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Zerweck L, Pohmann R, Klose U, Martirosian P, Haas P, Ernemann U, Khan N, Roder C, Hauser TK, Hennersdorf F. Evaluation of the contribution of individual arteries to the cerebral blood supply in patients with Moyamoya angiopathy: comparison of vessel-encoded arterial spin labeling and digital subtraction angiography. Neuroradiology 2024; 66:1131-1140. [PMID: 38492021 DOI: 10.1007/s00234-024-03338-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/11/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Vessel-encoded arterial spin labeling (VE-ASL) is able to provide noninvasive information about the contribution of individual arteries to the cerebral perfusion. The aim of this study was to compare VE-ASL to the diagnostic standard digital subtraction angiography (DSA) with respect to its ability to visualize vascular territories. METHODS In total, 20 VE-ASL and DSA data sets of 17 patients with Moyamoya angiopathy with and without revascularization surgery were retrospectively analyzed. Two neuroradiologists independently assessed the agreement between VE-ASL and DSA using a 4-point Likert scale (no- very high agreement). Additionally, grading of the vascular supply of subterritories (A1-A2, M1-M6) on the VE-ASL images and angiograms was performed. The intermodal agreement was calculated for all subterritories in total and for the subdivision into without and after revascularization (direct or indirect bypass). RESULTS There was a very high agreement between the VE-ASL and the DSA data sets (median = 1, modus = 1) with a substantial inter-rater agreement (kw = 0.762 (95% CI 0.561-0.963)). The inter-modality agreement between VE-ASL and DSA in vascular subterritories was almost perfect for all subterritories (k = 0.899 (0.865-0.945)), in the subgroup of direct revascularized subterritories (k = 0.827 (0.738-0.915)), in the subgroup of indirect revascularized subterritories (k = 0.843 (0.683-1.003)), and in the subgroup of never revascularized subterritories (k = 0.958 (0.899-1.017)). CONCLUSION Vessel-encoded ASL seems to be a promising non-invasive method to depict the contributions of individual arteries to the cerebral perfusion before and after revascularization surgery.
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Affiliation(s)
- Leonie Zerweck
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.
| | - Rolf Pohmann
- Magnetic Resonance Center, Max-Planck-Institute for Biological Cybernetics, Tuebingen, Germany
| | - Uwe Klose
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany
| | - Petros Martirosian
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University Hospital Tuebingen, Tuebingen, Germany
| | - Patrick Haas
- Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany
| | - Ulrike Ernemann
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany
| | - Nadia Khan
- Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany
- Moyamoya Center, University Children's Hospital, Zurich, Switzerland
| | - Constantin Roder
- Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany
| | - Till-Karsten Hauser
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany
| | - Florian Hennersdorf
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany
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Xie X, Mo L, Liu P, Liu C, Liu M, Deng Y, Zhang P, Yuan J, Song T, Ma L. Application of 3D-PCASL combined with t-ASL and MRA in the diagnosis of patients with isolated vertigo induced by posterior circulation ischemia. Magn Reson Imaging 2024; 110:78-85. [PMID: 38636674 DOI: 10.1016/j.mri.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVES Isolated vertigo induced by posterior circulation ischemia (PCIV) can further progress into posterior circulation infarction. This study aimed to explore the diagnostic values of three-dimensional pseudo-continuous arterial spin labeling (3D-PCASL) combined with territorial arterial spin labeling (t-ASL) and magnetic resonance angiography (MRA) in visualizing and evaluating PCIV, seeking improved diagnostic tools for clinical guidance. METHODS 28 PCIVs (11 males, 17 females, aged from 55 to 83 years, mean age: 69.68 ± 9.01 years) and 28 healthy controls (HCs, 12 male, 16 female, aged from 56 to 87 years, mean age: 66.75 ± 9.86 years) underwent conventional magnetic resonance imaging (MRI), diffusion-weighted imaging (DWI), MRA, 3D-PCASL, and t-ASL. We compared the incidence of anatomic variants of the posterior circle of Willis in MRA, cerebral blood flow (CBF) and anterior collateral blood flow on postprocessing maps obtained from 3D-PCASL and t-ASL sequence between PCIVs and HCs. Chi-square test and paired t-test were analyzed statistically with SPSS 24.0 software. RESULTS 7 PCIVs (7/28, 25%) and 6 HCs (6/28, 21%) showed fetal posterior cerebral artery (FPCA) on MRA, including 1 HC, and 6 PCIVs with FPCA appeared hypoperfusion. 18 PCIVs (64%) and 2 HCs (7%) showed hypoperfusion in the posterior circulation (PC), including 1 HC and 7 PCIVs displayed anterior circulation collateral flow. Chi-square analyses demonstrated a difference in PC hypoperfusion between PCIVs and HCs, whether in the whole or FPCA-positive group assessment (P < 0.05). Paired t-test showed that the CBF values were significant difference for the bilateral PC asymmetrical perfusion in the PCIVs (P < 0.01). When compared to the bilateral PC symmetrical non-hypoperfusion area in the PCIVs and HCs, the CBF values were not significant (P > 0.05). The CBF values of the PC in PCIVs were lower than in HCs (P < 0.05). The reduction rate in the hypoperfusion side of the bilateral PC asymmetrical perfusion of the PCIVs ranged from 4% to 37%, while the HCs reduction rate was 7.7%. The average PC symmetrical perfusion average reduction rate of the PCIVs was 52.25%, while the HCs reduction rate was 42.75%. CONCLUSION 3D-PCASL is a non-invasive and susceptible method for detecting hypoperfusion in PC, serving as a potential biomarker of PCIV. The suspected hypoperfusion in PC may be attributed to the emergence of FPCA and the manifestation of anterior collateral flow when combining t-ASL and MRA sequences. These findings demonstrated that 3D-PCASL combined with t-ASL and MRA sequences are the potential method to identify PCIV, leading to early diagnosis of PCIV and reducing the risk of progressing into infarction.
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Affiliation(s)
- Xiaotong Xie
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19, Nong Lin Xia Road, Guangzhou, Guangdong Province 510030, People's Republic of China
| | - Lingjiang Mo
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19, Nong Lin Xia Road, Guangzhou, Guangdong Province 510030, People's Republic of China
| | - Peifan Liu
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19, Nong Lin Xia Road, Guangzhou, Guangdong Province 510030, People's Republic of China
| | - Chunxing Liu
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19, Nong Lin Xia Road, Guangzhou, Guangdong Province 510030, People's Republic of China
| | - Mouyuan Liu
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19, Nong Lin Xia Road, Guangzhou, Guangdong Province 510030, People's Republic of China
| | - Yongyan Deng
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19, Nong Lin Xia Road, Guangzhou, Guangdong Province 510030, People's Republic of China
| | - Peina Zhang
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19, Nong Lin Xia Road, Guangzhou, Guangdong Province 510030, People's Republic of China
| | - Jinglei Yuan
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19, Nong Lin Xia Road, Guangzhou, Guangdong Province 510030, People's Republic of China
| | - Ting Song
- Department of Radiology, The Third Affiliated Hospital of Guangzhou Medical University, 63 Duobao Road, Guangzhou, Guangdong Province 510150, People's Republic of China.
| | - Liheng Ma
- Department of Medical Imaging, The First Affiliated Hospital of Guangdong Pharmaceutical University, No.19, Nong Lin Xia Road, Guangzhou, Guangdong Province 510030, People's Republic of China.
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Andre JB, Oztek MA, Anzai Y, Wilson GJ, Mossa-Basha M, Hippe DS, Hoff MN, Cross DJ, Minoshima S. Evaluation of 3-dimensional stereotactic surface projection rendering of arterial spin labeling data in a clinical cohort. J Neuroimaging 2023; 33:933-940. [PMID: 37695098 DOI: 10.1111/jon.13153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 09/12/2023] Open
Abstract
BACKGROUND AND PURPOSE To assess the feasibility of 3-dimensional stereotactic surface projection (3D-SSP) as applied to arterial spin labeling (ASL) in a clinical pilot study. METHODS A retrospective sample of 10 consecutive patients who underwent ASL as part of a clinically indicated MR examination was collected during this pilot study. Five additional subjects with normal cerebral perfusion served as a control group. Following voxel-wise M0-correction, cerebral blood flow (CBF) quantification, and stereotactic anatomic standardization, voxel-wise CBF from an individual's ASL dataset was extracted to a set of predefined surface pixels (3D-SSP). A normal database was created from averaging the extracted CBF datasets of the control group. Patients' datasets were compared individually with the normal database by calculating a Z-score on a pixel-by-pixel basis and were displayed in 3D-SSP views for visual inspection. Independent, two-expert reader assessment, using a 3-point scale, compared standard quantitative CBF images to the 3D-SSP maps. RESULTS Patterns and severities of regionally reduced CBF were identified, by both independent readers, in the 3D-SSP maps. Reader assessment demonstrated preference for 3D-SSP over traditionally displayed standard quantitative CBF images in three of four evaluated imaging metrics (p = .026, .031, and .013, respectively); 3D-SSP maps were never found to be inferior to the standard quantitative CBF images. CONCLUSIONS Three-dimensional SSP maps are feasible in a clinical population and enable quantitative data extraction and localization of perfusion abnormalities by means of stereotactic coordinates in a condensed display. The proposed method is a promising approach for interpreting cerebrovascular pathophysiology.
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Affiliation(s)
- Jalal B Andre
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Murat Alp Oztek
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Yoshimi Anzai
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Gregory J Wilson
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Mahmud Mossa-Basha
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Daniel S Hippe
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Michael N Hoff
- Department of Radiology, University of Washington, Seattle, Washington, USA
| | - Donna J Cross
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
| | - Satoshi Minoshima
- Department of Radiology, University of Utah, Salt Lake City, Utah, USA
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Garcia-Garcia B, Mattern H, Vockert N, Yakupov R, Schreiber F, Spallazzi M, Perosa V, Haghikia A, Speck O, Düzel E, Maass A, Schreiber S. Vessel Distance Mapping: A novel methodology for assessing vascular-induced cognitive resilience. Neuroimage 2023; 274:120094. [PMID: 37028734 DOI: 10.1016/j.neuroimage.2023.120094] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 03/30/2023] [Accepted: 04/04/2023] [Indexed: 04/09/2023] Open
Abstract
The association between cerebral blood supply and cognition has been widely discussed in the recent literature. One focus of this discussion has been the anatomical variability of the circle of Willis, with morphological differences being present in more than half of the general population. While previous studies have attempted to classify these differences and explore their contribution to hippocampal blood supply and cognition, results have been controversial. To disentangle these previously inconsistent findings, we introduce Vessel Distance Mapping (VDM) as a novel methodology for evaluating blood supply, which allows for obtaining vessel pattern metrics with respect to the surrounding structures, extending the previously established binary classification into a continuous spectrum. To accomplish this, we manually segmented hippocampal vessels obtained from high-resolution 7T time-of-flight MR angiographic imaging in older adults with and without cerebral small vessel disease, generating vessel distance maps by computing the distances of each voxel to its nearest vessel. Greater values of VDM-metrics, which reflected higher vessel distances, were associated with poorer cognitive outcomes in subjects affected by vascular pathology, while this relation was not observed in healthy controls. Therefore, a mixed contribution of vessel pattern and vessel density is proposed to confer cognitive resilience, consistent with previous research findings. In conclusion, VDM provides a novel platform, based on a statistically robust and quantitative method of vascular mapping, for addressing a variety of clinical research questions.
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Affiliation(s)
| | - Hendrik Mattern
- German Center for Neurodegenerative Diseases, 39120 Magdeburg, Germany; Biomedical Magnetic Resonance, Otto-von-Guericke-University Magdeburg, 39120 Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), 39106 Magdeburg, Germany
| | - Niklas Vockert
- German Center for Neurodegenerative Diseases, 39120 Magdeburg, Germany
| | - Renat Yakupov
- German Center for Neurodegenerative Diseases, 39120 Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, 39120 Magdeburg, Germany
| | - Frank Schreiber
- German Center for Neurodegenerative Diseases, 39120 Magdeburg, Germany; Department of Neurology, Otto-von-Guericke University, 39120, Magdeburg, Germany
| | - Marco Spallazzi
- Department of Medicine and Surgery, Unit of Neurology, Azienda Ospedalierouniversitaria, 43126 Parma, Italy
| | - Valentina Perosa
- Department of Neurology, Otto-von-Guericke University, 39120, Magdeburg, Germany; J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Aiden Haghikia
- German Center for Neurodegenerative Diseases, 39120 Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), 39106 Magdeburg, Germany; Department of Neurology, Otto-von-Guericke University, 39120, Magdeburg, Germany
| | - Oliver Speck
- German Center for Neurodegenerative Diseases, 39120 Magdeburg, Germany; Biomedical Magnetic Resonance, Otto-von-Guericke-University Magdeburg, 39120 Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), 39106 Magdeburg, Germany; Leibniz Institute for Neurobiology, 39118 Magdeburg, Germany
| | - Emrah Düzel
- German Center for Neurodegenerative Diseases, 39120 Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), 39106 Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke University, 39120 Magdeburg, Germany; Department of Neurology, Otto-von-Guericke University, 39120, Magdeburg, Germany; Institute of Cognitive Neuroscience, University College London, London WCIN 3AZ, UK
| | - Anne Maass
- German Center for Neurodegenerative Diseases, 39120 Magdeburg, Germany
| | - Stefanie Schreiber
- German Center for Neurodegenerative Diseases, 39120 Magdeburg, Germany; Center for Behavioral Brain Sciences (CBBS), 39106 Magdeburg, Germany; Department of Neurology, Otto-von-Guericke University, 39120, Magdeburg, Germany
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Toescu SM, Hales PW, Cooper J, Dyson EW, Mankad K, Clayden JD, Aquilina K, Clark CA. Arterial Spin-Labeling Perfusion Metrics in Pediatric Posterior Fossa Tumor Surgery. AJNR Am J Neuroradiol 2022; 43:1508-1515. [PMID: 36137658 PMCID: PMC9575521 DOI: 10.3174/ajnr.a7637] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 07/27/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND AND PURPOSE Pediatric posterior fossa tumors often present with hydrocephalus; postoperatively, up to 25% of patients develop cerebellar mutism syndrome. Arterial spin-labeling is a noninvasive means of quantifying CBF and bolus arrival time. The aim of this study was to investigate how changes in perfusion metrics in children with posterior fossa tumors are modulated by cerebellar mutism syndrome and hydrocephalus requiring pre-resection CSF diversion. MATERIALS AND METHODS Forty-four patients were prospectively scanned at 3 time points (preoperatively, postoperatively, and at 3-month follow-up) with single- and multi-inflow time arterial spin-labeling sequences. Regional analyses of CBF and bolus arrival time were conducted using coregistered anatomic parcellations. ANOVA and multivariable, linear mixed-effects modeling analysis approaches were used. The study was registered at clinicaltrials.gov (NCT03471026). RESULTS CBF increased after tumor resection and at follow-up scanning (P = .045). Bolus arrival time decreased after tumor resection and at follow-up scanning (P = .018). Bolus arrival time was prolonged (P = .058) following the midline approach, compared with cerebellar hemispheric surgical approaches to posterior fossa tumors. Multivariable linear mixed-effects modeling showed that regional perfusion changes were more pronounced in the 6 children who presented with symptomatic obstructive hydrocephalus requiring pre-resection CSF diversion, with hydrocephalus lowering the baseline mean CBF by 20.5 (standard error, 6.27) mL/100g/min. Children diagnosed with cerebellar mutism syndrome (8/44, 18.2%) had significantly higher CBF at follow-up imaging than those who were not (P = .040), but no differences in pre- or postoperative perfusion parameters were seen. CONCLUSIONS Multi-inflow time arterial spin-labeling shows promise as a noninvasive tool to evaluate cerebral perfusion in the setting of pediatric obstructive hydrocephalus and demonstrates increased CBF following resolution of cerebellar mutism syndrome.
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Affiliation(s)
- S M Toescu
- From the Departments of Neurosurgery (S.M.T., E.W.D., K.A.)
- Developmental Imaging and Biophysics Section (S.M.T., P.W.H., J.D.C.), University College London Great Ormond Street Institute of Child Health, London, UK
| | - P W Hales
- Developmental Imaging and Biophysics Section (S.M.T., P.W.H., J.D.C.), University College London Great Ormond Street Institute of Child Health, London, UK
| | - J Cooper
- Neuroradiology (J.C., K.M., C.A.C.), Great Ormond Street Hospital, London, UK
| | - E W Dyson
- From the Departments of Neurosurgery (S.M.T., E.W.D., K.A.)
| | - K Mankad
- Neuroradiology (J.C., K.M., C.A.C.), Great Ormond Street Hospital, London, UK
| | - J D Clayden
- Developmental Imaging and Biophysics Section (S.M.T., P.W.H., J.D.C.), University College London Great Ormond Street Institute of Child Health, London, UK
| | - K Aquilina
- From the Departments of Neurosurgery (S.M.T., E.W.D., K.A.)
| | - C A Clark
- Neuroradiology (J.C., K.M., C.A.C.), Great Ormond Street Hospital, London, UK
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Rocha NP, Charron O, Colpo GD, Latham LB, Patino JE, Stimming EF, Freeman L, Teixeira AL. Cerebral blood flow is associated with markers of neurodegeneration in Huntington’s disease. Parkinsonism Relat Disord 2022; 102:79-85. [DOI: 10.1016/j.parkreldis.2022.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 07/21/2022] [Accepted: 07/30/2022] [Indexed: 10/16/2022]
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Pineda Sanabria JP, Tolosa Cubillos JM. Accidente cerebrovascular isquémico de la arteria cerebral media. REPERTORIO DE MEDICINA Y CIRUGÍA 2022. [DOI: 10.31260/repertmedcir.01217372.1104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
La segunda causa de muerte a nivel mundial corresponde a los ataques cerebrovasculares (ACV), de los cuales más de dos terceras partes son de origen isquémico. Causan discapacidad a largo plazo por lo que conocer la anatomía de la circulación cerebral y las posibles manifestaciones clínicas del ACV isquémico permite sospechar, diagnosticar y brindar un manejo oportuno y apropiado, reduciendo el impacto en la salud y la calidad de vida del paciente y sus cuidadores. Objetivo: relacionar los últimos hallazgos en la anatomía arterial cerebral, los mecanismos fisiopatológicos y las manifestaciones clínicas del ACV isquémico de la arteria cerebral media (ACM). Materiales y métodos: revisión de la literatura mediante la búsqueda con términos MeSH en la base de datos Medline, incluyendo estudios, ensayos y metaanálisis publicados entre 2000 y 2020 en inglés y español, además de otras referencias para complementar la información. Resultados: se seleccionaron 59 publicaciones, priorizando la de los últimos 5 años y las más relevantes del rango temporal consultado. Conclusiones: son escasos los estudios sobre la presentación clínica de los ACV, lo que sumado a la variabilidad interindividual de la irrigación cerebral, dificulta la determinación clínica de la localización de la lesión dentro del lecho vascular. La reperfusión del área de penumbra isquémica como objetivo terapéutico se justifica por los mecanismos fisiopatológicos de la enfermedad.
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Cui B, Zheng W, Ren S, Chen Z, Wang Z. Differentiation of Cerebellum-Type and Parkinson-Type of Multiple System Atrophy by Using Multimodal MRI Parameters. Front Aging Neurosci 2021; 13:687649. [PMID: 34413766 PMCID: PMC8369927 DOI: 10.3389/fnagi.2021.687649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Recent studies have demonstrated the structural and functional changes in patients with multiple system atrophy (MSA). However, little is known about the different parameter changes of the most vulnerable regions in different types of MSA. In this study, we collected resting-state structure, perfusion, and patients with functional magnetic resonance imaging (fMRI) data of cerebellum-type of MSA (MSA-c) and Parkinson-type of MSA (MSA-p). First, by simultaneously using voxel-based morphology (VBM), arterial spin labeling (ASL), and amplitude of low-frequency fluctuation (ALFF), we analyzed the whole brain differences of structure, perfusion, and functional activation between patients with MSA-c and MSA-p. Second, we explored the relationships among structure, perfusion, function, and the clinical variables in patients with MSA. Finally, we extracted the MRI parameters of a specific region to separate the two groups and search for a sensitive imaging biomarker. As a result, compared with patients with MSA-p type, patients with MSA-c type showed decreased structure atrophy in several cerebella and vermis subregions, reduced perfusion in bilateral cerebellum_4_5 and vermis_4_5, and an decreased ALFF values in the right lingual gyrus (LG) and fusiform (FFG). Subsequent analyses revealed the close correlations among structure, perfusion, function, and clinical variables in both MSA-c and MSA-p. Finally, the receiver operating characteristic (ROC) analysis showed that the regional cerebral blood flow (rCBF) of bilateral cerebellum_4_5/vermis_4_5 could differentiate the two groups at a relatively high accuracy, yielding the sensitivity of 100%, specificity of 79.2%, and the area under the curve (AUC) value of 0.936. These findings have important implications for understanding the underlying neurobiology of different types of MSA and added the new evidence for the disrupted rCBF, structure, and function of MSA, which may provide the potential biomarker for accurately detecting different types of patients with MSA and new ideas for the treatment of different types of MSA in the future.
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Affiliation(s)
- Bin Cui
- Department of Radiology, Aerospace Center Hospital, Beijing, China
| | - Weimin Zheng
- Department of Radiology, Aerospace Center Hospital, Beijing, China
| | - Shan Ren
- Department of Neurology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhigang Chen
- Department of Neurology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhiqun Wang
- Department of Radiology, Aerospace Center Hospital, Beijing, China
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9
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Luciw NJ, Toma S, Goldstein BI, MacIntosh BJ. Correspondence between patterns of cerebral blood flow and structure in adolescents with and without bipolar disorder. J Cereb Blood Flow Metab 2021; 41:1988-1999. [PMID: 33487070 PMCID: PMC8323335 DOI: 10.1177/0271678x21989246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 12/06/2020] [Accepted: 12/23/2020] [Indexed: 11/16/2022]
Abstract
Adolescence is a period of rapid development of the brain's inherent functional and structural networks; however, little is known about the region-to-region organization of adolescent cerebral blood flow (CBF) or its relationship to neuroanatomy. Here, we investigate both the regional covariation of CBF MRI and the covariation of structural MRI, in adolescents with and without bipolar disorder. Bipolar disorder is a disease with increased onset during adolescence, putative vascular underpinnings, and evidence of anomalous CBF and brain structure. In both groups, through hierarchical clustering, we found CBF covariance was principally described by clusters of regions circumscribed to the left hemisphere, right hemisphere, and the inferior brain; these clusters were spatially reminiscent of cerebral vascular territories. CBF covariance was associated with structural covariance in both the healthy group (n = 56; r = 0.20, p < 0.0001) and in the bipolar disorder group (n = 68; r = 0.36, p < 0.0001), and this CBF-structure correspondence was higher in bipolar disorder (p = 0.0028). There was lower CBF covariance in bipolar disorder compared to controls between the left angular gyrus and pre- and post-central gyri. Altogether, CBF covariance revealed distinct brain organization, had modest correspondence to structural covariance, and revealed evidence of differences in bipolar disorder.
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Affiliation(s)
- Nicholas J Luciw
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Simina Toma
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
| | - Benjamin I Goldstein
- Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, Canada
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, Canada
- Departments of Pharmacology and Psychiatry, University of Toronto, Toronto, Canada
| | - Bradley J MacIntosh
- Department of Medical Biophysics, University of Toronto, Toronto, Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
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Józsa TI, Padmos RM, El-Bouri WK, Hoekstra AG, Payne SJ. On the Sensitivity Analysis of Porous Finite Element Models for Cerebral Perfusion Estimation. Ann Biomed Eng 2021; 49:3647-3665. [PMID: 34155569 PMCID: PMC8671295 DOI: 10.1007/s10439-021-02808-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/01/2021] [Indexed: 11/08/2022]
Abstract
Computational physiological models are promising tools to enhance the design of clinical trials and to assist in decision making. Organ-scale haemodynamic models are gaining popularity to evaluate perfusion in a virtual environment both in healthy and diseased patients. Recently, the principles of verification, validation, and uncertainty quantification of such physiological models have been laid down to ensure safe applications of engineering software in the medical device industry. The present study sets out to establish guidelines for the usage of a three-dimensional steady state porous cerebral perfusion model of the human brain following principles detailed in the verification and validation (V&V 40) standard of the American Society of Mechanical Engineers. The model relies on the finite element method and has been developed specifically to estimate how brain perfusion is altered in ischaemic stroke patients before, during, and after treatments. Simulations are compared with exact analytical solutions and a thorough sensitivity analysis is presented covering every numerical and physiological model parameter. The results suggest that such porous models can approximate blood pressure and perfusion distributions reliably even on a coarse grid with first order elements. On the other hand, higher order elements are essential to mitigate errors in volumetric blood flow rate estimation through cortical surface regions. Matching the volumetric flow rate corresponding to major cerebral arteries is identified as a validation milestone. It is found that inlet velocity boundary conditions are hard to obtain and that constant pressure inlet boundary conditions are feasible alternatives. A one-dimensional model is presented which can serve as a computationally inexpensive replacement of the three-dimensional brain model to ease parameter optimisation, sensitivity analyses and uncertainty quantification. The findings of the present study can be generalised to organ-scale porous perfusion models. The results increase the applicability of computational tools regarding treatment development for stroke and other cerebrovascular conditions.
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Affiliation(s)
- T I Józsa
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford, OX1 3PJ, UK.
| | - R M Padmos
- Computational Science Laboratory, Institute for Informatics, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam, 1098 XH, The Netherlands
| | - W K El-Bouri
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford, OX1 3PJ, UK.,Liverpool Centre for Cardiovascular Science, Department of Cardiovascular and Metabolic Medicine, University of Liverpool, Thomas Drive, Liverpool, L14 3PE, UK
| | - A G Hoekstra
- Computational Science Laboratory, Institute for Informatics, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam, 1098 XH, The Netherlands
| | - S J Payne
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford, OX1 3PJ, UK
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11
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Yuan J, Qu J, Lv Z, Wu C, Zhang D, Liu X, Yang B, Liu Y. Assessment of blood supply of the external carotid artery in moyamoya disease using super-selective pseudo-continuous arterial spin labeling technique. Eur Radiol 2021; 31:9287-9295. [PMID: 34021389 DOI: 10.1007/s00330-021-07893-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/23/2021] [Accepted: 03/15/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate the diagnostic accuracy of super-selective pseudo-continuous arterial spin labeling (ss-pCASL) at depicting external carotid artery (ECA) perfusion territory in moyamoya disease (MMD). METHODS In total, 103 patients with MMD who underwent both ss-pCASL and digital subtraction angiography (DSA, the reference standard) were included. There were 3, 184, and 19 normal, preoperative, and postoperative MMD hemispheres, respectively. The ss-pCASL results were interpreted by two different visual inspection criteria: presence or absence and definite or indefinite ECA perfusion territory. The performance of ss-pCASL at depiction of ECA perfusion territory was compared to that of DSA. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. The κ statistic was used to assess intermodality and inter-reader agreement. RESULTS When interpreted as presence or absence, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of ss-pCASL for depicting ECA perfusion territory were 78.3 %, 79.6 %, 92.5 %, 53.4 %, and 78.6 %, respectively, and the intermodality and inter-reader agreement were κ = 0.49 (CI: 0.43 - 0.55, p < 0.01) and 0.71 (CI: 0.66 - 0.76, p < 0.01), respectively. When interpreted as definite or indefinite, the respective values were 61.1%, 100%, 100%, 44.5%, 70.4%, κ = 0.42 (CI: 0.37 - 0.47, p < 0.01), and 0.90 (CI: 0.87 - 0.93, p < 0.01). CONCLUSION ss-pCASL has substantial sensitivity and specificity compared with DSA for depicting the presence versus absence of ECA perfusion territory in MMD. As a noninvasive method in which no ion radiation or contrast medium is needed, ss-pCASL may potentially reduce the need for repeated DSA examination. KEY POINTS • Super-selective pseudo-continuous arterial spin labeling (ss-pCASL) is a noninvasive vessel-selective MR technique to demonstrate perfusion territory of a single cerebral artery. • Compared with digital subtraction angiography, ss-pCASL has substantial sensitivity and specificity for depicting the perfusion territory of the external carotid artery in brain parenchyma in moyamoya disease. • ss-pCASL may potentially reduce the need for repeated DSA examination.
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Affiliation(s)
- Jing Yuan
- Radiology Department, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, People's Republic of China
| | | | - Zheng Lv
- Radiology Department, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, People's Republic of China
| | - Chunxue Wu
- Radiology Department, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, People's Republic of China
| | - Dong Zhang
- Neurosurgery Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xingju Liu
- Neurosurgery Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bao Yang
- Neurosurgery Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yaou Liu
- Radiology Department, Beijing Tiantan Hospital, Capital Medical University, No.119 South Fourth Ring West Road, Fengtai District, Beijing, 100070, People's Republic of China.
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12
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Fernandes JF. Editorial for "Can 3D Pseudo-Continuous Territorial Arterial Spin Labeling Diagnose Unilateral Middle Cerebral Artery Stenosis?". J Magn Reson Imaging 2021; 54:184-185. [PMID: 33974327 DOI: 10.1002/jmri.27660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 04/08/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Joao Filipe Fernandes
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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13
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Kavroulakis E, Simos NJ, Maris TG, Zaganas I, Panagiotakis S, Papadaki E. Evidence of Age-Related Hemodynamic and Functional Connectivity Impairment: A Resting State fMRI Study. Front Neurol 2021; 12:633500. [PMID: 33833727 PMCID: PMC8021915 DOI: 10.3389/fneur.2021.633500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: To assess age-related changes in intrinsic functional brain connectivity and hemodynamics during adulthood in the context of the retrogenesis hypothesis, which states that the rate of age-related changes is higher in late-myelinating (prefrontal, lateral-posterior temporal) cerebrocortical areas as compared to early myelinating (parietal, occipital) regions. In addition, to examine the dependence of age-related changes upon concurrent subclinical depression symptoms which are common even in healthy aging. Methods: Sixty-four healthy adults (28 men) aged 23-79 years (mean 45.0, SD = 18.8 years) were examined. Resting-state functional MRI (rs-fMRI) time series were used to compute voxel-wise intrinsic connectivity contrast (ICC) maps reflecting the strength of functional connectivity between each voxel and the rest of the brain. We further used Time Shift Analysis (TSA) to estimate voxel-wise hemodynamic lead or lag for each of 22 ROIs from the automated anatomical atlas (AAL). Results: Adjusted for depression symptoms, gender and education level, reduced ICC with age was found primarily in frontal, temporal regions, and putamen, whereas the opposite trend was noted in inferior occipital cortices (p < 0.002). With the same covariates, increased hemodynamic lead with advancing age was found in superior frontal cortex and thalamus, with the opposite trend in inferior occipital cortex (p < 0.002). There was also evidence of reduced coupling between voxel-wise intrinsic connectivity and hemodynamics in the inferior parietal cortex. Conclusion: Age-related intrinsic connectivity reductions and hemodynamic changes were demonstrated in several regions-most of them part of DMN and salience networks-while impaired neurovascular coupling was, also, found in parietal regions. Age-related reductions in intrinsic connectivity were greater in anterior as compared to posterior cortices, in line with implications derived from the retrogenesis hypothesis. These effects were affected by self-reported depression symptoms, which also increased with age.
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Affiliation(s)
- Eleftherios Kavroulakis
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, Heraklion, Greece
| | - Nicholas J Simos
- Department of Electrical and Computer Engineering, Technical University of Crete, Chania, Greece.,Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Greece
| | - Thomas G Maris
- Department of Medical Physics, School of Medicine, University of Crete, University Hospital of Heraklion, Heraklion, Greece
| | - Ioannis Zaganas
- Department of Neurology, School of Medicine, University of Crete, University Hospital of Heraklion, Heraklion, Greece
| | - Simeon Panagiotakis
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Greece
| | - Efrosini Papadaki
- Department of Radiology, School of Medicine, University of Crete, University Hospital of Heraklion, Heraklion, Greece.,Computational Bio-Medicine Laboratory, Institute of Computer Science, Foundation for Research and Technology - Hellas, Heraklion, Greece
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14
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Wang X, Dou W, Dong D, Wang X, Chen X, Chen K, Mao H, Guo Y, Zhang C. Can 3D Pseudo-Continuous Territorial Arterial Spin Labeling Effectively Diagnose Patients With Recanalization of Unilateral Middle Cerebral Artery Stenosis? J Magn Reson Imaging 2021; 54:175-183. [PMID: 33615609 DOI: 10.1002/jmri.27560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/29/2021] [Accepted: 02/01/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Unilateral middle cerebral artery (MCA) stenosis, as an independent risk factor for stroke, requires an intervention operation for vessel recanalization. Accurate perfusion measurement is thus essential after the operation. PURPOSE To explore the feasibility of three-dimensional (3D) pseudo-continuous territorial arterial-spin-labeling (tASL) in evaluating MCA recanalization. STUDY TYPE Prospective and longitudinal. SUBJECTS Forty-seven patients with unilateral MCA stenosis or occlusion. FIELD STRENGTH/SEQUENCE A 3.0 T, 3D time-of-flight fast-field-echo magnetic resonance (MR) angiography sequence, spin-echo echo-planar diffusion-weighted imaging sequence, 3D fast-spin-echo pseudo-continuous ASL (pcASL) and tASL sequences. ASSESSMENT All patients underwent MR examination before and after MCA recanalization and scored using the National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) at admission and discharge. An mRS score <2 was defined as a good prognosis. 3D-pcASL and tASL cerebral blood flow (CBF) maps were obtained, and the corresponding Alberta Stroke Program Early CT Score (ASPECTS)-based scores were evaluated. STATISTICAL TESTS The Kolmogorov-Smirnov test, intra-class correlation coefficient, paired t-test, receiver operating characteristic (ROC) curve, and multivariable logistic regression analysis. RESULTS After recanalization, tASL derived absolute CBFs between the affected and contralateral sides were significantly higher than before the operation (mean: 34.3 ± 8.5 mL/100 g/min vs. 40.6 ± 9.2 mL/100 g/min, 42.6 ± 9.8 mL/100 g/min vs. 43.5 ± 9.9 mL/100 g/min, both P < 0.05). In ROC analysis, tASL provided good prognosis (area under ROC curve [AUC] = 0.829; 95% CI: 0.651-1.000, P < 0.05), while pcASL had lower prognostic value (AUC = 0.760; 95% CI: 0.574-0.946, P < 0.05). The NIHSS score before recanalization, pcASL, and tASL-based ASPECTS scores were significantly associated with good clinical outcome (P < 0.05). Multivariable analysis revealed that ASPECTS-based scores of pcASL and tASL before and after surgery were independent predictors of good clinical outcome (all P < 0.05). DATA CONCLUSION: tASL can determine hypoperfusion in the responsible vascular perfusion area and predict clinical outcome. EVIDENCE LEVEL 4 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Xinyu Wang
- Department of Radiology, The First Affiliated Hospital of Shandong First Medical University (Shandong Qianfoshan Hospital), Jinan, Shandong Province, 250014, China.,Shandong First Medical University, Jinan, Shandong Province, 250000, China
| | - Weiqiang Dou
- MR Research, GE Healthcare, Beijing, 10076, China
| | - Dong Dong
- Shandong Qianfoshan Hospital, Cheeloo College of Medicine,Shandong University, Jinan, Shandong Province, 250014, China
| | - Xinyi Wang
- Department of Radiology, The First Affiliated Hospital of Shandong First Medical University (Shandong Qianfoshan Hospital), Jinan, Shandong Province, 250014, China
| | - Xueyu Chen
- Shandong First Medical University, Jinan, Shandong Province, 250000, China
| | - Kunjian Chen
- Shandong First Medical University, Jinan, Shandong Province, 250000, China
| | - Huimin Mao
- Shandong First Medical University, Jinan, Shandong Province, 250000, China
| | - Yu Guo
- Shandong First Medical University, Jinan, Shandong Province, 250000, China
| | - Chao Zhang
- Department of Radiology, The First Affiliated Hospital of Shandong First Medical University (Shandong Qianfoshan Hospital), Jinan, Shandong Province, 250014, China
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15
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Padmos RM, Józsa TI, El-Bouri WK, Konduri PR, Payne SJ, Hoekstra AG. Coupling one-dimensional arterial blood flow to three-dimensional tissue perfusion models for in silico trials of acute ischaemic stroke. Interface Focus 2021; 11:20190125. [PMID: 33335706 PMCID: PMC7739918 DOI: 10.1098/rsfs.2019.0125] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 01/08/2023] Open
Abstract
An acute ischaemic stroke is due to the sudden blockage of an intracranial blood vessel by an embolized thrombus. In the context of setting up in silico trials for the treatment of acute ischaemic stroke, the effect of a stroke on perfusion and metabolism of brain tissue should be modelled to predict final infarcted brain tissue. This requires coupling of blood flow and tissue perfusion models. A one-dimensional intracranial blood flow model and a method to couple this to a brain tissue perfusion model for patient-specific simulations is presented. Image-based patient-specific data on the anatomy of the circle of Willis are combined with literature data and models for vessel anatomy not visible in the images, to create an extended model for each patient from the larger vessels down to the pial surface. The coupling between arterial blood flow and tissue perfusion occurs at the pial surface through the estimation of perfusion territories. The coupling method is able to accurately estimate perfusion territories. Finally, we argue that blood flow can be approximated as steady-state flow at the interface between arterial blood flow and tissue perfusion to reduce the cost of organ-scale simulations.
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Affiliation(s)
- Raymond M. Padmos
- Computational Science Laboratory, Institute for Informatics, Faculty of Science, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
| | - Tamás I. Józsa
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
| | - Wahbi K. El-Bouri
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
| | - Praneeta R. Konduri
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location AMC, 1105 AZ Amsterdam, The Netherlands
- Biomedical Engineering and Physics, Amsterdam UMC, Location AMC, 1105 AZ Amsterdam, The Netherlands
| | - Stephen J. Payne
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
| | - Alfons G. Hoekstra
- Computational Science Laboratory, Institute for Informatics, Faculty of Science, University of Amsterdam, Science Park 904, 1098 XH Amsterdam, The Netherlands
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16
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Józsa TI, Padmos RM, Samuels N, El-Bouri WK, Hoekstra AG, Payne SJ. A porous circulation model of the human brain for in silico clinical trials in ischaemic stroke. Interface Focus 2021; 11:20190127. [PMID: 33343874 PMCID: PMC7739914 DOI: 10.1098/rsfs.2019.0127] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2020] [Indexed: 12/30/2022] Open
Abstract
The advancement of ischaemic stroke treatment relies on resource-intensive experiments and clinical trials. In order to improve ischaemic stroke treatments, such as thrombolysis and thrombectomy, we target the development of computational tools for in silico trials which can partially replace these animal and human experiments with fast simulations. This study proposes a model that will serve as part of a predictive unit within an in silico clinical trial estimating patient outcome as a function of treatment. In particular, the present work aims at the development and evaluation of an organ-scale microcirculation model of the human brain for perfusion prediction. The model relies on a three-compartment porous continuum approach. Firstly, a fast and robust method is established to compute the anisotropic permeability tensors representing arterioles and venules. Secondly, vessel encoded arterial spin labelling magnetic resonance imaging and clustering are employed to create an anatomically accurate mapping between the microcirculation and large arteries by identifying superficial perfusion territories. Thirdly, the parameter space of the problem is reduced by analysing the governing equations and experimental data. Fourthly, a parameter optimization is conducted. Finally, simulations are performed with the tuned model to obtain perfusion maps corresponding to an open and an occluded (ischaemic stroke) scenario. The perfusion map in the occluded vessel scenario shows promising qualitative agreement with computed tomography images of a patient with ischaemic stroke caused by large vessel occlusion. The results highlight that in the case of vessel occlusion (i) identifying perfusion territories is essential to capture the location and extent of underperfused regions and (ii) anisotropic permeability tensors are required to give quantitatively realistic estimation of perfusion change. In the future, the model will be thoroughly validated against experiments.
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Affiliation(s)
- T. I. Józsa
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
| | - R. M. Padmos
- Computational Science Laboratory, Institute for Informatics, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, The Netherlands
| | - N. Samuels
- Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center, Rotterdam 3015 GD, The Netherlands
| | - W. K. El-Bouri
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
| | - A. G. Hoekstra
- Computational Science Laboratory, Institute for Informatics, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, The Netherlands
| | - S. J. Payne
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
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17
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Peñate Medina T, Kolb JP, Hüttmann G, Huber R, Peñate Medina O, Ha L, Ulloa P, Larsen N, Ferrari A, Rafecas M, Ellrichmann M, Pravdivtseva MS, Anikeeva M, Humbert J, Both M, Hundt JE, Hövener JB. Imaging Inflammation - From Whole Body Imaging to Cellular Resolution. Front Immunol 2021; 12:692222. [PMID: 34248987 PMCID: PMC8264453 DOI: 10.3389/fimmu.2021.692222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/12/2021] [Indexed: 01/31/2023] Open
Abstract
Imaging techniques have evolved impressively lately, allowing whole new concepts like multimodal imaging, personal medicine, theranostic therapies, and molecular imaging to increase general awareness of possiblities of imaging to medicine field. Here, we have collected the selected (3D) imaging modalities and evaluated the recent findings on preclinical and clinical inflammation imaging. The focus has been on the feasibility of imaging to aid in inflammation precision medicine, and the key challenges and opportunities of the imaging modalities are presented. Some examples of the current usage in clinics/close to clinics have been brought out as an example. This review evaluates the future prospects of the imaging technologies for clinical applications in precision medicine from the pre-clinical development point of view.
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Affiliation(s)
- Tuula Peñate Medina
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
- *Correspondence: Tuula Peñate Medina, ; Jan-Bernd Hövener,
| | - Jan Philip Kolb
- Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany
| | - Gereon Hüttmann
- Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany
- Airway Research Center North (ARCN), Member of the German Center of Lung Research (DZL), Gießen, Germany
| | - Robert Huber
- Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany
| | - Oula Peñate Medina
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
- Institute for Experimental Cancer Research (IET), University of Kiel, Kiel, Germany
| | - Linh Ha
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein Lübeck (UKSH), Lübeck, Germany
| | - Patricia Ulloa
- Department of Radiology and Neuroradiology, University Medical Centers Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Naomi Larsen
- Department of Radiology and Neuroradiology, University Medical Centers Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Arianna Ferrari
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
| | - Magdalena Rafecas
- Institute of Medical Engineering (IMT), University of Lübeck, Lübeck, Germany
| | - Mark Ellrichmann
- Interdisciplinary Endoscopy, Medical Department1, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Mariya S. Pravdivtseva
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
- Department of Radiology and Neuroradiology, University Medical Centers Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Mariia Anikeeva
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
| | - Jana Humbert
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
- Department of Radiology and Neuroradiology, University Medical Centers Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Marcus Both
- Department of Radiology and Neuroradiology, University Medical Centers Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jennifer E. Hundt
- Lübeck Institute for Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Jan-Bernd Hövener
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
- *Correspondence: Tuula Peñate Medina, ; Jan-Bernd Hövener,
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18
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Hwang I, Cho WS, Yoo RE, Kang KM, Yoo DH, Yun TJ, Choi SH, Kim JH, Kim JE, Sohn CH. Revascularization Evaluation in Adult-Onset Moyamoya Disease after Bypass Surgery: Superselective Arterial Spin Labeling Perfusion MRI Compared with Digital Subtraction Angiography. Radiology 2020; 297:630-637. [PMID: 32960727 DOI: 10.1148/radiol.2020201448] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background A superselective (SS) arterial spin labeling (ASL) MRI technique can be used to monitor the revascularization area as a supplementary or alternative modality to digital subtraction angiography (DSA), with the advantage of being noninvasive. Purpose To evaluate whether SS-ASL perfusion MRI could be used to visualize the revascularization area after combined direct and indirect bypass surgery in adults with moyamoya disease compared with DSA. Materials and Methods Patients diagnosed with moyamoya disease who underwent DSA and SS-ASL 6 months after surgery between June 2017 and November 2019 in a single institution were retrospectively evaluated. Subjective grading of the revascularization area and collateral grading in 10 Alberta Stroke Program Early CT Score (ASPECTS) locations were performed. The change in perfusion status in a subgroup that underwent both preoperative and postoperative SS-ASL studies was evaluated. Intermodality agreement was analyzed by using weighted κ statistics. Results Thirty-seven hemispheres from 33 patients (mean age, 39 years ± 12 [standard deviation]; 20 women) were evaluated. The intermodality agreement of the revascularization area grading was substantial (weighted κ = 0.70; 95% confidence interval [CI]: 0.37, 1.00). The overall intermodality agreement of the postoperative collateral grading in the 10 ASPECTS locations for all vessels was substantial (weighted κ = 0.77; 95% CI: 0.74, 0.80). For the presence of postoperative collateral supplied by the ipsilateral external carotid artery in 10 ASPECTS locations (a total of 370 locations) using DSA as a reference test, the SS-ASL showed a sensitivity of 92% (183 of 199 locations; 95% CI: 87%, 95%) and a specificity of 83% (142 of 171 locations; 95% CI: 77%, 88%). The overall intermodality agreement of the changes in perfusion status was moderate (weighted κ = 0.59; 95% CI: 0.54, 0.65). Conclusion Superselective arterial spin labeling imaging precisely depicted the revascularization territory in patients with moyamoya disease who underwent bypass surgery, and it showed the changes in the vascular supplying territories before and after bypass surgery. © RSNA, 2020 Online supplemental material is available for this article. See also the editorial by Hendrikse in this issue.
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Affiliation(s)
- Inpyeong Hwang
- From the Departments of Radiology (I.H., R.E.Y., K.M.K., D.H.Y., T.J.Y., S.H.C., J..K., C.H.S.) and Neurosurgery (W.S.C., J.E.K.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; and Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (S.H.C., J..K., C.H.S.)
| | - Won-Sang Cho
- From the Departments of Radiology (I.H., R.E.Y., K.M.K., D.H.Y., T.J.Y., S.H.C., J..K., C.H.S.) and Neurosurgery (W.S.C., J.E.K.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; and Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (S.H.C., J..K., C.H.S.)
| | - Roh-Eul Yoo
- From the Departments of Radiology (I.H., R.E.Y., K.M.K., D.H.Y., T.J.Y., S.H.C., J..K., C.H.S.) and Neurosurgery (W.S.C., J.E.K.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; and Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (S.H.C., J..K., C.H.S.)
| | - Koung Mi Kang
- From the Departments of Radiology (I.H., R.E.Y., K.M.K., D.H.Y., T.J.Y., S.H.C., J..K., C.H.S.) and Neurosurgery (W.S.C., J.E.K.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; and Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (S.H.C., J..K., C.H.S.)
| | - Dong Hyun Yoo
- From the Departments of Radiology (I.H., R.E.Y., K.M.K., D.H.Y., T.J.Y., S.H.C., J..K., C.H.S.) and Neurosurgery (W.S.C., J.E.K.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; and Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (S.H.C., J..K., C.H.S.)
| | - Tae Jin Yun
- From the Departments of Radiology (I.H., R.E.Y., K.M.K., D.H.Y., T.J.Y., S.H.C., J..K., C.H.S.) and Neurosurgery (W.S.C., J.E.K.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; and Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (S.H.C., J..K., C.H.S.)
| | - Seung Hong Choi
- From the Departments of Radiology (I.H., R.E.Y., K.M.K., D.H.Y., T.J.Y., S.H.C., J..K., C.H.S.) and Neurosurgery (W.S.C., J.E.K.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; and Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (S.H.C., J..K., C.H.S.)
| | - Ji-Hoon Kim
- From the Departments of Radiology (I.H., R.E.Y., K.M.K., D.H.Y., T.J.Y., S.H.C., J..K., C.H.S.) and Neurosurgery (W.S.C., J.E.K.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; and Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (S.H.C., J..K., C.H.S.)
| | - Jeong Eun Kim
- From the Departments of Radiology (I.H., R.E.Y., K.M.K., D.H.Y., T.J.Y., S.H.C., J..K., C.H.S.) and Neurosurgery (W.S.C., J.E.K.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; and Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (S.H.C., J..K., C.H.S.)
| | - Chul-Ho Sohn
- From the Departments of Radiology (I.H., R.E.Y., K.M.K., D.H.Y., T.J.Y., S.H.C., J..K., C.H.S.) and Neurosurgery (W.S.C., J.E.K.), Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea; and Department of Radiology, Seoul National University College of Medicine, Seoul, Korea (S.H.C., J..K., C.H.S.)
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Lindner T, Jansen O, Helle M. Ternary encoded super-selective arterial spin labeling for time-resolved flow territory mapping. Phys Med Biol 2020; 65:10NT01. [DOI: 10.1088/1361-6560/ab7ef0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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20
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Subcortical atrophy and perfusion patterns in Parkinson disease and multiple system atrophy. Parkinsonism Relat Disord 2020; 72:49-55. [PMID: 32109737 DOI: 10.1016/j.parkreldis.2020.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 02/17/2020] [Accepted: 02/20/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The clinical differentiation between Parkinson disease (PD) and multiple system atrophy (MSA) is difficult. OBJECTIVES Arterial spin labeling (ASL) is an advanced MRI technique that obviates the use of an exogenous contrast agent for the estimation of cerebral perfusion. We explored the value of ASL in combination with structural MRI for the differentiation between PD and MSA. METHODS Ninety-four subjects (30 PD, 30 MSA and 34 healthy controls) performed a morphometric and ASL-MRI to measure volume and perfusion values within basal ganglia and cerebellum. A region-of-interest analysis was performed to test for structural atrophy and regional blood flow differences between groups. RESULTS MSA patients showed higher subcortical atrophy than both PD patients and HC, while no differences were observed between the latter. MSA and PD showed lower volume-corrected perfusion values than HC in several cerebellar areas (Crus I, Crus II, right VIIb, right VIIIa, right VIIIb), right caudate and both thalami. MSA and PD patients displayed similar perfusion values in all aforementioned areas, but the right cerebellar area VIIIb (lower in MSA) and right caudate and both thalami (lower in PD). Similar results were obtained when comparing PD and MSA patients with the parkinsonian variant. CONCLUSIONS A perfusion reduction was equally observed in both MSA and PD patients in cerebellar areas that are putatively linked to cognitive (i.e., executive) rather than motor functions. The observed hypo-perfusion could not be explained by atrophy, suggesting the involvement of the cerebellum in the pathophysiology of both MSA and PD.
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21
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A data-driven update of arterial perfusion territories. Nat Rev Neurol 2019; 15:624-625. [PMID: 31520084 DOI: 10.1038/s41582-019-0267-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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22
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Cerebral Perfusion Territory Changes After Direct Revascularization Surgery in Moyamoya Disease: A Territory Arterial Spin Labeling Study. World Neurosurg 2019; 122:e1128-e1136. [DOI: 10.1016/j.wneu.2018.11.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/30/2018] [Accepted: 11/01/2018] [Indexed: 11/23/2022]
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23
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Non contrast, Pseudo-Continuous Arterial Spin Labeling and Accelerated 3-Dimensional Radial Acquisition Intracranial 3-Dimensional Magnetic Resonance Angiography for the Detection and Classification of Intracranial Arteriovenous Shunts. Invest Radiol 2018; 53:80-86. [PMID: 28937545 DOI: 10.1097/rli.0000000000000411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The aim of this study was to assess the sensitivity and specificity of pseudo-continuous arterial spin labeling (PCASL) magnetic resonance angiography (MRA) with 3-dimensional (3D) radial acquisition for the detection of intracranial arteriovenous (AV) shunts. MATERIALS AND METHODS A total of 32 patients who underwent PCASL-MRA, clinical magnetic resonance imaging (MRI)/MRA exam, and digital subtraction angiography (DSA) were included in this retrospective analysis. Twelve patients presented with AV shunts. Among these were 8 patients with AV malformations (AVM) and 4 patients with AV fistulas (AVF). The clinical MRI/MRA included 3D time-of-flight MRA in all cases and time-resolved, contrast-enhanced MRA in 9 cases (6 cases with AV shunting). Research MRI and clinical MRI were independently evaluated by 2 neuroradiologists blinded to patient history. A third radiologist evaluated DSA imaging. A diagnostic confidence score was used for the presence of abnormalities associated with AV shunting (1-5). The AVMs were characterized using the Spetzler-Martin scale, whereas AVFs were characterized using the Borden classification. κ Statistics were applied to assess intermodality agreement. RESULTS Compared with clinical MRA, noncontrast PCASL-MRA with 3D radial acquisition yielded excellent sensitivity and specificity for the detection of intracranial AV shunts (reader 1: 100%/100%, clinical MRA: 91.7%, 94.4%; reader 2: 91.7%/100%, clinical MRA: 91.7%/100%). Diagnostic confidence was 4.8/4.66 with PCASL-MRA and 4.25/4.66 with clinical MRA. For AVM characterization with PCASL-MRA, intermodality agreement with DSA showed κ values of 0.43 and 0.6 for readers 1 and 2, respectively. For AVF characterization, intermodality agreement showed κ values of 0.56 for both readers. CONCLUSION Noncontrast PCASL-MRA with 3D radial acquisition is a potential tool for the detection and characterization of intracranial AV shunts with a sensitivity and specificity equivalent or higher than routine clinical MRA.
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Hartkamp NS, Petersen ET, Chappell MA, Okell TW, Uyttenboogaart M, Zeebregts CJ, Bokkers RP. Relationship between haemodynamic impairment and collateral blood flow in carotid artery disease. J Cereb Blood Flow Metab 2018; 38:2021-2032. [PMID: 28776469 PMCID: PMC6238174 DOI: 10.1177/0271678x17724027] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Collateral blood flow plays a pivotal role in steno-occlusive internal carotid artery (ICA) disease to prevent irreversible ischaemic damage. Our aim was to investigate the effect of carotid artery disease upon cerebral perfusion and cerebrovascular reactivity and whether haemodynamic impairment is influenced at brain tissue level by the existence of primary and/or secondary collateral. Eighty-eight patients with steno-occlusive ICA disease and 29 healthy controls underwent MR examination. The presence of collaterals was determined with time-of-flight, two-dimensional phase contrast MRA and territorial arterial spin labeling (ASL) imaging. Cerebral blood flow and cerebrovascular reactivity were assessed with ASL before and after acetazolamide. Cerebral haemodynamics were normal in asymptomatic ICA stenosis patients, as opposed to patients with ICA occlusion, in whom the haemodynamics in both hemispheres were compromised. Haemodynamic impairment in the affected brain region was always present in symptomatic patients. The degree of collateral blood flow was inversely correlated with haemodynamic impairment. Recruitment of secondary collaterals only occurred in symptomatic ICA occlusion patients. In conclusion, both CBF and cerebrovascular reactivity were found to be reduced in symptomatic patients with steno-occlusive ICA disease. The presence of collateral flow is associated with further haemodynamic impairment. Recruitment of secondary collaterals is associated with severe haemodynamic impairment.
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Affiliation(s)
- Nolan S Hartkamp
- 1 Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Esben T Petersen
- 2 Centre for Functional and Diagnostic Imaging and Research, Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital, Hvidovre, Denmark.,3 Center for Magnetic Resonance, Department of Electrical Engineering, Technical University of Denmark, Lyngby, Denmark
| | - Michael A Chappell
- 4 Department of Engineering Science, Institute of Biomedical Engineering, University of Oxford, Oxford, UK.,5 Oxford Center for Functional MRI of the Brain, University of Oxford, Oxford, UK
| | - Thomas W Okell
- 5 Oxford Center for Functional MRI of the Brain, University of Oxford, Oxford, UK
| | - Maarten Uyttenboogaart
- 6 Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,7 Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Clark J Zeebregts
- 8 Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Reinoud Ph Bokkers
- 6 Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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25
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Qian T, Zanchi D, Rodriguez C, Ackermann M, Giannakopoulos P, Haller S. Detecting Perfusion Pattern Based on the Background Low-Frequency Fluctuation in Resting-State Functional Magnetic Resonance Imaging Data and Its Influence on Resting-State Networks: An Iterative Postprocessing Approach. Brain Connect 2018; 7:627-634. [PMID: 29117709 DOI: 10.1089/brain.2017.0545] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Resting-state functional magnetic resonance imaging (RS-fMRI) is based on the assumption that the vascular response and the blood oxygenation level-dependent response are homogenous across the entire brain. However, this a priori hypothesis is not consistent with the well-known variability of cerebral vascular territories. To explore whether the RS networks are influenced by varied vascular speed in different vascular territories, we assessed the time-shift maps that give an estimate of the local timing of the vascular response and checked whether local differences in this timing have an impact on the estimates of RS networks. Two hundred seventeen elderly (≥60 years), healthy participants (73.74 ± 4.41 years, 143 females, 203 right handed) underwent one MRI examination, including an RS-fMRI session. After preprocessing, statistical analyses included time-shift analyses and RS-fMRI analyses using as regressor the delay maps obtained from the time-shift analyses. The functional connectivity map of default mode network (DMN) of each participant was then calculated by using the seed-to-voxel analysis in the REST toolbox. Faster cerebrovascular responses were notably present in the primary motor and somatosensory and peri-insular cortex, while slower responses were present in various regions, including notably the posterior cingulate cortex (PCC). Moreover, significant changes notably in the DMN, including medial prefrontal cortex (t = 11.95), PCC (t = 11.52), right middle temporal lobe (t = 10.72), and right angular gyrus (t = 10.88), were observed also taking into account the cerebrovascular delayed maps. As the most prominent example of the RS networks, DMN activation patterns change as a function of the cerebrovascular delay. These data suggest that a group correction for vascular maps in RS-fMRI measurements is essential to correctly depict functional differences and exclude potential confounding effects, notably in the elderly with increasing prevalence of vascular comorbidity.
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Affiliation(s)
- Tianyi Qian
- 1 MR Collaboration, Siemens Healthcare China , Beijing, China
| | - Davide Zanchi
- 2 Department of Psychiatry (UPK), University of Basel , Basel, Switzerland
| | - Cristelle Rodriguez
- 3 Department of Mental Health and Psychiatry, University Hospitals of Geneva , Geneva, Switzerland
| | - Marine Ackermann
- 3 Department of Mental Health and Psychiatry, University Hospitals of Geneva , Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- 3 Department of Mental Health and Psychiatry, University Hospitals of Geneva , Geneva, Switzerland .,4 Faculty of Medicine, University of Geneva , Geneva, Switzerland
| | - Sven Haller
- 4 Faculty of Medicine, University of Geneva , Geneva, Switzerland .,5 Affidea Carouge Radiologic Diagnostic Center , Geneva, Switzerland .,6 Department of Surgical Sciences, Radiology, Uppsala University , Uppsala, Sweden .,7 Department of Neuroradiology, University Hospital Freiburg , Freiburg im Breisgau, Germany
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Toescu SM, Hales PW, Aquilina K, Clark CA. Quantitative MRI in post-operative paediatric cerebellar mutism syndrome. Eur J Radiol 2018; 108:43-51. [PMID: 30396670 DOI: 10.1016/j.ejrad.2018.09.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/17/2018] [Accepted: 09/06/2018] [Indexed: 10/28/2022]
Abstract
Post-operative paediatric cerebellar mutism syndrome (pCMS) occurs in around 25% of children undergoing surgery for cerebellar and fourth ventricular tumours. Reversible mutism is the hallmark of a syndrome which comprises severe motor, cognitive and linguistic deficits. Recent evidence from advanced neuroimaging studies has led to the current theoretical understanding of the condition as a form of diaschisis contingent on damage to efferent cerebellar circuitry. Tractography data derived from diffusion MRI studies have shown disruption of the dentato-rubro-thalamo-cortical tract in patients with pCMS, and perfusion studies have indicated widespread supratentorial regions which may give rise to the florid signs and symptoms of pCMS. Given the difficulties in predicting pCMS from standard structural MRI, this review discusses findings from quantitative MRI modalities which have contributed to our understanding of this debilitating syndrome, and considers the goals and challenges which lie ahead in the field.
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Affiliation(s)
- Sebastian M Toescu
- Developmental Imaging and Biophysics Section, UCL GOS Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom; Department of Neurosurgery, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, United Kingdom.
| | - Patrick W Hales
- Developmental Imaging and Biophysics Section, UCL GOS Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom.
| | - Kristian Aquilina
- Department of Neurosurgery, Great Ormond Street Hospital for Children, Great Ormond Street, London WC1N 3JH, United Kingdom.
| | - Chris A Clark
- Developmental Imaging and Biophysics Section, UCL GOS Institute of Child Health, 30 Guilford Street, London WC1N 1EH, United Kingdom.
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27
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Lindner T, Jansen O, Helle M. Optimized super-selective Arterial Spin Labeling for quantitative flow territory mapping. Magn Reson Imaging 2018; 53:14-19. [PMID: 29966693 DOI: 10.1016/j.mri.2018.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 06/11/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
Abstract
Flow territory mapping using Arterial Spin Labeling (ASL) methods allows for deeper insights into the physiology of the brain. However, in most approaches assumptions of the labeling efficiency are used for calculation of brain perfusion which might result in inaccuracies. This becomes more important in super-selective ASL as the labeling focus could be positioned not exactly at the artery of interest. Therefore, measuring the labeling efficiency of the current scan seems important to obtain reliable results and to correct for potential errors. In this study, an optimized super-selective ASL tagging scheme is presented and the labeling efficiency is measured using quantitative phase-contrast angiography of the tagged artery and considering the volume of the supplied flow territory. The aim then is to evaluate the labeling efficiency of super-selective ASL and considering these values when shifting the labeling spot away from the artery of interest. The measured efficiency is compared to simulations performed for the optimized super-selective ASL approach. Considering the values of labeling efficiency after shifting the labeling focus, the values of cerebral blood flow still show accurate results despite the expected lower SNR up to an offset of 3 mm. Following this, to obtain accurate results for quantifying super-selective ASL perfusion images, measuring the labeling efficiency seems necessary to prevent false results.
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Affiliation(s)
- Thomas Lindner
- University Hospital Schleswig-Holstein, Department of Radiology and Neuroradiology, Arnold-Heller Str. 3, 24103 Kiel, Germany.
| | - Olav Jansen
- University Hospital Schleswig-Holstein, Department of Radiology and Neuroradiology, Arnold-Heller Str. 3, 24103 Kiel, Germany.
| | - Michael Helle
- Philips Research, Tomographic Imaging Department, Röntgenstr. 24, 22335 Hamburg, Germany.
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28
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Marusak HA, Iadipaolo AS, Harper FW, Elrahal F, Taub JW, Goldberg E, Rabinak CA. Neurodevelopmental consequences of pediatric cancer and its treatment: applying an early adversity framework to understanding cognitive, behavioral, and emotional outcomes. Neuropsychol Rev 2018; 28:123-175. [PMID: 29270773 PMCID: PMC6639713 DOI: 10.1007/s11065-017-9365-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 11/08/2017] [Indexed: 01/29/2023]
Abstract
Today, children are surviving pediatric cancer at unprecedented rates, making it one of modern medicine's true success stories. However, we are increasingly becoming aware of several deleterious effects of cancer and the subsequent "cure" that extend beyond physical sequelae. Indeed, survivors of childhood cancer commonly report cognitive, emotional, and psychological difficulties, including attentional difficulties, anxiety, and posttraumatic stress symptoms (PTSS). Cognitive late- and long-term effects have been largely attributed to neurotoxic effects of cancer treatments (e.g., chemotherapy, cranial irradiation, surgery) on brain development. The role of childhood adversity in pediatric cancer - namely, the presence of a life-threatening disease and endurance of invasive medical procedures - has been largely ignored in the existing neuroscientific literature, despite compelling research by our group and others showing that exposure to more commonly studied adverse childhood experiences (i.e., domestic and community violence, physical, sexual, and emotional abuse) strongly imprints on neural development. While these adverse childhood experiences are different in many ways from the experience of childhood cancer (e.g., context, nature, source), they do share a common element of exposure to threat (i.e., threat to life or physical integrity). Therefore, we argue that the double hit of early threat and cancer treatments likely alters neural development, and ultimately, cognitive, behavioral, and emotional outcomes. In this paper, we (1) review the existing neuroimaging research on child, adolescent, and adult survivors of childhood cancer, (2) summarize gaps in our current understanding, (3) propose a novel neurobiological framework that characterizes childhood cancer as a type of childhood adversity, particularly a form of early threat, focusing on development of the hippocampus and the salience and emotion network (SEN), and (4) outline future directions for research.
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Affiliation(s)
- Hilary A Marusak
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Suite 2190, Detroit, MI, 48202, USA.
| | - Allesandra S Iadipaolo
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Suite 2190, Detroit, MI, 48202, USA
| | - Felicity W Harper
- Population Studies and Disparities Research Program, Karmanos Cancer Institute, Detroit, MI, USA
- Department of Oncology, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Farrah Elrahal
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Suite 2190, Detroit, MI, 48202, USA
| | - Jeffrey W Taub
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA
- Children's Hospital of Michigan, Detroit, MI, USA
| | - Elimelech Goldberg
- Department of Pediatrics, School of Medicine, Wayne State University, Detroit, MI, USA
- Kids Kicking Cancer, Southfield, MI, USA
| | - Christine A Rabinak
- Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Suite 2190, Detroit, MI, 48202, USA
- Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA
- Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, Detroit, MI, USA
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Mormina E, Petracca M, Bommarito G, Piaggio N, Cocozza S, Inglese M. Cerebellum and neurodegenerative diseases: Beyond conventional magnetic resonance imaging. World J Radiol 2017; 9:371-388. [PMID: 29104740 PMCID: PMC5661166 DOI: 10.4329/wjr.v9.i10.371] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 07/18/2017] [Accepted: 08/02/2017] [Indexed: 02/06/2023] Open
Abstract
The cerebellum plays a key role in movement control and in cognition and cerebellar involvement is described in several neurodegenerative diseases. While conventional magnetic resonance imaging (MRI) is widely used for brain and cerebellar morphologic evaluation, advanced MRI techniques allow the investigation of cerebellar microstructural and functional characteristics. Volumetry, voxel-based morphometry, diffusion MRI based fiber tractography, resting state and task related functional MRI, perfusion, and proton MR spectroscopy are among the most common techniques applied to the study of cerebellum. In the present review, after providing a brief description of each technique’s advantages and limitations, we focus on their application to the study of cerebellar injury in major neurodegenerative diseases, such as multiple sclerosis, Parkinson’s and Alzheimer’s disease and hereditary ataxia. A brief introduction to the pathological substrate of cerebellar involvement is provided for each disease, followed by the review of MRI studies exploring structural and functional cerebellar abnormalities and by a discussion of the clinical relevance of MRI measures of cerebellar damage in terms of both clinical status and cognitive performance.
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Affiliation(s)
- Enricomaria Mormina
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Neuroradiology Unit, Department of Biomedical Sciences and Morphological and Functional Images, University of Messina, 98100 Messina, Italy
| | - Maria Petracca
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Giulia Bommarito
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
| | - Niccolò Piaggio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
- Department of Neuroradiology, San Martino Hospital, 16132 Genoa, Italy
| | - Sirio Cocozza
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80138 Naples, Italy
| | - Matilde Inglese
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health (DINOGMI), University of Genoa, 16132 Genoa, Italy
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30
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Self-controlled super-selective arterial spin labelling. Eur Radiol 2017; 28:1227-1233. [PMID: 28971235 DOI: 10.1007/s00330-017-5066-7] [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: 05/28/2017] [Revised: 08/18/2017] [Accepted: 09/07/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Arterial spin labelling (ASL) is a method of non-contrast-enhanced perfusion imaging that is generally based on the acquisition of two images which must be subtracted in order to obtain perfusion-weighted images. This is also the case for some flow territory mapping approaches that require the acquisition of two images for each artery of interest, thereby prolonging scan time and yielding largely redundant information. The aim of this study is to accelerate flow territory mapping using ASL by eliminating the acquisition of a control condition. METHODS Using super-selective ASL, only one artery of interest is tagged, while the contralateral arteries are in a state similar to the control condition. By using an arithmetic combination of the label images of all territories, selective images of flow territories can be obtained without the need to acquire an additional control condition. This approach for obtaining artery-selective perfusion-weighted images without acquiring a control condition is presented in this study and is referred to as "self-controlled super-selective ASL". RESULTS Quantitative perfusion measurements were similar to conventional super-selective and non-selective perfusion imaging across all subjects. CONCLUSION Super-selective arterial spin labelling can be performed without acquiring a control image. KEY POINTS • An accelerated method of flow territory mapping is presented. • Super-selective arterial spin labelling is performed without a control condition. • A new approach for calculating individual flow territories is presented. • The presented technique is compared to established approaches. • The outcome is similar to that using conventional techniques.
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31
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Wang S, Wang L, Jing P, Guo P, Zheng W, Li J, Qian M. Aberrant patterns of brain cerebral blood flow in Chinese han first-episode drug-naïve depressive patients with and without a family history of depression. Oncotarget 2017; 8:79906-79913. [PMID: 29108372 PMCID: PMC5668105 DOI: 10.18632/oncotarget.20306] [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] [Received: 06/08/2017] [Accepted: 08/04/2017] [Indexed: 01/18/2023] Open
Abstract
A positive family history plays a key role in the brain pathology of depression patients and previous research has confirmed that disturbed mood maintenance may be related to abnormal regional cerebral blood flow (rCBF). However, little is known about whether the rCBF is different between depression patients with and without family histories. To address this question, we examined the rCBF in drug-naïve, first-episode depression patients with and without family histories of depression using a 3D pseudo-continuous arterial spin-labelling technique. We found that decreased rCBF was predominantly observed in the patients without family histories, while decreased and increased rCBF co-existed in patients with family histories. The observed brain regions with altered rCBF were associated with affection processing, such as the prefrontal, occipital and insular areas. However the patterns of rCBF alteration observed in the present study were different from those found in previous studies where patients were compared with healthy controls. Our present findings, together with the findings from previous studies have prompted the need of a long-term follow-up study to characterize the brain features of the developmental trajectory of depression and investigate the targets for precise, personalized treatments.
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Affiliation(s)
- Shikai Wang
- Department of Psychological Medicine, Huzhou Third People’s Hospital, Huzhou, China
| | - Lina Wang
- Department of Psychological Medicine, Tianjin Anding Hospital, Tianjin, China
| | - Ping Jing
- Department of Psychological Medicine, Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Ping Guo
- Department of Psychological Medicine, Huzhou Third People’s Hospital, Huzhou, China
| | - Weifang Zheng
- Department of Psychological Medicine, Wenzhou Seventh People’s Hospital, Wenzhou, China
| | - Jie Li
- Department of Psychological Medicine, Tianjin Anding Hospital, Tianjin, China
| | - Mincai Qian
- Department of Psychological Medicine, Huzhou Third People’s Hospital, Huzhou, China
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Geri O, Shiran SI, Roth J, Artzi M, Ben-Sira L, Ben Bashat D. Vascular territorial segmentation and volumetric blood flow measurement using dynamic contrast enhanced magnetic resonance angiography of the brain. J Cereb Blood Flow Metab 2017; 37:3446-3456. [PMID: 28393638 PMCID: PMC5624396 DOI: 10.1177/0271678x17702394] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
This study proposes a method for territorial segmentation and volumetric flow rate (VFR) distribution measurement of cerebral territories based on time-resolved contrast enhanced magnetic-resonance-angiography (MRA). The method uses an iterative region-growing algorithm based on bolus-arrival-time with increased temporal resolution. Eight territories were segmented: (1) right and (2) left internal carotid arteries, including the middle cerebral artery (ICA+MCA), excluding the anterior cerebral arteries (ACA); (3) right and left ACA (R+L-ACA); (4) right and (5) left external carotid arteries (ECA); (6) right and (7) left posterior cerebral arteries (PCA); and (8) vertebrobasilar territory. VFR percentage, relative to the entire brain (rVFR), was measured based on territorial volume as a function of time. Mean rVFR values of fifteen healthy subjects were: ICA+MCA = 23 ± 2%, R + L-ACA = 17 ± 3%, ECA = 4 ± 2%, PCA = 12 ± 2%, and vertebrobasilar territory = 31 ± 4%. Excluding the ECA-rVFR, which is underestimated, these values are comparable to previously reported values. Six subjects were scanned twice, demonstrating comparable and even higher reproducibility than previously reported using phase-contrast, yet with faster scan time (∼1 min). This method was implemented in one patient with MCA occlusion and one with Moyamoya syndrome scanned before and after bypass surgery, demonstrating its clinical potential for quantitative assessment of the degree of occlusion and the effect of surgery.
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Affiliation(s)
- Oren Geri
- 1 Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Shelly I Shiran
- 3 Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Jonathan Roth
- 4 Department of NeuroSurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Moran Artzi
- 1 Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,5 Sackler Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Liat Ben-Sira
- 3 Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,5 Sackler Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dafna Ben Bashat
- 1 Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,2 Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,5 Sackler Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Perioperative Changes in Cerebral Perfusion Territories Assessed by Arterial Spin Labeling Magnetic Resonance Imaging Are Associated with Postoperative Increases in Cerebral Blood Flow in Patients with Carotid Stenosis. World Neurosurg 2017; 102:477-486. [DOI: 10.1016/j.wneu.2017.03.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 03/07/2017] [Accepted: 03/08/2017] [Indexed: 11/17/2022]
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Richter V, Helle M, van Osch MJP, Lindner T, Gersing AS, Tsantilas P, Eckstein HH, Preibisch C, Zimmer C. MR Imaging of Individual Perfusion Reorganization Using Superselective Pseudocontinuous Arterial Spin-Labeling in Patients with Complex Extracranial Steno-Occlusive Disease. AJNR Am J Neuroradiol 2017; 38:703-711. [PMID: 28183839 DOI: 10.3174/ajnr.a5090] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 12/04/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Patients with multiple stenoses or occlusions of the extracranial arteries require an individualized diagnostic approach. We evaluated the feasibility and clinical utility of a novel MR imaging technique for regional perfusion imaging in this patient group. MATERIALS AND METHODS Superselective pseudocontinuous arterial spin-labeling with a circular labeling spot enabling selective vessel labeling was added to routine imaging in a prospective pilot study in 50 patients (10 women, 70.05 ± 10.55 years of age) with extracranial steno-occlusive disease. Thirty-three had infarct lesions. DSC-MR imaging was performed in 16/50 (32%), and cerebral DSA, in 12/50 patients (24%). Vascular anatomy and the distribution of vessel stenoses and occlusions were defined on sonography and TOF-MRA. Stenoses were classified according to the NASCET criteria. Infarct lesions and perfusion deficits were defined on FLAIR and DSC-MR imaging, respectively. Individual perfusion patterns were defined on the superselective pseudocontinuous arterial spin-labeling maps and were correlated with vascular anatomy and infarct lesion localization. RESULTS The superselective pseudocontinuous arterial spin-labeling imaging sequence could be readily applied by trained technicians, and the additional scan time of 12.7 minutes was well-tolerated by patients. The detected vessel occlusions/stenoses and perfusion patterns corresponded between cerebral DSA and superselective pseudocontinuous arterial spin-labeling maps in all cases. Perfusion deficits on DSC-CBF maps significantly correlated with those on superselective pseudocontinuous arterial spin-labeling maps (Pearson r = 0.9593, P < .01). Individual collateral recruitment patterns were not predictable from the vascular anatomy in 71% of our patients. CONCLUSIONS Superselective pseudocontinuous arterial spin-labeling is a robust technique for regional brain perfusion imaging, suitable for the noninvasive diagnostics of individual perfusion patterns in patients with complex cerebrovascular disease.
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Affiliation(s)
- V Richter
- From the Department of Radiology (V.R.), Diagnostic and Interventional Radiology, University of Tübingen, Tübingen, Germany
| | - M Helle
- Department of Radiology and Neuroradiology (M.H., T.L.), University Medical Center Schleswig-Holstein, Kiel, Germany
- Philips GmbH Innovative Technologies (M.H.), Research Laboratories, Hamburg, Germany
| | - M J P van Osch
- The C. J. Gorter Center for High Field MRI (M.J.P.v.O.), Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - T Lindner
- Department of Radiology and Neuroradiology (M.H., T.L.), University Medical Center Schleswig-Holstein, Kiel, Germany
| | - A S Gersing
- Departments of Diagnostic and Interventional Neuroradiology (A.S.G., C.P., C.Z.)
| | - P Tsantilas
- Vascular and Endovascular Surgery (P.T., H.-H.E.), Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - H-H Eckstein
- Vascular and Endovascular Surgery (P.T., H.-H.E.), Klinikum Rechts der Isar, Technical University Munich, Munich, Germany
| | - C Preibisch
- Departments of Diagnostic and Interventional Neuroradiology (A.S.G., C.P., C.Z.)
| | - C Zimmer
- Departments of Diagnostic and Interventional Neuroradiology (A.S.G., C.P., C.Z.)
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Evaluation of the applicability of territorial arterial spin labeling in meningiomas for presurgical assessments compared with 3-dimensional time-of-flight magnetic resonance angiography. Eur Radiol 2017; 27:4072-4081. [DOI: 10.1007/s00330-017-4760-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/12/2017] [Accepted: 01/19/2017] [Indexed: 10/20/2022]
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Chen G, Bian H, Jiang D, Cui M, Ji S, Liu M, Lang X, Zhuo C. Pseudo-continuous arterial spin labeling imaging of cerebral blood perfusion asymmetry in drug-naïve patients with first-episode major depression. Biomed Rep 2016; 5:675-680. [PMID: 28101340 PMCID: PMC5228216 DOI: 10.3892/br.2016.796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/05/2016] [Indexed: 12/22/2022] Open
Abstract
Many previous studies have reported that regional cerebral blood flow (rCBF) aberrations may be one of the pathological characteristics of depression and rCBF has demonstrated a certain degree of asymmetry. However, studies investigating the cerebral blood perfusion asymmetry changes of drug-naïve patients experiencing their first episode of major depression using pseudo-continuous arterial spin labeling (pCASL) are rare. Ten drug-naïve patients experiencing their first major depression episode and 15 healthy volunteers were enrolled in the current study. A novel pCASL method was applied to whole brain MRI scans of all of the samples. The Statistics Parameter Mapping and Relative Expression Software Tool software packages were used for the pre-processing and statistical analysis of the two sets of images, and the differences in the cerebral blood perfusion at the whole brain level were compared between the two groups. Compared with the healthy control group, the cerebral perfusion of the depression patients showed an asymmetric pattern. Decreased cerebral blood perfusion regions were primarily located in the left hemisphere, specifically in the left temporal lobe, frontal lobe and cingulate cortex [P<0.05 and cluster size ≥30 with false discovery rate (FDR) correction]. Simultaneously, increased perfusion regions were predominantly located in the right hemisphere, specifically in the right cerebellum, thalamus, frontal lobe and anterior cingulate cortex (P<0.05 and cluster size ≥30, with FDR correction). Thus, pCASL may characterize the alterations in cerebral blood perfusion of patients with depression.
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Affiliation(s)
- Guangdong Chen
- Department of Psychiatry, Wenzhou 7th People's Hospital, Wenzhou, Zhejiang 325000, P.R. China
| | - Haiman Bian
- Department of Radiology, Tianjin 4th Centre Hospital, Tianjin 300143, P.R. China
| | - Deguo Jiang
- Department of Psychiatry, Wenzhou 7th People's Hospital, Wenzhou, Zhejiang 325000, P.R. China
| | - Mingwei Cui
- Department of Psychiatry, Tianjin Anning Hospital, Tianjin 300300, P.R. China
| | - Shengzhang Ji
- Department of Radiology, Tianjin 4th Centre Hospital, Tianjin 300143, P.R. China
| | - Mei Liu
- Department of Psychiatry, Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin 300222, P.R. China
| | - Xu Lang
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, P.R. China
| | - Chuanjun Zhuo
- Department of Psychiatry, Wenzhou 7th People's Hospital, Wenzhou, Zhejiang 325000, P.R. China; Department of Psychiatry, Tianjin Anning Hospital, Tianjin 300300, P.R. China; Department of Psychiatry, Tianjin Anding Hospital, Tianjin Mental Health Center, Tianjin 300222, P.R. China
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Lindner T, Larsen N, Jansen O, Helle M. Accelerated visualization of selected intracranial arteries by cycled super-selective arterial spin labeling. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 29:843-852. [DOI: 10.1007/s10334-016-0574-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Revised: 06/10/2016] [Accepted: 06/13/2016] [Indexed: 10/21/2022]
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Neumann JO, Giese H, Nagel AM, Biller A, Unterberg A, Meinzer HP. MR Angiography at 7T to Visualize Cerebrovascular Territories. J Neuroimaging 2016; 26:519-24. [PMID: 27074967 DOI: 10.1111/jon.12348] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 02/28/2016] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND There is considerable amount of interindividual variability in the size and location of the vascular territories of the major brain arteries. More data are needed to assess the amount of variability and the possible implications for further research and patient care. Arterial spin labeling (ASL) magnetic resonance imaging has been applied in various forms to facilitate noninvasive imaging of cerebrovascular flow territories, but it requires the definition of the flow territory of interest prior to image acquisition. OBJECTIVE Assessing the vascular territories of the major brain territories by using ultra-high-field time-of-flight (TOF) magnetic resonance angiography. METHODS We have developed an alternative method to ASL by simulating cerebrovascular dye injections. Following bias field normalization and segmentation of the vessels from 7 Tesla TOF imaging, a virtual model of the arterial vessel tree was generated and a simulation of dye dispersion into the brain tissue was performed. RESULTS The results provided by our method are consistent with the data obtained by autoptic dye injection studies in 23 human beings by van der Zwan in 1993. CONCLUSION Further technical improvements in imaging and segmentation techniques will improve the accuracy of the method and will facilitate the delineation of flow territories after image acquisition on even smaller subtrees of the cerebral vasculature.
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Affiliation(s)
- Jan-Oliver Neumann
- Department of Neurosurgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Henrik Giese
- Department of Neurosurgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Armin M Nagel
- Department of Medical Physics in Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Armin Biller
- Department of Neuroradiology, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Andreas Unterberg
- Department of Neurosurgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany
| | - Hans-Peter Meinzer
- Division Medical and Biological Informatics, German Cancer Research Center, Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
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Bokkers RPH, De Cocker LJ, van Osch MJP, Hartkamp NS, Hendrikse J. Selective Arterial Spin Labeling: Techniques and Neurovascular Applications. Top Magn Reson Imaging 2016; 25:73-80. [PMID: 27049244 DOI: 10.1097/rmr.0000000000000078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Knowledge of the distribution of blood flowing from the heart to the brain-feeding arteries is important for the understanding and diagnosis of cerebrovascular diseases. Due to anatomical variations and anomalies within the cerebrovasculature, together with changes caused by various cerebrovascular diseases, there is high variability in the distribution of blood to the parenchyma. This article reviews the various methods that are available for determining the flow territories of the brain-feeding arteries and provides an overview of the different territorial arterial spin labeling (ASL) magnetic resonance imaging (MRI) techniques that have been introduced during the past 2 decades. ASL is a noninvasive method that uses arterial blood as an endogenous contrast agent by magnetically labeling the inflowing blood with radiofrequency pulses. Several selective ASL MRI methods are available to visualize the perfusion territories of individual brain feeding arteries and determine the presence of collateral blood flow pathways. Clinically, these selective perfusion methods may replace more invasive procedures such as catheter angiography for various diseases in which it is of importance to determine the feeding blood vessels, evaluate the presence potential collateral pathways, and monitor the patency of surgical bypasses.
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Affiliation(s)
- Reinoud P H Bokkers
- *Department of Radiology, University of Groningen, Groningen, The Netherlands †Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands ‡Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands §Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
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Arterial Spin Labeling Techniques 2009-2014. J Med Imaging Radiat Sci 2016; 47:98-107. [PMID: 31047171 DOI: 10.1016/j.jmir.2015.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 07/03/2015] [Accepted: 08/18/2015] [Indexed: 12/23/2022]
Abstract
PURPOSE Arterial spin labeling (ASL) techniques have been implemented across a diverse range of clinical and experimental applications. This review aims to evaluate the current feasibility of ASL in clinical neuroradiology based on recent improvements to ASL sequences and highlight areas for potential clinical applications. METHODS AND MATERIALS In December 2014, a literature search was conducted on PubMed Central, EMBASE, and Scopus using the search terms: "arterial spin labeling, neuroradiology," for studies published between 2009 and 2014 (inclusive). Of 483 studies matching the inclusion criteria, the number of studies using continuous, pseudocontinuous, pulsed, and velocity-selective ASL sequences was 42, 209, 226, and 3, respectively. Studies were classified based on several common clinical applications according to the type of ASL sequence used. Studies using pulsed ASL and pseudo-continuous ASL were grouped based on common sequences. RESULTS The number of clinical studies was 264. Numerous studies applied ASL to stroke management (43 studies), drug testing (21 studies), neurodegenerative diseases (40 studies), and psychiatric disorders (26 studies). CONCLUSIONS This review discusses several factors hindering the implementation of clinical ASL and ASL-related radiofrequency safety issues encountered in clinical practice. However, a limited number of search terms were used. Further development of robust sequences with multislice imaging capabilities and reduced radiofrequency energy deposition will hopefully improve the clinical acceptance of ASL.
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A neuroradiologist's guide to arterial spin labeling MRI in clinical practice. Neuroradiology 2015; 57:1181-202. [PMID: 26351201 PMCID: PMC4648972 DOI: 10.1007/s00234-015-1571-z] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/05/2015] [Indexed: 01/01/2023]
Abstract
Arterial spin labeling (ASL) is a non-invasive MRI technique to measure cerebral blood flow (CBF). This review provides a practical guide and overview of the clinical applications of ASL of the brain, as well its potential pitfalls. The technical and physiological background is also addressed. At present, main areas of interest are cerebrovascular disease, dementia and neuro-oncology. In cerebrovascular disease, ASL is of particular interest owing to its quantitative nature and its capability to determine cerebral arterial territories. In acute stroke, the source of the collateral blood supply in the penumbra may be visualised. In chronic cerebrovascular disease, the extent and severity of compromised cerebral perfusion can be visualised, which may be used to guide therapeutic or preventative intervention. ASL has potential for the detection and follow-up of arteriovenous malformations. In the workup of dementia patients, ASL is proposed as a diagnostic alternative to PET. It can easily be added to the routinely performed structural MRI examination. In patients with established Alzheimer’s disease and frontotemporal dementia, hypoperfusion patterns are seen that are similar to hypometabolism patterns seen with PET. Studies on ASL in brain tumour imaging indicate a high correlation between areas of increased CBF as measured with ASL and increased cerebral blood volume as measured with dynamic susceptibility contrast-enhanced perfusion imaging. Major advantages of ASL for brain tumour imaging are the fact that CBF measurements are not influenced by breakdown of the blood–brain barrier, as well as its quantitative nature, facilitating multicentre and longitudinal studies.
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Jensen-Kondering U, Lindner T, van Osch MJ, Rohr A, Jansen O, Helle M. Superselective pseudo-continuous arterial spin labeling angiography. Eur J Radiol 2015; 84:1758-67. [DOI: 10.1016/j.ejrad.2015.05.034] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 05/22/2015] [Accepted: 05/30/2015] [Indexed: 10/23/2022]
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Lindner T, Helle M, Jansen O. A Short Introduction to Arterial Spin Labeling and its Application to Flow Territory Mapping. Clin Neuroradiol 2015; 25 Suppl 2:211-8. [PMID: 26308246 DOI: 10.1007/s00062-015-0450-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 08/04/2015] [Indexed: 11/29/2022]
Abstract
Arterial spin labeling (ASL) is an emerging method for the assessment of perfusion in various diseases of the brain. In ASL, the magnetization of arterial blood water spins is manipulated in a complete non-invasive way before flowing into the tissue of interest. This allows absolute quantification of cerebral blood flow, thereby, presenting an alternative to contrast-enhanced methods based on computed tomography or magnetic resonance imaging. Furthermore, its potential application for flow territory mapping can provide additional information of the individual configuration of intracerebral blood flow. This article gives a brief overview of the basic ASL methodology and its approaches to image individual perfusion territories. Additionally, the utilization of ASL in a variety of cerebrovascular diseases is presented to provide examples of potential applications of (territorial) ASL in clinical routine.
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Affiliation(s)
- T Lindner
- Clinic for Radiology and Neuroradiology, UKSH Campus Kiel, 24105, Kiel, Arnold-Heller-Straße 3, Germany.
| | - M Helle
- Philips GmbH Innovative Technologies, Research Laboratories, Hamburg, Germany
| | - O Jansen
- Clinic for Radiology and Neuroradiology, UKSH Campus Kiel, 24105, Kiel, Arnold-Heller-Straße 3, Germany
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Lindner T, Jensen-Kondering U, van Osch MJ, Jansen O, Helle M. 3D time-resolved vessel-selective angiography based on pseudo-continuous arterial spin labeling. Magn Reson Imaging 2015; 33:840-6. [PMID: 25777269 DOI: 10.1016/j.mri.2015.03.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 03/07/2015] [Indexed: 10/23/2022]
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Lövblad KO, Montandon ML, Viallon M, Rodriguez C, Toma S, Golay X, Giannakopoulos P, Haller S. Arterial Spin-Labeling Parameters Influence Signal Variability and Estimated Regional Relative Cerebral Blood Flow in Normal Aging and Mild Cognitive Impairment: FAIR versus PICORE Techniques. AJNR Am J Neuroradiol 2015; 36:1231-6. [PMID: 25882291 DOI: 10.3174/ajnr.a4291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 12/05/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Arterial spin-labeling is a noninvasive method to map cerebral blood flow, which might be useful for early diagnosis of neurodegenerative diseases. We directly compared 2 arterial spin-labeling techniques in healthy elderly controls and individuals with mild cognitive impairment. MATERIALS AND METHODS This prospective study was approved by the local ethics committee and included 198 consecutive healthy controls (mean age, 73.65 ± 4.02 years) and 43 subjects with mild cognitive impairment (mean age, 73.38 ± 5.85 years). Two pulsed arterial spin-labeling sequences were performed at 3T: proximal inversion with a control for off-resonance effects (PICORE) and flow-sensitive alternating inversion recovery technique (FAIR). Relative cerebral blood flow maps were calculated by using commercial software and standard parameters. Data analysis included spatial normalization of gray matter-corrected relative CBF maps, whole-brain average, and voxelwise comparison of both arterial spin-labeling sequences. RESULTS Overall, FAIR yielded higher relative CBF values compared with PICORE (controls, 32.7 ± 7.1 versus 30.0 ± 13.1 mL/min/100 g, P = .05; mild cognitive impairment, 29.8 ± 5.4 versus 26.2 ± 8.6 mL/min/100 g, P < .05; all, 32.2 ± 6.8 versus 29.3 ± 12.3 mL/min/100 g, P < .05). FAIR had lower variability (controls, 36.2% versus 68.8%, P < .00001; mild cognitive impairment, 18.9% versus 22.9%, P < .0001; all, 34.4% versus 64.9% P < .00001). The detailed voxelwise analysis revealed a higher signal for FAIR, notably in both convexities, while PICORE had higher signal predominantly in deep cerebral regions. CONCLUSIONS Overall, FAIR had higher estimated relative CBF and lower interindividual variability than PICORE. In more detail, there were regional differences between both arterial spin-labeling sequences. In summary, these results highlight the need to calibrate arterial spin-labeling sequences.
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Affiliation(s)
- K-O Lövblad
- From the Divisions of Diagnostic and Interventional Neuroradiology (K.-O.L., M.-L.M., M.V., S.H.)
| | - M-L Montandon
- From the Divisions of Diagnostic and Interventional Neuroradiology (K.-O.L., M.-L.M., M.V., S.H.)
| | - M Viallon
- From the Divisions of Diagnostic and Interventional Neuroradiology (K.-O.L., M.-L.M., M.V., S.H.) CREATIS (M.V.), UMR CNRS 5220-Institut National de la Santé et de la Recherche Médicale U1044, INSA de Lyon, Université de Lyon, Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France
| | - C Rodriguez
- Psychiatry (C.R., S.T., P.G.), Geneva University Hospitals, Geneva, Switzerland
| | - S Toma
- Psychiatry (C.R., S.T., P.G.), Geneva University Hospitals, Geneva, Switzerland
| | - X Golay
- Institute of Neurology (X.G.), University College London, London, United Kingdom
| | - P Giannakopoulos
- Psychiatry (C.R., S.T., P.G.), Geneva University Hospitals, Geneva, Switzerland
| | - S Haller
- From the Divisions of Diagnostic and Interventional Neuroradiology (K.-O.L., M.-L.M., M.V., S.H.)
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Calibrated MRI to evaluate cerebral hemodynamics in patients with an internal carotid artery occlusion. J Cereb Blood Flow Metab 2015; 35:1015-23. [PMID: 25712500 PMCID: PMC4640248 DOI: 10.1038/jcbfm.2015.14] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 12/29/2014] [Accepted: 01/09/2015] [Indexed: 01/29/2023]
Abstract
The purpose of this study was to assess whether calibrated magnetic resonance imaging (MRI) can identify regional variances in cerebral hemodynamics caused by vascular disease. For this, arterial spin labeling (ASL)/blood oxygen level-dependent (BOLD) MRI was performed in 11 patients (65±7 years) and 14 controls (66±4 years). Cerebral blood flow (CBF), ASL cerebrovascular reactivity (CVR), BOLD CVR, oxygen extraction fraction (OEF), and cerebral metabolic rate of oxygen (CMRO2) were evaluated. The CBF was 34±5 and 36±11 mL/100 g per minute in the ipsilateral middle cerebral artery (MCA) territory of the patients and the controls. Arterial spin labeling CVR was 44±20 and 53±10% per 10 mm Hg ▵EtCO2 in patients and controls. The BOLD CVR was lower in the patients compared with the controls (1.3±0.8 versus 2.2±0.4% per 10 mm Hg ▵EtCO2, P<0.01). The OEF was 41±8% and 38±6%, and the CMRO2 was 116±39 and 111±40 μmol/100 g per minute in the patients and the controls. The BOLD CVR was lower in the ipsilateral than in the contralateral MCA territory of the patients (1.2±0.6 versus 1.6±0.5% per 10 mmHg ▵EtCO2, P<0.01). Analysis was hampered in three patients due to delayed arrival time. Thus, regional hemodynamic impairment was identified with calibrated MRI. Delayed arrival artifacts limited the interpretation of the images in some patients.
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Ghariq E, Chappell MA, Schmid S, Teeuwisse WM, van Osch MJP. Effects of background suppression on the sensitivity of dual-echo arterial spin labeling MRI for BOLD and CBF signal changes. Neuroimage 2014; 103:316-322. [PMID: 25280450 DOI: 10.1016/j.neuroimage.2014.09.051] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Revised: 09/18/2014] [Accepted: 09/22/2014] [Indexed: 10/24/2022] Open
Abstract
Dual-echo arterial spin labeling (DE-ASL) enables the simultaneous acquisition of BOLD and CBF fMRI data and is often used for calibrated BOLD and cerebrovascular CO2 reactivity measurements. DE-ASL, like all ASL techniques, suffers from a low intrinsic CBF SNR, which can be improved by suppressing the background signal via the inclusion of additional inversion pulses. However, until now this approach has been considered to be undesirable for DE-ASL, because the BOLD signal is extracted from the background signal and attenuating the background signal could decrease the sensitivity of DE-ASL scans for BOLD changes. In this study, the effect of background suppression on the sensitivity of DE-ASL MRI for BOLD and CBF signal changes with a visual stimulation paradigm was studied. Results showed that with an average background suppression level of 70% the BOLD sensitivity of DE-ASL MRI decreases slightly (15%), while the CBF sensitivity of the scans increased by almost a factor-of-two (81%). These findings support the conclusion that the gains in CBF sensitivity of DE-ASL MRI due to background suppression outweigh the slight decrease in sensitivity of these scans for BOLD changes, and thus that background suppression is highly recommended for DE-ASL.
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Affiliation(s)
- Eidrees Ghariq
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands.
| | - Michael A Chappell
- Institute of Biomedical Engineering, University of Oxford, Oxford, United Kingdom; FMRIB Centre, University of Oxford, Oxford, United Kingdom
| | - Sophie Schmid
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Wouter M Teeuwisse
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
| | - Matthias J P van Osch
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, Zuid-Holland, The Netherlands
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Assessment of collateral flow in patients with cerebrovascular disorders. J Neuroradiol 2014; 41:234-42. [DOI: 10.1016/j.neurad.2013.11.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 11/05/2013] [Accepted: 11/13/2013] [Indexed: 11/21/2022]
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Wright S, Kochunov P, Chiappelli J, McMahon R, Muellerklein F, Wijtenburg SA, White MG, Rowland LM, Hong LE. Accelerated white matter aging in schizophrenia: role of white matter blood perfusion. Neurobiol Aging 2014; 35:2411-2418. [PMID: 24680326 PMCID: PMC4087059 DOI: 10.1016/j.neurobiolaging.2014.02.016] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 02/13/2014] [Accepted: 02/24/2014] [Indexed: 12/11/2022]
Abstract
Elevated rate of age-related decline in white matter integrity, indexed by fractional anisotropy (FA) from diffusion tensor imaging, was reported in patients with schizophrenia. Its etiology is unknown. We hypothesized that a decline of blood perfusion to the white matter may underlie the accelerated age-related reduction in FA in schizophrenia. Resting white matter perfusion and FA were collected using pseudo-continuous arterial spin labeling and high-angular-resolution diffusion tensor imaging, respectively, in 50 schizophrenia patients and 70 controls (age = 18-63 years). Main outcome measures were the diagnosis-by-age interaction on whole-brain white matter perfusion, and FA. Significant age-related decline in brain white matter perfusion and FA were present in both groups. Age-by-diagnosis interaction was significant for FA (p < 0.001) but not white matter perfusion. Age-by-diagnosis interaction for FA values remained significant even after accounting for age-related decline in perfusion. Therefore, we replicated the finding of an increased rate of age-related white matter FA decline in schizophrenia and observed a significant age-related decline in white matter blood perfusion, although the latter did not contribute to the accelerated age-related decline in FA. The results suggest that factors other than reduced perfusion account for the accelerated age-related decline in white matter integrity in schizophrenia.
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Affiliation(s)
- Susan Wright
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Peter Kochunov
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Joshua Chiappelli
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Robert McMahon
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Florian Muellerklein
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - S Andrea Wijtenburg
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Michael G White
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - Laura M Rowland
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore
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Jahng GH, Li KL, Ostergaard L, Calamante F. Perfusion magnetic resonance imaging: a comprehensive update on principles and techniques. Korean J Radiol 2014; 15:554-77. [PMID: 25246817 PMCID: PMC4170157 DOI: 10.3348/kjr.2014.15.5.554] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 07/05/2014] [Indexed: 12/16/2022] Open
Abstract
Perfusion is a fundamental biological function that refers to the delivery of oxygen and nutrients to tissue by means of blood flow. Perfusion MRI is sensitive to microvasculature and has been applied in a wide variety of clinical applications, including the classification of tumors, identification of stroke regions, and characterization of other diseases. Perfusion MRI techniques are classified with or without using an exogenous contrast agent. Bolus methods, with injections of a contrast agent, provide better sensitivity with higher spatial resolution, and are therefore more widely used in clinical applications. However, arterial spin-labeling methods provide a unique opportunity to measure cerebral blood flow without requiring an exogenous contrast agent and have better accuracy for quantification. Importantly, MRI-based perfusion measurements are minimally invasive overall, and do not use any radiation and radioisotopes. In this review, we describe the principles and techniques of perfusion MRI. This review summarizes comprehensive updated knowledge on the physical principles and techniques of perfusion MRI.
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Affiliation(s)
- Geon-Ho Jahng
- Department of Radiology, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul 134-727, Korea
| | - Ka-Loh Li
- Wolfson Molecular Imaging Center, The University of Manchester, Manchester M20 3LJ, UK
| | - Leif Ostergaard
- Center for Functionally Integrative Neuroscience, Department of Neuroradiology, Aarhus University Hospital, Aarhus C 8000, Denmark
| | - Fernando Calamante
- Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria 3084, Australia
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