map in SDWI was less than 10 s. The results indicate that susceptibility-weighted imaging is feasible in vertical-field MRI using SDWI.
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Affiliation(s)
- Ryota Sato
- Research and Development Group, Hitachi Ltd., 1-280, Higashi-Koigakubo, Kokubunji-shi, Tokyo, 185-8601, Japan.
| | - Toru Shirai
- Research and Development Group, Hitachi Ltd., 1-280, Higashi-Koigakubo, Kokubunji-shi, Tokyo, 185-8601, Japan
| | - Yo Taniguchi
- Research and Development Group, Hitachi Ltd., 1-280, Higashi-Koigakubo, Kokubunji-shi, Tokyo, 185-8601, Japan
| | - Takenori Murase
- Healthcare Business Unit, Hitachi, Ltd., Ueno East Tower, 2-16-1, Higashi-Ueno, Taito-ku, Tokyo, 110-0015, Japan
| | - Yoshitaka Bito
- Healthcare Business Unit, Hitachi, Ltd., Ueno East Tower, 2-16-1, Higashi-Ueno, Taito-ku, Tokyo, 110-0015, Japan
| | - Yoshihisa Soutome
- Research and Development Group, Hitachi Ltd., 1-280, Higashi-Koigakubo, Kokubunji-shi, Tokyo, 185-8601, Japan
| | - Hisaaki Ochi
- Research and Development Group, Hitachi Ltd., 1-280, Higashi-Koigakubo, Kokubunji-shi, Tokyo, 185-8601, Japan
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Halefoglu AM, Yousem DM. Susceptibility weighted imaging: Clinical applications and future directions. World J Radiol 2018; 10:30-45. [PMID: 29849962 PMCID: PMC5971274 DOI: 10.4329/wjr.v10.i4.30] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 04/08/2018] [Accepted: 04/20/2018] [Indexed: 02/06/2023] Open
Abstract
Susceptibility weighted imaging (SWI) is a recently developed magnetic resonance imaging (MRI) technique that is increasingly being used to narrow the differential diagnosis of many neurologic disorders. It exploits the magnetic susceptibility differences of various compounds including deoxygenated blood, blood products, iron and calcium, thus enabling a new source of contrast in MR. In this review, we illustrate its basic clinical applications in neuroimaging. SWI is based on a fully velocity-compensated, high-resolution, three dimensional gradient-echo sequence using magnitude and phase images either separately or in combination with each other, in order to characterize brain tissue. SWI is particularly useful in the setting of trauma and acute neurologic presentations suggestive of stroke, but can also characterize occult low-flow vascular malformations, cerebral microbleeds, intracranial calcifications, neurodegenerative diseases and brain tumors. Furthermore, advanced MRI post-processing technique with quantitative susceptibility mapping, enables detailed anatomical differentiation based on quantification of brain iron from SWI raw data.
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Affiliation(s)
- Ahmet Mesrur Halefoglu
- Department of Radiology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul 34371, Turkey
| | - David Mark Yousem
- Division of Neuroradiology, Department of Radiology, Johns Hopkins Medical Institution, Baltimore, MI 21287, United States
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185
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Performance of Magnetic Resonance Susceptibility-Weighted Imaging for Detection of Calcifications in Patients With Hepatic Echinococcosis. J Comput Assist Tomogr 2018; 42:211-215. [PMID: 29189399 DOI: 10.1097/rct.0000000000000687] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE We evaluated the performance of susceptibility-weighted imaging (SWI) for identification of hepatic calcifications in alveolar echinococcosis and cystic echinococcosis. METHODS The SWI images of 58 lesions in 40 patients (age, 49 ± 14 y) with alveolar echinococcosis (n = 22) or cystic echinococcosis (n = 18) were reviewed for calcifications. First, calcifications were suggested by visual assessment. Second, ratios of minimum intralesional intensity and mean lumbar muscle intensity were recorded. Computed tomography (CT) served as the criterion standard. RESULTS Thirty-seven lesions showed calcifications on CT. Susceptibility-weighted imaging provided a sensitivity of 89.2% (95% confidence interval [CI], 50.1-75.7) and a specificity of 57.1% (95% CI, 34.4-77.4) for calcifications detected by visual assessment. Receiver operating characteristic curves demonstrated a sensitivity of 67.6% and a specificity of 85.0% for an intensity ratio of 0.61. A specificity of 100% (95% CI, 80.8-100) and a sensitivity of 84.5% (95% CI, 67.3-93.2) were achieved by SWI for calcifications with a density greater than 184 HU in CT. CONCLUSIONS Identification of hepatic calcifications is possible with SWI. Susceptibility-weighted imaging offers the potential to reduce the need for of CT imaging for evaluation of echinococcosis.
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186
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Chen Y, Liu S, Buch S, Hu J, Kang Y, Haacke EM. An interleaved sequence for simultaneous magnetic resonance angiography (MRA), susceptibility weighted imaging (SWI) and quantitative susceptibility mapping (QSM). Magn Reson Imaging 2018; 47:1-6. [DOI: 10.1016/j.mri.2017.11.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/01/2017] [Accepted: 11/13/2017] [Indexed: 12/14/2022]
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187
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Li W, Wang X, Wei X, Wang M. Susceptibility-weighted and diffusion kurtosis imaging to evaluate encephalomalacia with epilepsy after traumatic brain injury. Ann Clin Transl Neurol 2018; 5:552-558. [PMID: 29761118 PMCID: PMC5945961 DOI: 10.1002/acn3.552] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 02/16/2018] [Accepted: 02/17/2018] [Indexed: 12/31/2022] Open
Abstract
Objective Encephalomalacia after traumatic brain injury (TBI) is one of the factors leading to epilepsy. In this study, magnetic resonance imaging (MRI) was used to explore the brain image features of epilepsy after traumatic encephalomalacia, and to provide objective evidence for predicting the possible occurrence of epilepsy after traumatic encephalomalacia. Methods Two‐hundred‐fifty‐two patients with traumatic encephalomalacia were prospectively enrolled in the study. All patients underwent MRI after discharge from the hospital. At the 1‐year follow‐up, participants were divided into epilepsy and nonepilepsy groups. All participants underwent MRI including conventional imaging, susceptibility‐weighted imaging (SWI), and diffusion kurtosis imaging (DKI). The lesion volume, iron deposition, mean diffusion (MD), and mean kurtosis (MK) around the lesions were calculated for each group and compared using t‐tests. P values < 0.05 were considered statistically significant. Results Sixty patients with epilepsy and 91 without epilepsy were reported. There were no significant differences in Glasgow Coma Scale (GCS), lesion volume, encephalomalacia, or MD values between the two groups. Iron deposition was significantly higher in the epilepsy group (P < 0.05). The MK values were significantly different (P < 0.05). Interpretation Advanced MRI is an important means of evaluating risk of developing epilepsy at 1 year due to encephalomalacia in patients with TBI. SWI and DKI could be used to assess the microstructural changes around the encephalomalacia, and therefore be used to evaluate risk of developing epilepsy at 1 year.
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Affiliation(s)
- Wenbin Li
- Department of Radiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China.,Imaging Center Kashgar Prefecture Second People's Hospital Kashgar 844000 Xinjiang China
| | - Xuan Wang
- Department of Radiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China
| | - Xiaoer Wei
- Department of Radiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China
| | - Mingliang Wang
- Department of Radiology Shanghai Jiao Tong University Affiliated Sixth People's Hospital Shanghai 200233 China
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188
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Dou S, Bai Y, Shandil A, Ding D, Shi D, Haacke EM, Wang M. Detecting prostate cancer and prostatic calcifications using advanced magnetic resonance imaging. Asian J Androl 2018; 19:439-443. [PMID: 27004542 PMCID: PMC5507089 DOI: 10.4103/1008-682x.177840] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Prostate cancer and prostatic calcifications have a high incidence in elderly men. We aimed to investigate the diagnostic capabilities of susceptibility-weighted imaging in detecting prostate cancer and prostatic calcifications. A total number of 156 men, including 34 with prostate cancer and 122 with benign prostate were enrolled in this study. Computed tomography, conventional magnetic resonance imaging, diffusion-weighted imaging, and susceptibility-weighted imaging were performed on all the patients. One hundred and twelve prostatic calcifications were detected in 87 patients. The sensitivities and specificities of the conventional magnetic resonance imaging, apparent diffusion coefficient, and susceptibility-filtered phase images in detecting prostate cancer and prostatic calcifications were calculated. McNemar's Chi-square test was used to compare the differences in sensitivities and specificities between the techniques. The results showed that the sensitivity and specificity of susceptibility-filtered phase images in detecting prostatic cancer were greater than that of conventional magnetic resonance imaging and apparent diffusion coefficient (P < 0.05). In addition, the sensitivity and specificity of susceptibility-filtered phase images in detecting prostatic calcifications were comparable to that of computed tomography and greater than that of conventional magnetic resonance imaging and apparent diffusion coefficient (P < 0.05). Given the high incidence of susceptibility-weighted imaging (SWI) abnormality in prostate cancer, we conclude that susceptibility-weighted imaging is more sensitive and specific than conventional magnetic resonance imaging, diffusion-weighted imaging, and computed tomography in detecting prostate cancer. Furthermore, susceptibility-weighted imaging can identify prostatic calcifications similar to computed tomography, and it is much better than conventional magnetic resonance imaging and diffusion-weighted imaging.
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Affiliation(s)
- Shewei Dou
- Department of Radiology, Henan Provincial People's Hospital and The People's Hospital of Zhengzhou University, Zhengzhou 450003, Henan, China
| | - Yan Bai
- Department of Radiology, Henan Provincial People's Hospital and The People's Hospital of Zhengzhou University, Zhengzhou 450003, Henan, China
| | - Ankit Shandil
- Department of Postgraduate Education, School of International Education, Zhengzhou University, Zhengzhou 450001, Henan, China
| | - Degang Ding
- Department of Urology, Henan Provincial People's Hospital and The People's Hospital of Zhengzhou University, Zhengzhou 450003, Henan, China
| | - Dapeng Shi
- Department of Radiology, Henan Provincial People's Hospital and The People's Hospital of Zhengzhou University, Zhengzhou 450003, Henan, China
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit 48202, MI, USA.,Department of Administration, Magnetic Resonance Innovations Inc., Detroit 48202, USA
| | - Meiyun Wang
- Department of Radiology, Henan Provincial People's Hospital and The People's Hospital of Zhengzhou University, Zhengzhou 450003, Henan, China
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189
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Neu MA, Tanyildizi Y, Wingerter A, Henninger N, El Malki K, Alt F, Doerr B, Schmidberger H, Stockinger M, Wagner W, Keweloh S, Brockmann MA, Russo A, Faber J. Susceptibility-weighted magnetic resonance imaging of cerebrovascular sequelae after radiotherapy for pediatric brain tumors. Radiother Oncol 2018; 127:280-286. [PMID: 29605477 DOI: 10.1016/j.radonc.2018.03.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 03/01/2018] [Accepted: 03/13/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND PURPOSE Due to sensitive neuroimaging techniques, cerebrovascular complications such as cerebral microbleeds (CMB) and cerebral cavernous malformations (CCM) are increasingly recognized as considerable late effects after treatment for pediatric brain tumor. The aim of this study was to analyze CMB in a cohort of patients after cranial irradiation therapy for medulloblastoma or other pediatric brain tumors using susceptibility-weighted magnetic resonance imaging (SWI). MATERIALS AND METHODS Forty former pediatric brain tumor patients were enrolled in this prospective cross-sectional study and examined by cranial MRI including SWI sequences. Cerebral microbleeds, clinical symptoms and disability were evaluated. RESULTS Thirty-six (90%) of the examined individuals (mean follow-up age 22.2 y; mean follow-up time 13.5 y) were affected by CMB. Longer follow-up time and higher craniospinal irradiation doses correlated with higher total lesion count (p < 0.01). Thirteen patients (32.5%) presented with clinical symptoms. Individuals with CMB were more severely disabled than patients without CMB (p < 0.05). CONCLUSIONS Cerebrovascular sequelae occur frequently after treatment for pediatric brain tumor. In this study, a remarkable part of pediatric brain tumor patients presents with CMB. As a sign of vascular damage, they can cause clinical symptoms and may correspond to neurocognitive decline. Further studies are needed to standardize MRI protocols and to improve quality of long-term follow-up.
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Affiliation(s)
- Marie A Neu
- Department of Pediatric Hematology/Oncology/Hemostaseology, University Medical Center Mainz, Germany
| | | | - Arthur Wingerter
- Department of Pediatric Hematology/Oncology/Hemostaseology, University Medical Center Mainz, Germany
| | - Nicole Henninger
- Department of Pediatric Hematology/Oncology/Hemostaseology, University Medical Center Mainz, Germany
| | - Khalifa El Malki
- Department of Pediatric Hematology/Oncology/Hemostaseology, University Medical Center Mainz, Germany
| | - Francesca Alt
- Department of Pediatric Hematology/Oncology/Hemostaseology, University Medical Center Mainz, Germany
| | - Barbara Doerr
- Department of Pediatric Hematology/Oncology/Hemostaseology, University Medical Center Mainz, Germany
| | - Heinz Schmidberger
- Department of Radiation Oncology and Radiation Therapy, University Medical Center Mainz, Germany
| | - Marcus Stockinger
- Department of Radiation Oncology and Radiation Therapy, University Medical Center Mainz, Germany
| | - Wolfgang Wagner
- Division of Pediatric Neurosurgery, Department of Neurosurgery, University Medical Center Mainz, Germany
| | - Stefanie Keweloh
- Department of Neuroradiology, University Medical Center Mainz, Germany
| | - Marc A Brockmann
- Department of Neuroradiology, University Medical Center Mainz, Germany
| | - Alexandra Russo
- Department of Pediatric Hematology/Oncology/Hemostaseology, University Medical Center Mainz, Germany
| | - Joerg Faber
- Department of Pediatric Hematology/Oncology/Hemostaseology, University Medical Center Mainz, Germany.
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190
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Luo S, Yang L, Luo Y. Susceptibility-weighted imaging predicts infarct size and early-stage clinical prognosis in acute ischemic stroke. Neurol Sci 2018; 39:1049-1055. [PMID: 29557515 DOI: 10.1007/s10072-018-3324-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 03/13/2018] [Indexed: 11/30/2022]
Abstract
Susceptibility-weighted imaging (SWI) is a non-invasive technique that can reveal venous structures and iron in the brain. This retrospective study evaluated SWI, relative to other imaging techniques, for determining cerebral infarct size and early-stage clinical prognosis in patients with acute ischemic stroke. Within 3 days after onset, 22 patients with acute ischemic stroke underwent SWI, diffusion-weighted imaging (DWI), perfusion-weighted imaging (PWI), fluid-attenuated inversion recovery (FLAIR), and magnetic resonance angiography (MRA). At least 7 days after onset, the patients also underwent cranial FLAIR or computed tomography (CT). The severity of neurological damage was adjudged with NIHSS (National Institutes of Health Stroke Scale) scores. The imaged cranial lesions were evaluated according to ASPECTS (Alberta Stroke Program Early CT Score). The SWI-ASPECTS significantly correlated with mean transit time (MTT)-ASPECTS (Spearman's test, r = 0.662, P = 0.001) in evaluating ischemic penumbra and significantly correlated with the FLAIR and CT-ASPECTS (Spearman's test, r = 0.765, P < 0.001) in predicting infarct size. SWI is feasible for the early evaluation of cerebral infarct size and clinical prognosis of patients with acute cerebral infarction. SWI is a useful predictor of early infarct growth and early-stage outcome.
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Affiliation(s)
- Song Luo
- Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, China.
| | - Lijuan Yang
- Department of Pediatrics, The First Affiliated Hospital of Bengbu Medical College, Bengbu, 233004, China
| | - Yanfei Luo
- Department of Urology, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, 233000, China
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191
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Benson JC, Cervantes G, Baron TR, Tyan AE, Flanagan S, Lucato LT, McKinney AM, Ott F. Imaging features of neurotoxoplasmosis: A multiparametric approach, with emphasis on susceptibility-weighted imaging. Eur J Radiol Open 2018; 5:45-51. [PMID: 29719858 PMCID: PMC5926851 DOI: 10.1016/j.ejro.2018.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/13/2018] [Accepted: 03/13/2018] [Indexed: 01/01/2023] Open
Abstract
Background Neurotoxoplasmosis is a common opportunistic infection in HIV/AIDS patients. Imaging identification of neurotoxoplasmosis assists in timely treatment. Purpose To delineate the frequency of imaging abnormalities in patients with neurotoxoplasmosis on different MR sequences with a particular focus on SWI, and NCCT. Material and methods The PACS database was retroactively searched over a 5-year period for patients with neurotoxoplasmosis who underwent MRI with SWI. Included patients had imaging features of neurotoxoplasmosis based on consensus review by two neuroradiologists, a clinical diagnosis of neurotoxoplasmosis at the time of MRI, and diagnostic confirmation based on positive serum or CSF serology or histopathology; 15 patients were included. The number of abnormal foci with restricted diffusion, increased FLAIR signal, intrinsic T1 hyperintensity, abnormal enhancement (CE-T1WI), and intrinsic hyperdensity on CT were recorded. Results Intralesional susceptibility signal (ISS) foci on SWI were observed in 93.3% of patients with neurotoxoplasmosis (mean size 5.2 ± 3.8 mm). The average number of ISS foci was 3.9 per patient; 3/15 (20.0%) had a single ISS. Amongst other MR sequences, hyperintense FLAIR foci were the most common abnormalities observed (12.4 lesions/patient), followed by enhancing foci (8.2 lesions/patient), foci of restricted diffusion (7.1 lesions/patient), and intrinsic T1 hyperintense foci (3.4 lesions/patient). Abnormalities were least frequently observed on NCCT: abnormalities were identified in 5/15 (33.3%) patients, at a rate of 0.4 lesions/patient. Conclusion ISS foci are present in the vast majority of neurotoxoplasmosis patients, likely representing hemorrhage. The incidence and frequency of other abnormal foci are highest on FLAIR, and lowest on NCCT.
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Affiliation(s)
- John C Benson
- University of Minnesota Medical Center, Department of Radiology, Minneapolis, MN USA
| | - Gustavo Cervantes
- Marcelino Campagnat Hospital, Department of Radiology, Division of Neuroradiology, Curitiba, Brazil
| | - Thomas R Baron
- University of Minnesota Medical Center, Department of Radiology, Minneapolis, MN USA
| | - Andrew E Tyan
- Johns Hopkins, Department of Radiology, Baltimore, MD, USA
| | - Siobhan Flanagan
- University of Minnesota Medical Center, Department of Radiology, Minneapolis, MN USA
| | - Leandro T Lucato
- University of Sao Paulo, Department of Neuroradiology, Sao Paulo, SP, Brazil
| | - Alexander M McKinney
- University of Minnesota Medical Center, Department of Radiology, Minneapolis, MN USA
| | - Frederick Ott
- University of Minnesota Medical Center, Department of Radiology, Minneapolis, MN USA
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192
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Assessment of cerebral microbleeds by susceptibility-weighted imaging at 3T in patients with end-stage organ failure. Radiol Med 2018; 123:441-448. [PMID: 29455423 DOI: 10.1007/s11547-018-0863-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 02/07/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE Cerebral microbleeds (CMBs) are small rounded lesions representing cerebral hemosiderin deposits surrounded by macrophages that results from previous microhemorrhages. The aim of this study was to review the distribution of cerebral microbleeds in patients with end-stage organ failure and their association with specific end-stage organ failure risk factors. MATERIALS AND METHODS Between August 2015 and June 2017, we evaluated 15 patients, 9 males, and 6 females, (mean age 65.5 years). Patients population was subdivided into three groups according to the organ failure: (a) chronic kidney failure (n = 8), (b) restrictive cardiomyopathy undergoing heart transplantation (n = 1), and (c) end-stage liver failure undergoing liver transplantation (n = 6). The MR exams were performed on a 3T MR unit and the SWI sequence was used for the detection of CMBs. CMBs were subdivided in supratentorial lobar distributed, supratentorial non-lobar distributed, and infratentorial distributed. RESULTS A total of 91 microbleeds were observed in 15 patients. Fifty-nine CMBs lesions (64.8%) had supratentorial lobar distribution, 17 CMBs lesions (18.8%) had supratentorial non-lobar distribution and the remaining 15 CMBs lesions (16.4%) were infratentorial distributed. An overall predominance of supratentorial multiple lobar localizations was found in all types of end-stage organ failure. The presence of CMBs was significantly correlated with age, hypertension, and specific end-stage organ failure risk factors (p < 0.001). CONCLUSIONS CMBs are mostly founded in supratentorial lobar localization in end-stage organ failure. The improved detection of CMBs with SWI sequences may contribute to a more accurate identification of patients with cerebral risk factors to prevent complications during or after the organ transplantation.
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193
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Yuan T, Ren G, Quan G, Gao D. Fewer peripheral asymmetrical cortical veins is a predictor of favorable outcome in MCA infarctions with SWI-DWI mismatch. J Magn Reson Imaging 2018; 48:964-970. [PMID: 29424126 DOI: 10.1002/jmri.25965] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 01/20/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Outcome prediction of asymmetrical prominent cortical veins (APCVs) on infarction is still debated and may help in selecting patients for reperfusion treatment. PURPOSE To explore the relationship between fewer peripheral APCVs and the outcome in the patients of acute/subacute middle cerebral artery (MCA) infarctions as well as the relationship between this sign and stenosis of ipsilateral MCA. STUDY TYPE Retrospective case-control study. POPULATION We enrolled 41 patients with MCA acute/subacute infarction. Compared to the low sign of cortical veins of contralateral hemisphere on susceptibility-weighted imaging (SWI), these patients were divided into fewer (n = 28) and prominent APCVs (n = 13) groups. FIELD STRENGTH/SEQUENCE 3.0T conventional stroke sequences, including T1 -weighted imaging, T2 -weighted imaging, fluid-attenuated inversion recovery (FLAIR), diffusion-weighted imaging (DWI) (b = 0 and 1000 s/mm2 ), MR angiography (MRA), and SWI. ASSESSMENT We explored the relationships between fewer peripheral APCVs sign and clinical outcome, as well as the relationship between this sign and the degree of ipsilateral MCA stenosis. STATISTICAL TESTS Fisher's exact analysis, logistical regression, as well as Cohen's kappa coefficient were used for statistical analysis. RESULTS Fewer and prominent peripheral APCVs were detected in 28 (56.10%) and 13 (43.90%) patients. In 28 patients with fewer peripheral APCVs, 23 patients (82.14%) had a favorable outcome (modified Rankin Scale [mRS] ≤2), and five patients (17.76%) had an unfavorable outcome (mRS >2) (P = 0.010). In terms of MCA stenosis, the rate of normal and mild to moderate stenosis of MCA in the fewer APCVs group (82.14%) was higher than that in the prominent APCVs group (23.08%) (P < 0.001). More severe stenosis of ipsilateral MCA was found in patients with prominent APCVs group (76.92%) than that of fewer APCVs group (17.86%). The peripheral APCVs was positively correlated with the degree of MCA stenosis (r = 0.538, P < 0.001). DATA CONCLUSION Fewer peripheral APCVs may suggest a favorable outcome in unilateral MCA infarction. The patency of ipsilateral MCA may correlate to fewer APCVs and favorable outcome. LEVEL OF EVIDENCE 3 Technical Efficacy: Stage 5 J. Magn. Reson. Imaging 2018;48:964-970.
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Affiliation(s)
- Tao Yuan
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guoli Ren
- Department of Medical Imaging, Liaocheng Pepople's Hospital, Liaocheng, China
| | - Guanmin Quan
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Duo Gao
- Department of Medical Imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Useche JN, Bermudez S. Conventional Computed Tomography and Magnetic Resonance in Brain Concussion. Neuroimaging Clin N Am 2018; 28:15-29. [DOI: 10.1016/j.nic.2017.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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195
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Lee WJ, Jung KH, Ryu YJ, Kim JM, Lee ST, Chu K, Kim M, Lee SK, Sohn CH, Roh JK. Impact of stroke mechanism in acute basilar occlusion with reperfusion therapy. Ann Clin Transl Neurol 2018; 5:357-368. [PMID: 29560380 PMCID: PMC5846447 DOI: 10.1002/acn3.536] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 12/13/2017] [Accepted: 12/30/2017] [Indexed: 12/27/2022] Open
Abstract
Objective We aimed to evaluate the impact of underlying mechanism of basilar artery (BA) occlusion on the outcomes after endovascular therapy (EVT) for reperfusion and the outcome factors associated with each mechanism, and to identify radiologic parameters enabling to distinguish the underlying mechanism. Methods From a registry database, 194 consecutive patients with acute BA occlusion who underwent EVT were analyzed. Stroke mechanism, classified into in situ atherosclerotic thrombosis (ISAT) and embolism, clot sign location profiles in pre‐angiography magnetic resonance image (MRI), parameters of angiography and EVT, and reperfusion were assessed. Poor outcome was defined as a modified Rankin‐Scale score at 90 days of 3–6. Results The mean age was 68.8±11.8 years (range 21–92 years) and seventy‐eight (40.2%) were female patients. 102 (52.6%) patients were classified into an embolism mechanism and 92 (47.4%) into an ISAT mechanism. Overall, ISAT mechanism compared with embolism was significantly associated with poor outcomes (P = 0.002), along with the NIHSS scores, reperfusion status, and collateral status. In the embolism group, reperfusion (P = 0.001), NIHSS scores (P < 0.001), and onset‐to‐treatment time (P = 0.030) were significant outcome factors. However, in the ISAT group, baseline collateral status (P = 0.001) and NIHSS scores (P < 0.001) were significant outcome factors. A clot sign at the distal BA segment on pre‐angiography MRI was strongly associated with embolism mechanism (P < 0.001). Interpretation Stroke mechanism has a major influence on outcomes, and outcome predictors differ according to the underlying mechanism in acute BA occlusion with EVT. Clot sign profile on pre‐angiography MRI might be useful to determine the underlying mechanism.
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Affiliation(s)
- Woo-Jin Lee
- Department of Neurology Seoul National University Hospital Seoul South Korea
| | - Keun-Hwa Jung
- Department of Neurology Seoul National University Hospital Seoul South Korea.,Program in Neuroscience Neuroscience Research Institute of SNUMRC College of Medicine Seoul National University Seoul South Korea
| | - Young Jin Ryu
- Department of Radiology Seoul National University Hospital Seoul South Korea
| | - Jeong-Min Kim
- Department of Neurology Chung-Ang University Hospital Seoul South Korea
| | - Soon-Tae Lee
- Department of Neurology Seoul National University Hospital Seoul South Korea.,Program in Neuroscience Neuroscience Research Institute of SNUMRC College of Medicine Seoul National University Seoul South Korea
| | - Kon Chu
- Department of Neurology Seoul National University Hospital Seoul South Korea.,Program in Neuroscience Neuroscience Research Institute of SNUMRC College of Medicine Seoul National University Seoul South Korea
| | - Manho Kim
- Department of Neurology Seoul National University Hospital Seoul South Korea.,Program in Neuroscience Neuroscience Research Institute of SNUMRC College of Medicine Seoul National University Seoul South Korea
| | - Sang Kun Lee
- Department of Neurology Seoul National University Hospital Seoul South Korea.,Program in Neuroscience Neuroscience Research Institute of SNUMRC College of Medicine Seoul National University Seoul South Korea
| | - Chul-Ho Sohn
- Department of Radiology Seoul National University Hospital Seoul South Korea
| | - Jae-Kyu Roh
- Department of Neurology Seoul National University Hospital Seoul South Korea.,Department of Neurology Armed Forces Capital Hospital Sungnam South Korea
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196
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Eisele P, Szabo K, Ebert A, Brueck W, Platten M, Gass A. Spatiotemporal evolution of venous narrowing in acute MS lesions. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2018; 5:e440. [PMID: 29359176 PMCID: PMC5773855 DOI: 10.1212/nxi.0000000000000440] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/06/2017] [Indexed: 01/14/2023]
Abstract
Objective To investigate the spatiotemporal evolution of venous narrowing in newly developing MS lesions in a longitudinal MRI study including susceptibility-weighted images (SWIs). Methods We retrospectively investigated serial MR examinations of 18 patients with MS acquired on a 3T MRI system including SWI for acute contrast-enhancing lesions with at least 1 MRI examination before contrast enhancement. The mean diameter of veins at the time point of contrast enhancement was compared with the mean diameter of veins before and after contrast enhancement. Results A total of 40 acute contrast-enhancing lesions with a corresponding intralesional central vein were included in the study. The mean diameter of intralesional veins at the time of contrast enhancement (0.80 ± 0.12 mm) was smaller than that at before (1.16 ± 0.19 mm) and after contrast enhancement (1.07 ± 0.15 mm; p < 0.001 for all comparisons). Conclusions Our findings contribute to the increasing database of plaque development and evolution. The smaller diameter of intralesional veins on SWI at the time of blood-brain barrier breakdown may reflect morphologic changes because of perivascular inflammation and/or decreased levels of deoxygenated hemoglobin.
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Affiliation(s)
- Philipp Eisele
- Department of Neurology (P.E., K.S., A.E., M.P., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim; and Institute for Neuropathology (W.B.), Universitätsmedizin Göttingen, Germany
| | - Kristina Szabo
- Department of Neurology (P.E., K.S., A.E., M.P., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim; and Institute for Neuropathology (W.B.), Universitätsmedizin Göttingen, Germany
| | - Anne Ebert
- Department of Neurology (P.E., K.S., A.E., M.P., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim; and Institute for Neuropathology (W.B.), Universitätsmedizin Göttingen, Germany
| | - Wolfgang Brueck
- Department of Neurology (P.E., K.S., A.E., M.P., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim; and Institute for Neuropathology (W.B.), Universitätsmedizin Göttingen, Germany
| | - Michael Platten
- Department of Neurology (P.E., K.S., A.E., M.P., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim; and Institute for Neuropathology (W.B.), Universitätsmedizin Göttingen, Germany
| | - Achim Gass
- Department of Neurology (P.E., K.S., A.E., M.P., A.G.), Universitätsmedizin Mannheim, University of Heidelberg, Mannheim; and Institute for Neuropathology (W.B.), Universitätsmedizin Göttingen, Germany
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197
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Bansal M, Sinha VD, Bansal J. Diagnostic and Prognostic Capability of Newer Magnetic Resonance Imaging Brain Sequences in Diffuse Axonal Injury Patient. Asian J Neurosurg 2018; 13:348-356. [PMID: 29682033 PMCID: PMC5898104 DOI: 10.4103/ajns.ajns_229_16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives: Diffuse axonal injury is one of the major causes of unconsciousness, profound neurologic deficits and persistent vegetative state after head trauma. In recent years, MR imaging has been gaining popularity as an adjunctive imaging method in patients with DAI. Our study aims to assess the relative diagnostic and prognostic capability of various MRI sequences. Patients and Methods: Retrospective observational study done in 1 year duration on 30 DAI patients. Clinical assessment done with GCS at admission and GOS at 6 month. MRI Brain FLAIR, DWI, T2*GRE AND SWI sequences taken. DAI grade were evaluated for different MRI sequences. Prognosis was correlated to total number of lesion/locations and DAI grade of patients. Statistical analysis was done using SPSS Statistical software (ver.20.0.0) and XL-Stat and ANOVA one way test, post hoc test (Turkey test) and Chi square test. Result: We studied 30 male patients, mean age 32.57±8.72 ranges. The commonest mode of injury is RTA-80%, fall-16% followed by assault-3.33%. Out of 30 patients, 17 patients (56.67%) had GCS <=8, 13 patients (43.33%) had GCS between 9 and 12 and no patient had a GCS score between 13 and 15. The mean GCS score was 8.47±1.50. At a 6 month follow up, out of a total of 30 patients, 2 patients (6.66%) expired (GOS-1), 3 patients (10%) remained in persistent vegetative state (GOS-2), 11 patients (36.67%) and 10 patients (33.33%) were found to be severely (GOS-3) and moderately (GOS-4) disabled respectively and 4 patients (13.33%) showed good recovery (GOS-5). Mean GOS is 3.37+/-1.06. Newer imaging -SWI able to detects lesion better (diagnosis of DAI) as compared to other older sequences like FLAIR,DWI,T2*GRE. But no statistically significant found between total number of lesion/locations to the outcome and also newer imaging do not change the grade of DAI patients. Conclusion: Although advanced imaging in head injury, SWI helps in diagnosing the diffuse axonal injury more efficiently than other imaging sequences, but it is the grade of patients at admission that predicts the outcome best.
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Affiliation(s)
- Mayank Bansal
- Department of Neurosurgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Virendra Deo Sinha
- Department of Neurosurgery, SMS Medical College, Jaipur, Rajasthan, India
| | - Juhi Bansal
- Department of Radiology, SMS Medical College, Jaipur, Rajasthan, India
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198
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Monti S, Borrelli P, Tedeschi E, Cocozza S, Palma G. RESUME: Turning an SWI acquisition into a fast qMRI protocol. PLoS One 2017; 12:e0189933. [PMID: 29261786 PMCID: PMC5738122 DOI: 10.1371/journal.pone.0189933] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 12/05/2017] [Indexed: 12/26/2022] Open
Abstract
Susceptibility Weighted Imaging (SWI) is a common MRI technique that exploits the magnetic susceptibility differences between the tissues to provide valuable image contrasts, both in research and clinical contexts. However, despite its increased clinical use, SWI is not intrinsically suitable for quantitation purposes. Conversely, quantitative Magnetic Resonance Imaging (qMRI) provides a way to disentangle the sources of common MR image contrasts (e.g. proton density, T1, etc.) and to measure physical parameters intrinsically related to tissue microstructure. Unfortunately, the poor signal-to-noise ratio and resolution, coupled with the long imaging time of most qMRI strategies, have hindered the integration of quantitative imaging into clinical protocols. Here we present the RElaxometry and SUsceptibility Mapping Expedient (RESUME) to show that the standard acquisition leading to a clinical SWI dataset can be easily turned into a thorough qMRI protocol at the cost of a further 50% of the SWI scan time. The R1, R2*, proton density and magnetic susceptibility maps provided by the RESUME scheme alongside the SWI reconstruction exhibit high reproducibility and accuracy, and a submillimeter resolution is proven to be compatible with a total scan time of 7 minutes.
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Affiliation(s)
| | | | - Enrico Tedeschi
- Department of Advanced Biomedical Sciences, University “Federico II”, Naples, Italy
| | - Sirio Cocozza
- Department of Advanced Biomedical Sciences, University “Federico II”, Naples, Italy
| | - Giuseppe Palma
- Institute of Biostructures and Bioimaging, National Research Council, Naples, Italy
- * E-mail:
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199
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Evaluation of vertebral body fractures using susceptibility-weighted magnetic resonance imaging. Eur Radiol 2017; 28:2228-2235. [DOI: 10.1007/s00330-017-5195-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/10/2017] [Accepted: 11/15/2017] [Indexed: 02/08/2023]
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200
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Tsitsopoulos PP, Abu Hamdeh S, Marklund N. Current Opportunities for Clinical Monitoring of Axonal Pathology in Traumatic Brain Injury. Front Neurol 2017; 8:599. [PMID: 29209266 PMCID: PMC5702013 DOI: 10.3389/fneur.2017.00599] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 10/25/2017] [Indexed: 01/14/2023] Open
Abstract
Traumatic brain injury (TBI) is a multidimensional and highly complex disease commonly resulting in widespread injury to axons, due to rapid inertial acceleration/deceleration forces transmitted to the brain during impact. Axonal injury leads to brain network dysfunction, significantly contributing to cognitive and functional impairments frequently observed in TBI survivors. Diffuse axonal injury (DAI) is a clinical entity suggested by impaired level of consciousness and coma on clinical examination and characterized by widespread injury to the hemispheric white matter tracts, the corpus callosum and the brain stem. The clinical course of DAI is commonly unpredictable and it remains a challenging entity with limited therapeutic options, to date. Although axonal integrity may be disrupted at impact, the majority of axonal pathology evolves over time, resulting from delayed activation of complex intracellular biochemical cascades. Activation of these secondary biochemical pathways may lead to axonal transection, named secondary axotomy, and be responsible for the clinical decline of DAI patients. Advances in the neurocritical care of TBI patients have been achieved by refinements in multimodality monitoring for prevention and early detection of secondary injury factors, which can be applied also to DAI. There is an emerging role for biomarkers in blood, cerebrospinal fluid, and interstitial fluid using microdialysis in the evaluation of axonal injury in TBI. These biomarker studies have assessed various axonal and neuroglial markers as well as inflammatory mediators, such as cytokines and chemokines. Moreover, modern neuroimaging can detect subtle or overt DAI/white matter changes in diffuse TBI patients across all injury severities using magnetic resonance spectroscopy, diffusion tensor imaging, and positron emission tomography. Importantly, serial neuroimaging studies provide evidence for evolving axonal injury. Since axonal injury may be a key risk factor for neurodegeneration and dementias at long-term following TBI, the secondary injury processes may require prolonged monitoring. The aim of the present review is to summarize the clinical short- and long-term monitoring possibilities of axonal injury in TBI. Increased knowledge of the underlying pathophysiology achieved by advanced clinical monitoring raises hope for the development of novel treatment strategies for axonal injury in TBI.
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Affiliation(s)
- Parmenion P Tsitsopoulos
- Section of Neurosurgery, Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Hippokratio General Hospital, Aristotle University, Thessaloniki, Greece
| | - Sami Abu Hamdeh
- Section of Neurosurgery, Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Niklas Marklund
- Section of Neurosurgery, Department of Neuroscience, Uppsala University, Uppsala, Sweden.,Department of Clinical Sciences Lund, Neurosurgery, Skåne University Hospital, Lund University, Lund, Sweden
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