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Ligneul C, Najac C, Döring A, Beaulieu C, Branzoli F, Clarke WT, Cudalbu C, Genovese G, Jbabdi S, Jelescu I, Karampinos D, Kreis R, Lundell H, Marjańska M, Möller HE, Mosso J, Mougel E, Posse S, Ruschke S, Simsek K, Szczepankiewicz F, Tal A, Tax C, Oeltzschner G, Palombo M, Ronen I, Valette J. Diffusion-weighted MR spectroscopy: Consensus, recommendations, and resources from acquisition to modeling. Magn Reson Med 2024; 91:860-885. [PMID: 37946584 DOI: 10.1002/mrm.29877] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/18/2023] [Accepted: 09/08/2023] [Indexed: 11/12/2023]
Abstract
Brain cell structure and function reflect neurodevelopment, plasticity, and aging; and changes can help flag pathological processes such as neurodegeneration and neuroinflammation. Accurate and quantitative methods to noninvasively disentangle cellular structural features are needed and are a substantial focus of brain research. Diffusion-weighted MRS (dMRS) gives access to diffusion properties of endogenous intracellular brain metabolites that are preferentially located inside specific brain cell populations. Despite its great potential, dMRS remains a challenging technique on all levels: from the data acquisition to the analysis, quantification, modeling, and interpretation of results. These challenges were the motivation behind the organization of the Lorentz Center workshop on "Best Practices & Tools for Diffusion MR Spectroscopy" held in Leiden, the Netherlands, in September 2021. During the workshop, the dMRS community established a set of recommendations to execute robust dMRS studies. This paper provides a description of the steps needed for acquiring, processing, fitting, and modeling dMRS data, and provides links to useful resources.
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Affiliation(s)
- Clémence Ligneul
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Chloé Najac
- C.J. Gorter MRI Center, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - André Döring
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
| | - Christian Beaulieu
- Departments of Biomedical Engineering and Radiology, University of Alberta, Alberta, Edmonton, Canada
| | - Francesca Branzoli
- Paris Brain Institute-ICM, Sorbonne University, UMR S 1127, Inserm U 1127, CNRS UMR 7225, Paris, France
| | - William T Clarke
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Cristina Cudalbu
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
- Animal Imaging and Technology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Guglielmo Genovese
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minnesota, Minneapolis, USA
| | - Saad Jbabdi
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Ileana Jelescu
- Department of Radiology, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Dimitrios Karampinos
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Roland Kreis
- MR Methodology, Department for Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
- Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland
| | - Henrik Lundell
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital-Amager anf Hvidovre, Hvidovre, Denmark
- Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Małgorzata Marjańska
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minnesota, Minneapolis, USA
| | - Harald E Möller
- NMR Methods & Development Group, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jessie Mosso
- CIBM Center for Biomedical Imaging, Lausanne, Switzerland
- Animal Imaging and Technology, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- LIFMET, EPFL, Lausanne, Switzerland
| | - Eloïse Mougel
- Université Paris-Saclay, CEA, CNRS, MIRCen, Laboratoires des Maladies Neurodégénératives, Fontenay-aux-Roses, France
| | - Stefan Posse
- Department of Neurology, University of New Mexico School of Medicine, New Mexico, Albuquerque, USA
- Department of Physics and Astronomy, University of New Mexico School of Medicine, New Mexico, Albuquerque, USA
| | - Stefan Ruschke
- Department of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany
| | - Kadir Simsek
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
- School of Computer Science and Informatics, Cardiff University, Cardiff, UK
| | | | - Assaf Tal
- Department of Chemical and Biological Physics, The Weizmann Institute of Science, Rehovot, Israel
| | - Chantal Tax
- University Medical Center Utrecht, Utrecht, The Netherlands
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Physics and Astronomy, Cardiff University, Cardiff, United Kingdom
| | - Georg Oeltzschner
- Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Maryland, Baltimore, USA
- F. M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Maryland, Baltimore, USA
| | - Marco Palombo
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, UK
- School of Computer Science and Informatics, Cardiff University, Cardiff, UK
| | - Itamar Ronen
- Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, Brighton, UK
| | - Julien Valette
- Université Paris-Saclay, CEA, CNRS, MIRCen, Laboratoires des Maladies Neurodégénératives, Fontenay-aux-Roses, France
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Huang X, Xu X, Sun Y, Cai G, Jiang R, Chen J, Xue Y. Ultra-high b value DWI in distinguishing fresh gray matter ischemic lesions from white matter ones: a comparative study with routine and high b value DWI. Quant Imaging Med Surg 2021; 11:4583-4593. [PMID: 34737925 DOI: 10.21037/qims-20-1241] [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: 11/05/2020] [Accepted: 05/28/2021] [Indexed: 11/06/2022]
Abstract
Background Fresh ischemic lesions (FILs) can occur in both the brain's gray matter (GM) and white matter (WM), with each location signifying a different prognosis for patients. This study aims to investigate the application of ultra-high b value diffusion-weighted imaging (DWI) in distinguishing FILs in these two areas via a comparative study with routine and high b value DWI. Methods Multiple b value DWI (b=0, 500, 1,000, 2,000, 4,000, 6,000, 8,000, 10,000 s/mm2) was performed on 47 patients with suspected acute ischemic stroke (AIS). Apparent diffusion coefficient (ADC) maps, including ADC500, ADC1,000, ADC2,000, ADC4,000, ADC6,000, ADC8,000, and ADC10,000, were calculated, and the mean ADC value of the FILs in the GM and WM on each map was obtained by referring to the structural magnetic resonance imaging (MRI). ADC value differences of the FILs in the GM and WM were compared using Mann-Whitney U tests, and receiver operating characteristic (ROC) curves evaluated the diagnostic efficiency of each ADC value in distinguishing FILs in the two areas. Results In the enrolled 34 patients, 145 FILs were identified, of which 42 involved the GM, 87 the WM, and 16 both the GM and WM. A total of 161 regions were delineated, 58 in the GM and 103 in the WM. The values of FILs in the WM on ADC2,000, ADC4,000, ADC6,000, ADC8,000, and ADC10,000 maps were significantly lower than those in the GM (P=0.007, P<0.001, P<0.001, P<0.001 and P<0.001, respectively), while no significant differences were found on ADC500 and ADC1,000 maps (P=0.427 and P=0.225, respectively). ROC curves demonstrated that the area under the curve (AUC) paralleled the increasing b value, ascending from ADC500 to ADC10,000 (0.538, 0.558, 0.629, 0.766, 0.827, 0.859, 0.872, in that order). Conclusions Ultra-high b value DWI is extremely sensitive to the slight diffusion difference between FILs in the GM and the WM. Its sensitivity parallels the increasing b value, indicating its clinical advantage in identifying the microstructure of FILs.
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Affiliation(s)
- Xinming Huang
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xue Xu
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yifan Sun
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Guoen Cai
- Department of Neurology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Rifeng Jiang
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jianhua Chen
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yunjing Xue
- Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, China
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Bagdasarian FA, Yuan X, Athey J, Bunnell BA, Grant SC. NODDI highlights recovery mechanisms in white and gray matter in ischemic stroke following human stem cell treatment. Magn Reson Med 2021; 86:3211-3223. [PMID: 34355818 DOI: 10.1002/mrm.28929] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/22/2021] [Accepted: 06/28/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE Diffusion MRI offers insight into ischemic stroke progression in both human and rodent models. However, diffusion MRI to evaluate therapeutic application of mesenchymal stem cells is limited. Robust analytical techniques are required to identify potential physiological changes as a function of cell therapy in stroke. Here, we seek to establish Neurite Orientation Dispersion and Density Imaging (NODDI) as a feasible method in evaluating stroke evolution in response to cell-based therapeutics. METHODS Diffusion MRI data at 21.1T were acquired from 16 male rats. Rats were grouped randomly: naïve (baseline, N = 5), stroke with injections of phosphate buffered saline (N = 6), stroke with injection of 2D human mesenchymal stem cells (hMSC, N = 5). Data were acquired on days 1, 3, 7, and 21 post-surgery. DTI and NODDI maps were generated, with regions of interest placed in the ischemic hemisphere external capsule and striatum. Diffusion parameters were compared between groups each day, and within groups across hemispheres and longitudinally. Behavioral characterizations were on days 0 (pre-surgery), 3, 7, 14, and 21. RESULTS The 2D hMSC preserved diffusional restriction in the external capsule compared to saline (day 1: MD, P = .4060; AD, P = .0220). NODDI indicates that hMSC may have preserved intracellular volume fractions (ICVF: day 1, P = .0086; day 3, P = .0021; day 21, P = .0383). Diffusion metrics of hMSC treated animals were comparable to naïve for the external capsule. CONCLUSIONS NODDI compliments DTI metrics, enhances interpretation of tissue outcome in ischemic stroke following hMSC application, and may be useful in evaluating or predicting therapeutic response.
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Affiliation(s)
- F Andrew Bagdasarian
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida, USA.,Chemical & Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, Florida, USA
| | - Xuegang Yuan
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida, USA.,Chemical & Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, Florida, USA
| | - Jacob Athey
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida, USA.,Chemical & Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, Florida, USA
| | - Bruce A Bunnell
- Department of Microbiology, Immunology, and Genetics, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Samuel C Grant
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, Florida, USA.,Chemical & Biomedical Engineering, FAMU-FSU College of Engineering, Florida State University, Tallahassee, Florida, USA
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Abstract
In this review, our intension is to present imaging features of several categories of uncommon cases of brain infarctions including infarctions associated with neurovascular variants, infarctions along small arterial territories, and brainstem stroke syndromes. Infarctions associated with neurovascular variants include azygos anterior cerebral artery territory infarction and artery of Percheron infarction. In the second group, we discuss anterior choroidal artery infarction and artery of Heubner infarction. The third group highlights brainstem stroke syndromes, including Claude and Benedikt syndromes due to midbrain infarction; Foville, Marie Foix, and locked-in syndromes due to pontine infarction; and Dejerine (medial medullary), bilateral medial medullary, and Wallenberg (lateral medullary) syndromes.
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Wang Z, Zhang S, Liu C, Yao Y, Shi J, Zhang J, Qin Y, Zhu W. A study of neurite orientation dispersion and density imaging in ischemic stroke. Magn Reson Imaging 2019; 57:28-33. [DOI: 10.1016/j.mri.2018.10.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 10/25/2018] [Accepted: 10/27/2018] [Indexed: 01/11/2023]
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Deng W, Teng J, Liebeskind D, Miao W, Du R. Predictors of Infarct Growth Measured by Apparent Diffusion Coefficient Quantification in Patients with Acute Ischemic Stroke. World Neurosurg 2019; 123:e797-e802. [DOI: 10.1016/j.wneu.2018.12.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 11/25/2022]
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Related Research and Recent Progress of Ischemic Penumbra. World Neurosurg 2018; 116:5-13. [DOI: 10.1016/j.wneu.2018.04.193] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 11/20/2022]
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Imaging the Transformation of Ipsilateral Internal Capsule Following Focal Cerebral Ischemia in Rat by Diffusion Kurtosis Imaging. J Stroke Cerebrovasc Dis 2017; 26:42-48. [DOI: 10.1016/j.jstrokecerebrovasdis.2016.08.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 08/05/2016] [Accepted: 08/17/2016] [Indexed: 12/13/2022] Open
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Morgan CD, Stephens M, Zuckerman SL, Waitara MS, Morone PJ, Dewan MC, Mocco J. Physiologic imaging in acute stroke: Patient selection. Interv Neuroradiol 2015; 21:499-510. [PMID: 26063695 DOI: 10.1177/1591019915587227] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Treatment of acute stroke is changing, as endovascular intervention becomes an important adjunct to tissue plasminogen activator. An increasing number of sophisticated physiologic imaging techniques have unique advantages and applications in the evaluation, diagnosis, and treatment-decision making of acute ischemic stroke. In this review, we first highlight the strengths, weaknesses, and possible indications for various stroke imaging techniques. How acute imaging findings in each modality have been used to predict functional outcome is discussed. Furthermore, there is an increasing emphasis on using these state-of-the-art imaging modalities to offer maximal patient benefit through IV therapy, endovascular thrombolytics, and clot retrieval. We review the burgeoning literature in the determination of stroke treatment based on acute, physiologic imaging findings.
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Affiliation(s)
- Clinton D Morgan
- Department of Neurological Surgery, Vanderbilt University School of Medicine, USA
| | | | - Scott L Zuckerman
- Department of Neurological Surgery, Vanderbilt University School of Medicine, USA
| | | | - Peter J Morone
- Department of Neurological Surgery, Vanderbilt University School of Medicine, USA
| | - Michael C Dewan
- Department of Neurological Surgery, Vanderbilt University School of Medicine, USA
| | - J Mocco
- Department of Neurosurgery, Icahn School of Medicine at Mouth Sinai, USA
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Nartsissov YR, Tyukina ES, Boronovsky SE, Sheshegova EV. Computer modeling of spatial-time distribution of metabolite concentrations in phantoms of biological objects by example of rat brain pial. Biophysics (Nagoya-shi) 2014. [DOI: 10.1134/s0006350913050102] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Purushotham A, Campbell BCV, Straka M, Mlynash M, Olivot JM, Bammer R, Kemp SM, Albers GW, Lansberg MG. Apparent diffusion coefficient threshold for delineation of ischemic core. Int J Stroke 2013; 10:348-53. [PMID: 23802548 DOI: 10.1111/ijs.12068] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Accepted: 10/22/2012] [Indexed: 01/31/2023]
Abstract
BACKGROUND MRI-based selection of patients for acute stroke interventions requires rapid accurate estimation of the infarct core on diffusion-weighted MRI. Typically used manual methods to delineate restricted diffusion lesions are subjective and time consuming. These limitations would be overcome by a fully automated method that can rapidly and objectively delineate the ischemic core. An automated method would require predefined criteria to identify the ischemic core. AIM The aim of this study is to determine apparent diffusion coefficient-based criteria that can be implemented in a fully automated software solution for identification of the ischemic core. METHODS Imaging data from patients enrolled in the Diffusion and Perfusion Imaging Evaluation for Understanding Stroke Evolution (DEFUSE) study who had early revascularization following intravenous thrombolysis were included. The patients' baseline restricted diffusion and 30-day T2 -weighted fluid-attenuated inversion recovery lesions were manually delineated after coregistration. Parts of the restricted diffusion lesion that corresponded with 30-day infarct were considered ischemic core, whereas parts that corresponded with normal brain parenchyma at 30 days were considered noncore. The optimal apparent diffusion coefficient threshold to discriminate core from noncore voxels was determined by voxel-based receiver operating characteristics analysis using the Youden index. RESULTS 51,045 diffusion positive voxels from 14 patients who met eligibility criteria were analyzed. The mean DWI lesion volume was 24 (± 23) ml. Of this, 18 (± 22) ml was ischemic core and 3 (± 5) ml was noncore. The remainder corresponded to preexisting gliosis, cerebrospinal fluid, or was lost to postinfarct atrophy. The apparent diffusion coefficient of core was lower than that of noncore voxels (P < 0.0001). The optimal threshold for identification of ischemic core was an apparent diffusion coefficient ≤ 620 × 10(-6) mm(2) /s (sensitivity 69% and specificity 78%). CONCLUSIONS Our data suggest that the ischemic core can be identified with an absolute apparent diffusion coefficient threshold. This threshold can be implemented in image analysis software for fully automated segmentation of the ischemic core.
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Affiliation(s)
- Archana Purushotham
- Department of Neurology and Neurological Sciences, the Stanford Stroke Center, Stanford University Medical Center, Stanford, CA, USA; Institute for Stem Cell Biology and Regenerative Medicine, National Center for Biological Sciences, Bangalore, India
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Hui ES, Fieremans E, Jensen JH, Tabesh A, Feng W, Bonilha L, Spampinato MV, Adams R, Helpern JA. Stroke assessment with diffusional kurtosis imaging. Stroke 2012; 43:2968-73. [PMID: 22933581 DOI: 10.1161/strokeaha.112.657742] [Citation(s) in RCA: 180] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Despite being the gold standard technique for stroke assessment, conventional diffusion MRI provides only partial information about tissue microstructure. Diffusional kurtosis imaging is an advanced diffusion MRI method that yields, in addition to conventional diffusion information, the diffusional kurtosis, which may help improve characterization of tissue microstructure. In particular, this additional information permits the description of white matter (WM) in terms of WM-specific diffusion metrics. The goal of this study is to elucidate possible biophysical mechanisms underlying ischemia using these new WM metrics. METHODS We performed a retrospective review of clinical and diffusional kurtosis imaging data of 44 patients with acute/subacute ischemic stroke. Patients with a history of brain neoplasm or intracranial hemorrhages were excluded from this study. Region of interest analysis was performed to measure percent change of diffusion metrics in ischemic WM lesions compared with the contralateral hemisphere. RESULTS Kurtosis maps exhibit distinct ischemic lesion heterogeneity that is not apparent on apparent diffusion coefficient maps. Kurtosis metrics also have significantly higher absolute percent change than complementary conventional diffusion metrics. Our WM metrics reveal an increase in axonal density and a larger decrease in the intra-axonal (Da) compared with extra-axonal diffusion microenvironment of the ischemic WM lesion. CONCLUSIONS The well-known decrease in the apparent diffusion coefficient of WM after ischemia is found to be mainly driven by a significant drop in the intra-axonal diffusion microenvironment. Our results suggest that ischemia preferentially alters intra-axonal environment, consistent with a proposed mechanism of focal enlargement of axons known as axonal swelling or beading.
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Affiliation(s)
- Edward S Hui
- Center for Biomedical Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, 68 President Street, MSC 120, Charleston, SC 29425, USA
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