1
|
Józsa TI, Petr J, Payne SJ, Mutsaerts HJMM. MRI-based parameter inference for cerebral perfusion modelling in health and ischaemic stroke. Comput Biol Med 2023; 166:107543. [PMID: 37837725 DOI: 10.1016/j.compbiomed.2023.107543] [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: 03/07/2023] [Revised: 09/07/2023] [Accepted: 09/28/2023] [Indexed: 10/16/2023]
Abstract
Cerebral perfusion modelling is a promising tool to predict the impact of acute ischaemic stroke treatments on the spatial distribution of cerebral blood flow (CBF) in the human brain. To estimate treatment efficacy based on CBF, perfusion simulations need to become suitable for group-level investigations and thus account for physiological variability between individuals. However, computational perfusion modelling to date has been restricted to a few patient-specific cases. This study set out to establish automated parameter inference for perfusion modelling based on neuroimaging data and thus enable CBF simulations of groups. Magnetic resonance imaging (MRI) data from 75 healthy senior adults were utilised. Brain geometries were computed from healthy reference subjects' T1-weighted MRI. Haemodynamic model parameters were determined from spatial CBF maps measured by arterial spin labelling (ASL) perfusion MRI. Thereafter, perfusion simulations were conducted in 75 healthy cases followed by 150 acute ischaemic stroke cases representing an occlusion and CBF cessation in the left and right middle cerebral arteries. The anatomical fitness of the brain geometries was evaluated by comparing the simulated grey (GM) and white matter (WM) volumes to measurements in healthy reference subjects. Strong positive correlations were found in both tissue types (GM: Pearson's r 0.74, P<0.001; WM: Pearson's r 0.84, P<0.001). Haemodynamic parameter tuning was verified by comparing the total volumetric blood flow rate to the brain in healthy reference subjects and simulations (Pearson's r 0.89, P<0.001). In acute ischaemic stroke cases, the simulated infarct volume using a perfusion-based estimate was 197±25 ml. Computational predictions were in agreement with anatomical and haemodynamic values from the literature concerning T1-weighted, T2-weighted, and phase-contrast MRI measurements in healthy scenarios and acute ischaemic stroke cases. The acute stroke simulations did not capture small infarcts (left tail of the distribution), which could be explained by neglected compensatory mechanisms, e.g. collaterals. The proposed parameter inference method provides a foundation for group-level CBF simulations and for in silico clinical stroke trials which could assist in medical device and drug development.
Collapse
Affiliation(s)
- T I Józsa
- Centre for Computational Engineering Sciences, School of Aerospace, Transport and Manufacturing, Cranfield University, Cranfield, UK.
| | - J Petr
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany; Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| | - S J Payne
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, UK; Institute of Applied Mechanics, National Taiwan University, Taipei, Taiwan
| | - H J M M Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Centers, Location VUmc, Amsterdam, The Netherlands
| |
Collapse
|
2
|
Dounavi ME, Mak E, Swann P, Low A, Muniz-Terrera G, McKeever A, Pope M, Williams GB, Wells K, Lawlor B, Naci L, Malhotra P, Mackay C, Koychev I, Ritchie K, Su L, Ritchie CW, O’Brien JT. Differential association of cerebral blood flow and anisocytosis in APOE ε4 carriers at midlife. J Cereb Blood Flow Metab 2023; 43:1672-1684. [PMID: 37132287 PMCID: PMC10581239 DOI: 10.1177/0271678x231173587] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 05/04/2023]
Abstract
Cerebral hemodynamic alterations have been observed in apolipoprotein ε4 (APOE4) carriers at midlife, however the physiological underpinnings of this observation are poorly understood. Our goal was to investigate cerebral blood flow (CBF) and its spatial coefficient of variation (CoV) in relation to APOE4 and a measure of erythrocyte anisocytosis (red blood cell distribution width - RDW) in a middle-aged cohort. Data from 563 participants in the PREVENT-Dementia study scanned with 3 T MRI cross-sectionally were analysed. Voxel-wise and region-of-interest analyses within nine vascular regions were run to detect areas of altered perfusion. Within the vascular regions, interaction terms between APOE4 and RDW in predicting CBF were examined. Areas of hyperperfusion in APOE4 carriers were detected mainly in frontotemporal regions. The APOE4 allele differentially moderated the association between RDW and CBF, an association which was more prominent in the distal vascular territories (p - [0.01, 0.05]). The CoV was not different between the considered groups. We provide novel evidence that in midlife, RDW and CBF are differentially associated in APOE4 carriers and non-carriers. This association is consistent with a differential hemodynamic response to hematological alterations in APOE4 carriers.
Collapse
Affiliation(s)
- Maria-Eleni Dounavi
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Elijah Mak
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Peter Swann
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Audrey Low
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Anna McKeever
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Marianna Pope
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Guy B Williams
- Department of Clinical Neurosciences and Wolfson Brain Imaging Centre, University of Cambridge, Cambridge, UK
| | - Katie Wells
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Brian Lawlor
- Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Lorina Naci
- Institute of Neuroscience, Trinity College Dublin, University of Dublin, Dublin, Ireland
| | - Paresh Malhotra
- Division of Brain Science, Imperial College Healthcare NHS Trust, UK
| | - Clare Mackay
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Ivan Koychev
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Li Su
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Craig W Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - John T O’Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| |
Collapse
|
3
|
Padrela BE, Lorenzini L, Collij LE, García DV, Coomans E, Ingala S, Tomassen J, Deckers Q, Shekari M, de Geus EJC, van de Giessen E, Kate MT, Visser PJ, Barkhof F, Petr J, den Braber A, Mutsaerts HJMM. Genetic, vascular and amyloid components of cerebral blood flow in a preclinical population. J Cereb Blood Flow Metab 2023; 43:1726-1736. [PMID: 37231665 PMCID: PMC10581242 DOI: 10.1177/0271678x231178993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 04/05/2023] [Accepted: 04/09/2023] [Indexed: 05/27/2023]
Abstract
Aging-related cognitive decline can be accelerated by a combination of genetic factors, cardiovascular and cerebrovascular dysfunction, and amyloid-β burden. Whereas cerebral blood flow (CBF) has been studied as a potential early biomarker of cognitive decline, its normal variability in healthy elderly is less known. In this study, we investigated the contribution of genetic, vascular, and amyloid-β components of CBF in a cognitively unimpaired (CU) population of monozygotic older twins. We included 134 participants who underwent arterial spin labeling (ASL) MRI and [18F]flutemetamol amyloid-PET imaging at baseline and after a four-year follow-up. Generalized estimating equations were used to investigate the associations of amyloid burden and white matter hyperintensities with CBF. We showed that, in CU individuals, CBF: 1) has a genetic component, as within-pair similarities in CBF values were moderate and significant (ICC > 0.40); 2) is negatively associated with cerebrovascular damage; and 3) is positively associated with the interaction between cardiovascular risk scores and early amyloid-β burden, which may reflect a vascular compensatory response of CBF to early amyloid-β accumulation. These findings encourage future studies to account for multiple interactions with CBF in disease trajectory analyses.
Collapse
Affiliation(s)
- Beatriz E Padrela
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
| | - Luigi Lorenzini
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
| | - Lyduine E Collij
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
| | - David Vállez García
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
| | - Emma Coomans
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
| | - Silvia Ingala
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
| | - Jori Tomassen
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
| | - Quinten Deckers
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
| | - Mahnaz Shekari
- BBRC: Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Eco JC de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Elsmarieke van de Giessen
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
| | - Mara ten Kate
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
- Queen Square Institute of Neurology and Centre for Medical Image Computing (CMIC), University College London, London, UK
| | - Jan Petr
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Anouk den Braber
- Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Neurodegeneration, Amsterdam, the Netherlands
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Henk JMM Mutsaerts
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, the Netherlands
| |
Collapse
|
4
|
Takeuchi K, Isozaki M, Higashino Y, Kosaka N, Kikuta KI, Ishida S, Kanamoto M, Takei N, Okazawa H, Kimura H. The Utility of Arterial Transit Time Measurement for Evaluating the Hemodynamic Perfusion State of Patients with Chronic Cerebrovascular Stenosis or Occlusive Disease: Correlative Study between MR Imaging and 15O-labeled H 2O Positron Emission Tomography. Magn Reson Med Sci 2023; 22:289-300. [PMID: 35545508 PMCID: PMC10449557 DOI: 10.2463/mrms.mp.2020-0123] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 02/07/2022] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To verify whether arterial transit time (ATT) mapping can correct arterial spin labeling-cerebral blood flow (ASL-CBF) values and to verify whether ATT is a parameter that correlates with positron emission tomography (PET)-oxygen extraction fraction (OEF) and PET-mean transit time (MTT). METHODS Eleven patients with unilateral major cerebral artery stenosis or occlusion underwent MRI and PET in the chronic or asymptomatic phase. ASL-MRI acquisitions were conducted with each of two post-label delay (PLD) settings (0.7s and 2.0s) using a pseudo-continuous ASL pulse sequence and 3D-spin echo spiral readout with vascular crusher gradient. ATT maps were obtained using a low-resolution pre-scan approach with five PLD settings. Using the ASL perfusion images and ATT mapping, ATT-corrected ASL-CBF images were obtained. Four kinds of ASL-CBF methods (PLD 0.7s with or without ATT correction and PLD 2.0s with or without ATT correction) were compared to PET-CBF, using vascular territory ROIs. ATT and OEF were compared for all ROIs, unaffected side ROIs, and affected side ROIs, respectively. ATT and MTT were compared by the ratio of the affected side to the unaffected side. Transit time-based ROIs were used for the comparison with ATT. RESULTS Comparing ASL-CBF and PET-CBF, the correlation was higher with ATT correction than without correction, and for a PLD of 2.0s compared with 0.7s. The best correlation was for PLD of 2.0s with ATT correction (R2 = 0.547). ROIs on the affected side showed a low but significant correlation between ATT and PET-OEF (R2 = 0.141). There was a low correlation between the ATT ratio and the MTT ratio (R2 = 0.133). CONCLUSION Low-resolution ATT correction may increase the accuracy of ASL-CBF measurements in patients with unilateral major cerebral artery stenosis or occlusion. In addition, ATT itself might have a potential role in detecting compromised hemodynamic state.
Collapse
Affiliation(s)
- Kayo Takeuchi
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Makoto Isozaki
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Yoshifumi Higashino
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Nobuyuki Kosaka
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Ken-ichiro Kikuta
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Shota Ishida
- Radiological Center, University of Fukui Hospital, Yoshida-gun, Fukui, Japan
| | - Masayuki Kanamoto
- Radiological Center, University of Fukui Hospital, Yoshida-gun, Fukui, Japan
| | - Naoyuki Takei
- Global MR Applications and Workflow, GE Healthcare, Tokyo, Japan
| | - Hidehiko Okazawa
- Biomedical Imaging Research Center, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Yoshida-gun, Fukui, Japan
| |
Collapse
|
5
|
Dogra S, Wang X, Gupta A, Veraart J, Ishida K, Qiu D, Dehkharghani S. Acetazolamide-augmented BOLD MRI to Assess Whole-Brain Cerebrovascular Reactivity in Chronic Steno-occlusive Disease Using Principal Component Analysis. Radiology 2023; 307:e221473. [PMID: 36916889 PMCID: PMC10140639 DOI: 10.1148/radiol.221473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 01/12/2023] [Accepted: 02/10/2023] [Indexed: 03/16/2023]
Abstract
Background Exhaustion of cerebrovascular reactivity (CVR) portends increased stroke risk. Acetazolamide-augmented blood oxygenation level-dependent (BOLD) MRI has been used to estimate CVR, but low signal-to-noise conditions relegate its use to terminal CVR (CVRend) measurements that neglect dynamic features of CVR. Purpose To demonstrate comprehensive characterization of acetazolamide-augmented BOLD MRI response in chronic steno-occlusive disease using a computational framework to precondition signal time courses for dynamic whole-brain CVR analysis. Materials and Methods This study focused on retrospective analysis of consecutive patients with unilateral chronic steno-occlusive disease who underwent acetazolamide-augmented BOLD imaging for recurrent minor stroke or transient ischemic attack at an academic medical center between May 2017 and October 2020. A custom principal component analysis-based denoising pipeline was used to correct spatially varying non-signal-bearing contributions obtained by a local principal component analysis of the MRI time series. Standard voxelwise CVRend maps representing terminal responses were produced and compared with maximal CVR (CVRmax) as isolated from binned (per-repetition time) denoised BOLD time course. A linear mixed-effects model was used to compare CVRmax and CVRend in healthy and diseased hemispheres. Results A total of 23 patients (median age, 51 years; IQR, 42-61, 13 men) who underwent 32 BOLD examinations were included. Processed MRI data showed twofold improvement in signal-to-noise ratio, allowing improved isolation of dynamic characteristics in signal time course for sliding window CVRmax analysis to the level of each BOLD repetition time (approximately 2 seconds). Mean CVRmax was significantly higher than mean CVRend in diseased (5.2% vs 3.8%, P < .01) and healthy (5.5% vs 4.0%, P < .01) hemispheres. Several distinct time-signal signatures were observed, including nonresponsive; delayed/blunted; brisk; and occasionally nonmonotonic time courses with paradoxical features in normal and abnormal tissues (ie, steal and reverse-steal patterns). Conclusion A principal component analysis-based computational framework for analysis of acetazolamide-augmented BOLD imaging can be used to measure unsustained CVRmax through twofold improvements in signal-to-noise ratio. © RSNA, 2023 Supplemental material is available for this article.
Collapse
Affiliation(s)
- Siddhant Dogra
- From the Departments of Radiology (S. Dogra, A.G., J.V., S. Dehkharghani) and Neurology (K.I., S. Dehkharghani), New York University Langone Health, 660 First Ave, New York, NY 10016; Department of Radiology, Weill Cornell Medical College, New York, NY (X.W.); and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (D.Q.)
| | - Xiuyuan Wang
- From the Departments of Radiology (S. Dogra, A.G., J.V., S. Dehkharghani) and Neurology (K.I., S. Dehkharghani), New York University Langone Health, 660 First Ave, New York, NY 10016; Department of Radiology, Weill Cornell Medical College, New York, NY (X.W.); and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (D.Q.)
| | - Alejandro Gupta
- From the Departments of Radiology (S. Dogra, A.G., J.V., S. Dehkharghani) and Neurology (K.I., S. Dehkharghani), New York University Langone Health, 660 First Ave, New York, NY 10016; Department of Radiology, Weill Cornell Medical College, New York, NY (X.W.); and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (D.Q.)
| | - Jelle Veraart
- From the Departments of Radiology (S. Dogra, A.G., J.V., S. Dehkharghani) and Neurology (K.I., S. Dehkharghani), New York University Langone Health, 660 First Ave, New York, NY 10016; Department of Radiology, Weill Cornell Medical College, New York, NY (X.W.); and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (D.Q.)
| | - Koto Ishida
- From the Departments of Radiology (S. Dogra, A.G., J.V., S. Dehkharghani) and Neurology (K.I., S. Dehkharghani), New York University Langone Health, 660 First Ave, New York, NY 10016; Department of Radiology, Weill Cornell Medical College, New York, NY (X.W.); and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (D.Q.)
| | - Deqiang Qiu
- From the Departments of Radiology (S. Dogra, A.G., J.V., S. Dehkharghani) and Neurology (K.I., S. Dehkharghani), New York University Langone Health, 660 First Ave, New York, NY 10016; Department of Radiology, Weill Cornell Medical College, New York, NY (X.W.); and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (D.Q.)
| | - Seena Dehkharghani
- From the Departments of Radiology (S. Dogra, A.G., J.V., S. Dehkharghani) and Neurology (K.I., S. Dehkharghani), New York University Langone Health, 660 First Ave, New York, NY 10016; Department of Radiology, Weill Cornell Medical College, New York, NY (X.W.); and Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (D.Q.)
| |
Collapse
|
6
|
Rahimzadeh H, Kamkar H, Hoseini-Tabatabaei N, Mobarakeh NM, Habibabadi JM, Hashemi-Fesharaki SS, Nazem-Zadeh MR. Alteration of intracranial blood perfusion in temporal lobe epilepsy, an arterial spin labeling study. Heliyon 2023; 9:e14854. [PMID: 37089370 PMCID: PMC10119575 DOI: 10.1016/j.heliyon.2023.e14854] [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: 09/25/2022] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 04/25/2023] Open
Abstract
Background A critical necessity before surgical resection in mesial temporal lobe epilepsy (mTLE) is lateralizing the seizure focus in the temporal lobe. This study aimed to investigate the differences in perfusion pattern changes in right and left mTLE. Methods 42 mTLE patients (22 left and 20 right mTLE) and 14 controls were surveyed with pulsed arterial spin labeling at 3.0 T. The mean cerebral blood flow (CBF) and asymmetry index (AI) were calculated in the bilateral temporal lobe, amygdala, hippocampus, parahippocampus, and nine bilateral vascular territories ROIs. The alterations in whole-brain CBF were identified using statistical parametric mapping (SPM). Results CBF decreased in ipsilateral sides in both epilepsy subcohorts, with right mTLE showing a significant difference in most ROIs while left mTLE exhibiting no significant change. CBF comparison of left mTLE and controls showed a significant drop in ROI analysis in left middle temporal and left intermediate posterior cerebral artery and in AI analysis in parahippocampus, distal anterior cerebral artery, distal middle cerebral artery, and intermediate anterior cerebral artery. CBF hypoperfusion was seen in ROI analysis in the left intermediate anterior cerebral artery, left middle temporal, right middle temporal, left superior temporal in the right mTLE compared to controls. Left mTLE CBF differed significantly from right mTLE CBF in right distal middle cerebral artery ROI and AI of proximal middle cerebral artery. Conclusion Our result revealed that mTLE affects extratemporal regions and both mTLE subcohorts with different perfusion patterns, which may enhance the performance of preoperative MRI assessment in lateralization procedures.
Collapse
Affiliation(s)
- Hossein Rahimzadeh
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
- Department of Biomedical Engineering and Medical Physics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hadi Kamkar
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
- Bioinformatics and Biophysics Department, Tarbiat Modares University, Tehran, Iran
| | | | - Neda Mohammadi Mobarakeh
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Mohammad-Reza Nazem-Zadeh
- Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran
- Medical Physics and Biomedical Engineering Department, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neuroscience, Monash University, Melbourne, Australia
- Corresponding author.Research Center for Molecular and Cellular Imaging, Advanced Medical Technologies and Equipment Institute (AMTEI), Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
7
|
Vestergaard MB, Iversen HK, Simonsen SA, Lindberg U, Cramer SP, Andersen UB, Larsson HB. Capillary transit time heterogeneity inhibits cerebral oxygen metabolism in patients with reduced cerebrovascular reserve capacity from steno-occlusive disease. J Cereb Blood Flow Metab 2023; 43:460-475. [PMID: 36369740 PMCID: PMC9941865 DOI: 10.1177/0271678x221139084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
The healthy cerebral perfusion demonstrates a homogenous distribution of capillary transit times. A disruption of this homogeneity may inhibit the extraction of oxygen. A high degree of capillary transit time heterogeneity (CTH) describes that some capillaries have very low blood flows, while others have excessively high blood flows and consequently short transit times. Very short transit times could hinder the oxygen extraction due to insufficient time for diffusion of oxygen into the tissue. CTH could be a consequence of cerebral vessel disease. We examined whether patients with cerebral steno-occlusive vessel disease demonstrate high CTH and if elevation of cerebral blood flow (CBF) by administration of acetazolamide (ACZ) increases the cerebral metabolic rate of oxygen (CMRO2), or if some patients demonstrate reduced CMRO2 related to detrimental CTH. Thirty-four patients and thirty-one healthy controls participated. Global CBF and CMRO2 were acquired using phase-contrast MRI. Regional brain maps of CTH were acquired using dynamic contrast-enhanced MRI. Patients with impaired cerebrovascular reserve capacity demonstrated elevated CTH and a significant reduction of CMRO2 after administration of ACZ, which could be related to high CTH. Impaired oxygen extraction from CTH could be a contributing part of the declining brain health observed in patients with cerebral vessel disease.
Collapse
Affiliation(s)
- Mark B Vestergaard
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Helle K Iversen
- Department of Neurology, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Sofie Amalie Simonsen
- Department of Neurology, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Ulrich Lindberg
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Stig P Cramer
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Ulrik B Andersen
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Henrik Bw Larsson
- Functional Imaging Unit, Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
8
|
Khalil AA, Tanritanir AC, Grittner U, Kirilina E, Villringer A, Fiebach JB, Mekle R. Reproducibility of cerebral perfusion measurements using BOLD delay. Hum Brain Mapp 2023; 44:2778-2789. [PMID: 36840928 PMCID: PMC10089099 DOI: 10.1002/hbm.26244] [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: 12/03/2022] [Revised: 02/06/2023] [Accepted: 02/11/2023] [Indexed: 02/26/2023] Open
Abstract
BOLD delay is an emerging, noninvasive method for assessing cerebral perfusion that does not require the use of intravenous contrast agents and is thus particularly suited for longitudinal monitoring. In this study, we assess the reproducibility of BOLD delay using data from 136 subjects with normal cerebral perfusion scanned on two separate occasions with scanners, sequence parameters, and intervals between scans varying between subjects. The effects of various factors on the reproducibility of BOLD delay, defined here as the differences in BOLD delay values between the scanning sessions, were investigated using a linear mixed model. Reproducibility was additionally assessed using the intraclass correlation coefficient of BOLD delay between sessions. Reproducibility was highest in the posterior cerebral artery territory. The mean BOLD delay test-retest difference after accounting for the aforementioned factors was 1.2 s (95% CI = 1.0 to 1.4 s). Overall, BOLD delay shows good reproducibility, but care should be taken when interpreting longitudinal BOLD delay changes that are either very small or are located in certain brain regions.
Collapse
Affiliation(s)
- Ahmed A Khalil
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Ayse C Tanritanir
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrike Grittner
- Berlin Institute of Health (BIH), Berlin, Germany.,Charité - Universitätsmedizin Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Evgeniya Kirilina
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Center for Cognitive Neuroscience Berlin, Free University, Berlin, Germany
| | - Arno Villringer
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jochen B Fiebach
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ralf Mekle
- Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
9
|
Takata K, Kimura H, Ishida S, Isozaki M, Higashino Y, Kikuta KI, Okazawa H, Tsujikawa T. Assessment of Arterial Transit Time and Cerebrovascular Reactivity in Moyamoya Disease by Simultaneous PET/MRI. Diagnostics (Basel) 2023; 13:diagnostics13040756. [PMID: 36832244 PMCID: PMC9955140 DOI: 10.3390/diagnostics13040756] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/07/2023] [Accepted: 02/14/2023] [Indexed: 02/19/2023] Open
Abstract
We investigated the relationship between MRI-arterial spin labeling (ASL) parameters and PET-cerebral blood flow (CBF)/cerebrovascular reactivity (CVR) simultaneously obtained by PET/MRI in Moyamoya disease. Twelve patients underwent 15O-water PET/MRI with the acetazolamide (ACZ) challenge test. PET-CBF and PET-CVR were measured using 15O-water PET. Pseudo-continuous ASL obtained the robust arterial transit time (ATT) and ASL-CBF estimation. ASL parameters were compared with PET-CBF and PET-CVR. Before ACZ loading, absolute and relative ASL-CBF were significantly correlated with absolute and relative PET-CBF (r = 0.44, p < 0.0001, and r = 0.55, p < 0.0001, respectively). After ACZ loading, absolute and relative ASL-CBF were significantly correlated with absolute and relative PET-CBF (r = 0.56, p < 0.001, and r = 0.75, p < 0.0001, respectively), and ΔASL-CBF was significantly correlated with ΔPET-CBF (r = 0.65, p < 0.0001). Baseline ASL-ATT had strong negative correlations with ΔPET-CBF and PET-CVR (r = -0.72, p < 0.0001, and r = -0.66, p < 0.0001, respectively). Baseline ASL-ATT of MCA territories with CVR <30% (1546 ± 79 ms) was significantly higher than that with CVR > 30% (898 ± 197 ms). ASL-ATT ratio of MCA territories with CVR < 30% (94.0 ± 10.5%) was significantly higher than that with CVR > 30% (81.4 ± 11.3%). ATT correction using multiple postlabeling delays increased the accuracy of ASL-CBF quantitation. Baseline ASL-ATT is a hemodynamic parameter and may represent an efficient alternative to PET-CVR.
Collapse
Affiliation(s)
- Kenji Takata
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Shota Ishida
- Department of Radiological Technology, Faculty of Medical Sciences, Kyoto College of Medical Science, Kyoto 622-0041, Japan
| | - Makoto Isozaki
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Yoshifumi Higashino
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Ken-Ichiro Kikuta
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
| | - Hidehiko Okazawa
- Biomedical Imaging Research Center, University of Fukui, Fukui 910-1193, Japan
| | - Tetsuya Tsujikawa
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Fukui 910-1193, Japan
- Correspondence: ; Tel.: +81-776-61-3111; Fax: +81-776-61-8137
| |
Collapse
|
10
|
Zerweck L, Hauser TK, Roder C, Blazhenets G, Khan N, Ernemann U, Meyer PT, Klose U. Evaluation of the cerebrovascular reactivity in patients with Moyamoya Angiopathy by use of breath-hold fMRI: investigation of voxel-wise hemodynamic delay correction in comparison to [ 15O]water PET. Neuroradiology 2023; 65:539-550. [PMID: 36434312 PMCID: PMC9905170 DOI: 10.1007/s00234-022-03088-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/12/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Patients with Moyamoya Angiopathy (MMA) require hemodynamic assessment to evaluate the risk of stroke. Hemodynamic evaluation by use of breath-hold-triggered fMRI (bh-fMRI) was proposed as a readily available alternative to the diagnostic standard [15O]water PET. Recent studies suggest voxel-wise hemodynamic delay correction in hypercapnia-triggered fMRI. The aim of this study was to evaluate the effect of delay correction of bh-fMRI in patients with MMA and to compare the results with [15O]water PET. METHODS bh-fMRI data sets of 22 patients with MMA were evaluated without and with voxel-wise delay correction within different shift ranges and compared to the corresponding [15O]water PET data sets. The effects were evaluated combined and in subgroups of data sets with most severely impaired CVR (apparent steal phenomenon), data sets with territorial time delay, and data sets with neither steal phenomenon nor delay between vascular territories. RESULTS The study revealed a high mean cross-correlation (r = 0.79, p < 0.001) between bh-fMRI and [15O]water PET. The correlation was strongly dependent on the choice of the shift range. Overall, no shift range revealed a significantly improved correlation between bh-fMRI and [15O]water PET compared to the correlation without delay correction. Delay correction within shift ranges with positive high high cutoff revealed a lower agreement between bh-fMRI and PET overall and in all subgroups. CONCLUSION Voxel-wise delay correction, in particular with shift ranges with high cutoff, should be used critically as it can lead to false-negative results in regions with impaired CVR and a lower correlation to the diagnostic standard [15O]water PET.
Collapse
Affiliation(s)
- Leonie Zerweck
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076, Tuebingen, Germany.
| | - Till-Karsten Hauser
- grid.411544.10000 0001 0196 8249Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany
| | - Constantin Roder
- grid.411544.10000 0001 0196 8249Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany
| | - Ganna Blazhenets
- grid.5963.9Department of Nuclear Medicine, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nadia Khan
- grid.411544.10000 0001 0196 8249Department of Neurosurgery, University Hospital Tuebingen, Tuebingen, Germany ,grid.412341.10000 0001 0726 4330Moyamoya Center, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Ulrike Ernemann
- grid.411544.10000 0001 0196 8249Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany
| | - Philipp T. Meyer
- grid.5963.9Department of Nuclear Medicine, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Uwe Klose
- grid.411544.10000 0001 0196 8249Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, 72076 Tuebingen, Germany
| |
Collapse
|
11
|
Mouches P, Wilms M, Aulakh A, Langner S, Forkert ND. Multimodal brain age prediction fusing morphometric and imaging data and association with cardiovascular risk factors. Front Neurol 2022; 13:979774. [PMID: 36588902 PMCID: PMC9794870 DOI: 10.3389/fneur.2022.979774] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 11/16/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction The difference between the chronological and biological brain age, called the brain age gap (BAG), has been identified as a promising biomarker to detect deviation from normal brain aging and to indicate the presence of neurodegenerative diseases. Moreover, the BAG has been shown to encode biological information about general health, which can be measured through cardiovascular risk factors. Current approaches for biological brain age estimation, and therefore BAG estimation, either depend on hand-crafted, morphological measurements extracted from brain magnetic resonance imaging (MRI) or on direct analysis of brain MRI images. The former can be processed with traditional machine learning models while the latter is commonly processed with convolutional neural networks (CNNs). Using a multimodal setting, this study aims to compare both approaches in terms of biological brain age prediction accuracy and biological information captured in the BAG. Methods T1-weighted MRI, containing brain tissue information, and magnetic resonance angiography (MRA), providing information about brain arteries, from 1,658 predominantly healthy adults were used. The volumes, surface areas, and cortical thickness of brain structures were extracted from the T1-weighted MRI data, while artery density and thickness within the major blood flow territories and thickness of the major arteries were extracted from MRA data. Independent multilayer perceptron and CNN models were trained to estimate the brain age from the hand-crafted features and image data, respectively. Next, both approaches were fused to assess the benefits of combining image data and hand-crafted features for brain age prediction. Results The combined model achieved a mean absolute error of 4 years between the chronological and predicted biological brain age. Among the independent models, the lowest mean absolute error was observed for the CNN using T1-weighted MRI data (4.2 years). When evaluating the BAGs obtained using the different approaches and imaging modalities, diverging associations between cardiovascular risk factors were found. For example, BAGs obtained from the CNN models showed an association with systolic blood pressure, while BAGs obtained from hand-crafted measurements showed greater associations with obesity markers. Discussion In conclusion, the use of more diverse sources of data can improve brain age estimation modeling and capture more diverse biological deviations from normal aging.
Collapse
Affiliation(s)
- Pauline Mouches
- Biomedical Engineering Program, University of Calgary, Calgary, AB, Canada,Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada,Department of Radiology, University of Calgary, Calgary, AB, Canada,*Correspondence: Pauline Mouches
| | - Matthias Wilms
- Department of Paediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Agampreet Aulakh
- Schulich School of Engineering, University of Calgary, Calgary, AB, Canada
| | - Sönke Langner
- Institute for Diagnostic Radiology and Neuroradiology, Rostock University Medical Center, Rostock, Germany
| | - Nils D. Forkert
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada,Department of Radiology, University of Calgary, Calgary, AB, Canada,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
12
|
Padmos RM, Arrarte Terreros N, Józsa TI, Závodszky G, Marquering HA, Majoie CBLM, Payne SJ, Hoekstra AG. Modelling collateral flow and thrombus permeability during acute ischaemic stroke. J R Soc Interface 2022; 19:20220649. [PMID: 36195117 PMCID: PMC9532024 DOI: 10.1098/rsif.2022.0649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The presence of collaterals and high thrombus permeability are associated with good functional outcomes after an acute ischaemic stroke. We aim to understand the combined effect of the collaterals and thrombus permeability on cerebral blood flow during an acute ischaemic stroke. A cerebral blood flow model including the leptomeningeal collateral circulation is used to simulate cerebral blood flow during an acute ischaemic stroke. The collateral circulation is varied to capture the collateral scores: absent, poor, moderate and good. Measurements of the transit time, void fraction and thrombus length in acute ischaemic stroke patients are used to estimate thrombus permeability. Estimated thrombus permeability ranges between 10-7 and 10-4 mm2. Measured flow rates through the thrombus are small and the effect of a permeable thrombus on brain perfusion during stroke is small compared with the effect of collaterals. Our simulations suggest that the collaterals are a dominant factor in the resulting infarct volume after a stroke.
Collapse
Affiliation(s)
- Raymond M. Padmos
- Computational Science Laboratory, Informatics Institute, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam 1098, The Netherlands,Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Mekelweg 2, Delft 2628, The Netherlands
| | - Nerea Arrarte Terreros
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands,Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Tamás I. Józsa
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK,Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Amsterdam University Medical Center, Location VUmc, Amsterdam, The Netherlands
| | - Gábor Závodszky
- Computational Science Laboratory, Informatics Institute, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam 1098, The Netherlands
| | - Henk A. Marquering
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands,Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Charles B. L. M. Majoie
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, The Netherlands
| | - Stephen J. Payne
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK,Institute of Applied Mechanics, National Taiwan University, Taiwan
| | - Alfons G. Hoekstra
- Computational Science Laboratory, Informatics Institute, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam 1098, The Netherlands
| |
Collapse
|
13
|
Yu Z, Bai X, Zhang Y, Zhang G, Qiu C, Chen L, Li S, He S, Ma J, Zhao J. Baseline Hemodynamic Impairment and Revascularization Outcome in Newly Diagnosed Adult Moyamoya Disease Determined by Pseudocontinuous Arterial Spin Labeling. World Neurosurg 2022; 165:e494-e504. [PMID: 35750142 DOI: 10.1016/j.wneu.2022.06.084] [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: 03/24/2022] [Revised: 06/15/2022] [Accepted: 06/16/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The study aimed to investigate the hemodynamic features and independent predictors of neoangiogenesis after revascularization in moyamoya disease (MMD) by pseudocontinuous arterial spin labeling magnetic resonance imaging (pCASL MRI). METHODS Thirty-nine MMD patients were categorized into infarction group, hemorrhagic group, and atypical group. All patients underwent combined bypass surgery and pCASL MRI with postlabeling delays (PLD) of 1525 ms and 2525 ms. Absolute CBFMCA (cerebral blood flow in middle cerebral artery territory), relative CBFMCA (CBFMCA 2525 ms/CBFMCA 1525 ms), and spatial coefficient of variation of MCA (CoVMCA) were analyzed. Relationships between CBFMCA and the following clinical parameters were assessed: Suzuki stage, modified Rankin scale (mRS), cerebrovascular accident lesion score, and deep medullary veins score. Potential predictors for favorable neoangiogenesis and hemodynamic changes were explored as well. RESULTS Preoperative CBFMCA differed among MMD patients with variable clinical presentations, Matsushima stages, modified Rankin Scale scores, CVA scores, and deep medullary vein scores. After bypass surgery, mean CBFMCA increased significantly in the infarction group (P = 0.027) and decreased in the hemorrhagic group (P = 0.043), while spatial CoVMCA was observed to decline in all groups. Higher preoperative relative CBFMCA and spatial CoVMCA were independent predictors for robust neoangiogenesis after bypass. The cutoff value of 0.330 of spatial CoVMCA at long PLD yielded the best sensitivity at 82.1% and specificity at 81.8%. Furthermore, both preoperative relative CBFMCA and spatial CoVMCA showed mild positive correlations with ΔmRS in MMD patients. CONCLUSIONS pCASL-MRI with multiple PLDs could reflect preoperative hemodynamic impairment and predict the neoangiogenesis after combined bypass surgery in moyamoya patients.
Collapse
Affiliation(s)
- Zhiqiang Yu
- Nanjing Comprehensive Stroke Center, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Xingcheng Bai
- Nanjing Comprehensive Stroke Center, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Yanping Zhang
- Nanjing Comprehensive Stroke Center, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Guangxu Zhang
- Nanjing Comprehensive Stroke Center, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Chen Qiu
- Nanjing Comprehensive Stroke Center, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Lijiu Chen
- Nanjing Comprehensive Stroke Center, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Shun Li
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Shengxue He
- Nanjing Comprehensive Stroke Center, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Jun Ma
- Nanjing Comprehensive Stroke Center, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Jinbing Zhao
- Nanjing Comprehensive Stroke Center, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China.
| |
Collapse
|
14
|
Yedavalli VS, Quon JL, Tong E, van Staalduinen EK, Mouches P, Kim LH, Steinberg GK, Grant GA, Yeom KW, Forkert ND. Intracranial Artery Morphology in Pediatric Moya Moya Disease and Moya Moya Syndrome. Neurosurgery 2022; 91:710-716. [PMID: 36084178 DOI: 10.1227/neu.0000000000002099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 06/05/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Moya Moya disease (MMD) and Moya Moya syndrome (MMS) are cerebrovascular disorders, which affect the internal carotid arteries (ICAs). Diagnosis and surveillance of MMD/MMS in children mostly rely on qualitative evaluation of vascular imaging, especially MR angiography (MRA). OBJECTIVE To quantitatively characterize arterial differences in pediatric patients with MMD/MMS compared with normal controls. METHODS MRA data sets from 17 presurgery MMD/MMS (10M/7F, mean age = 10.0 years) patients were retrospectively collected and compared with MRA data sets of 98 children with normal vessel morphology (49 male patients; mean age = 10.6 years). Using a level set segmentation method with anisotropic energy weights, the cerebral arteries were automatically extracted and used to compute the radius of the ICA, middle cerebral artery (MCA), anterior cerebral artery (ACA), posterior cerebral artery (PCA), and basilar artery (BA). Moreover, the density and the average radius of all arteries in the MCA, ACA, and PCA flow territories were quantified. RESULTS Statistical analysis revealed significant differences comparing children with MMD/MMS and those with normal vasculature (P < .001), whereas post hoc analyses identified significantly smaller radii of the ICA, MCA-M1, MCA-M2, and ACA (P < .001) in the MMD/MMS group. No significant differences were found for the radii of the PCA and BA or any artery density and average artery radius measurement in the flow territories (P > .05). CONCLUSION His study describes the results of an automatic approach for quantitative characterization of the cerebrovascular system in patients with MMD/MMS with promising preliminary results for quantitative surveillance in pediatric MMD/MMS management.
Collapse
Affiliation(s)
- Vivek S Yedavalli
- Department of Radiology and Radiological Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Jennifer L Quon
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Elizabeth Tong
- Department of Radiology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Eric K van Staalduinen
- Department of Radiology, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Pauline Mouches
- Department of Radiology, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| | - Lily H Kim
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Gary K Steinberg
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Gerald A Grant
- Department of Neurosurgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Kristen W Yeom
- Department of Radiology, Stanford University School of Medicine, Palo Alto, California, USA
| | - Nils D Forkert
- Department of Radiology, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
15
|
Ueda Y, Tanaka Y, Hara S, Inaji M, Ishii K, Maehara T, Nariai T. Differences in cerebral blood flow measurement using arterial spin labeling MRI between patients with moyamoya disease and patients with arteriosclerotic cerebrovascular disease. Acta Radiol 2022; 64:311-319. [PMID: 35037475 DOI: 10.1177/02841851211069245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND It is unclear whether the accuracy of arterial spin labeling (ASL) magnetic resonance imaging (MRI) is the same between moyamoya disease (MMD), which is known to have markedly elevated cerebral blood volume (CBV), and atherosclerotic intracranial arterial stenosis (AS), which has relatively less elevated CBV. PURPOSE To investigate how the differences in hemodynamics affect measurement of ASL-cerebral blood flow (CBF) using ASL for patients with MMD and AS. MATERIAL AND METHODS Fourteen MMD and ten AS patients were evaluated with ASL-MRI, magnetic resonance angiography (MRA), and 15O-gas positron emission computed tomography (PET). The regional CBF values of ASL using two post-labeling delays (PLDs; 1525 ms and 2525 ms) were compared with the PET-derived CBF, CBV, and mean transit time (MTT). Corresponding anterior circulation results were evaluated by flow territory map-based analysis. RESULTS The correlation between the ASL-CBF values (2525 ms) and PET-CBF declined in the MMD group (r = 0.28; P < 0.01), while the AS group showed good correlation (r = 0.77; P < 0.01). In the MMD group, the ASL-CBF values (2525 ms) overestimated the PET-CBF values as the regional CBV values increased (r = 0.35; P < 0.01). When the regions of interest were divided into two subgroups according to the degree of arterial stenosis by MRA, the correlation coefficient between the ASL-CBF (2525 ms) and PET-CBF values improved (mild stenosis: r = 0.36; P = 0.06; severe stenosis: r = 0.51; P < 0.01). CONCLUSION The accuracy of CBF measurements using ASL-MRI differed between patients with MMD and AS. The prominent increase of CBV and the degree of arterial stenosis may have affected the accuracy of ASL-CBF in patients with MMD.
Collapse
Affiliation(s)
- Yasuhiro Ueda
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yoji Tanaka
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Shoko Hara
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Motoki Inaji
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Kenji Ishii
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tadashi Nariai
- Department of Neurosurgery, Tokyo Medical and Dental University, Tokyo, Japan
- Research Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| |
Collapse
|
16
|
Dounavi ME, Low A, McKiernan EF, Mak E, Muniz-Terrera G, Ritchie K, Ritchie CW, Su L, O’Brien JT. Evidence of cerebral hemodynamic dysregulation in middle-aged APOE ε4 carriers: The PREVENT-Dementia study. J Cereb Blood Flow Metab 2021; 41:2844-2855. [PMID: 34078163 PMCID: PMC8543665 DOI: 10.1177/0271678x211020863] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 11/22/2022]
Abstract
Accumulating evidence suggests vascular dysregulation in preclinical Alzheimer's disease. In this study, cerebral hemodynamics and their coupling with cognition in middle-aged apolipoprotein ε4 carriers (APOEε4+) were investigated. Longitudinal 3 T T1-weighted and arterial spin labelling MRI data from 158 participants (40-59 years old) in the PREVENT-Dementia study were analysed (125 two-year follow-up). Cognition was evaluated using the COGNITO battery. Cerebral blood flow (CBF) and cerebrovascular resistance index (CVRi) were quantified for the flow territories of the anterior, middle and posterior cerebral arteries. CBF was corrected for underlying atrophy and individual hematocrit. Hemodynamic measures were the dependent variables in linear regression models, with age, sex, years of education and APOEε4 carriership as predictors. Further analyses were conducted with cognitive outcomes as dependent variables, using the same model as before with additional APOEε4 × hemodynamics interactions. At baseline, APOEε4+ showed increased CBF and decreased CVRi compared to non-carriers in the anterior and middle cerebral arteries, suggestive of potential vasodilation. Hemodynamic changes were similar between groups. Interaction analysis revealed positive associations between CBF changes and performance changes in delayed recall (for APOEε4 non-carriers) and verbal fluency (for APOEε4 carriers) cognitive tests. These observations are consistent with neurovascular dysregulation in middle-aged APOEε4+.
Collapse
Affiliation(s)
- Maria-Eleni Dounavi
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Audrey Low
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Elizabeth F McKiernan
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Elijah Mak
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Karen Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
- INSERM, Montpellier, France
| | - Craig W Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Li Su
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - John T. O’Brien
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| |
Collapse
|
17
|
Ishida S, Kimura H, Takei N, Fujiwara Y, Matsuda T, Kanamoto M, Matta Y, Kosaka N, Kidoya E. Separating spin compartments in arterial spin labeling using delays alternating with nutation for tailored excitation (DANTE) pulse: A validation study using T 2 -relaxometry and application to arterial cerebral blood volume imaging. Magn Reson Med 2021; 87:1329-1345. [PMID: 34687085 DOI: 10.1002/mrm.29052] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 08/31/2021] [Accepted: 09/30/2021] [Indexed: 11/07/2022]
Abstract
PURPOSE To clarify the type of spin compartment in arterial spin labeling (ASL) that is eliminated by delays alternating with nutation for tailored excitation (DANTE) pulse using T2 -relaxometry, and to demonstrate the feasibility of arterial cerebral blood volume (CBVa ) imaging using DANTE-ASL in combination with a simplified two-compartment model. METHOD The DANTE and T2 -preparation modules were combined into a single ASL sequence. T2 values under the application of DANTE were determined to evaluate changes in T2 , along with the post-labeling delay (PLD) and the relationship between transit time without DANTE (TTnoVS ) and T2 . The reference tissue T2 (T2_ref ) was also obtained. Subsequently, the DANTE module was embedded into the Hadamard-encoded ASL. Cerebral blood flow (CBF) and CBVa were computed using two Hadamard-encoding datasets (with and without DANTE) in a rest and breath-holding (BH) task. RESULTS While T2 without DANTE (T2_noVS ) decreased as the PLD increased, T2 with DANTE (T2_DANTE ) was equivalent to T2_ref and did not change with the PLD. Although there was a significant positive correlation between TTnoVS and T2_noVS with short PLD, T2_DANTE was not correlated with TTnoVS nor PLD. Baseline CBVa values obtained at rest were 0.64 ± 0.12, 0.64 ± 0.11, and 0.58 ± 0.15 mL/100 g for anterior, middle, and posterior cerebral arteries, respectively. Significant CBF and CBVa elevations were observed in the BH task. CONCLUSION Microvascular compartment signals were eliminated from the total ASL signals by DANTE. CBVa can be measured using Hadamard-encoded DANTE-ASL in combination with a simplified two-compartment model.
Collapse
Affiliation(s)
- Shota Ishida
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Naoyuki Takei
- Global MR Applications and Workflow, GE Healthcare Japan, Hino, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
| | - Tsuyoshi Matsuda
- Division of Ultra-high Field MRI, Institute for Biomedical Science, Iwate Medical University, Iwate, Japan
| | - Masayuki Kanamoto
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Yuki Matta
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Nobuyuki Kosaka
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Eiji Kidoya
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| |
Collapse
|
18
|
Spatial coefficient of variation of arterial spin labeling MRI for detecting hemodynamic disturbances measured with 15O-gas PET in patients with moyamoya disease. Neuroradiology 2021; 64:675-684. [PMID: 34499192 DOI: 10.1007/s00234-021-02802-y] [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: 06/02/2021] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this study was to investigate whether the spatial coefficient of variation of arterial spin labeling (ASL-CoV) acquired in clinical settings can be used to estimate the hemodynamic disturbances measured with 15O-gas positron emission tomography (PET), especially an increased oxygen extraction fraction (OEF), in patients with moyamoya disease. METHODS We evaluated 68 adult patients with moyamoya disease who underwent ASL (postlabeling delay (PLD) = 1525 ms and 2525 ms) and PET. Regional values were measured using the middle cerebral artery territorial atlas divided into proximal, middle, and distal regions based on the arterial transit time, and correlations of ASL-CoV with cerebral blood flow, cerebral blood volume, mean transit time, and OEF, as well as the relationship between increased OEF and ASL-CoV, were evaluated. RESULTS Regardless of the choice of region and PLD, ASL-CoV was significantly correlated with PET-measured parameters, including OEF (|ρ|= 0.30-0.80, P < 0.001). Regions with an increased OEF showed a significantly higher ASL-CoV than regions with a nonincreased OEF (P ≤ 0.03) regardless of the choice of region and PLD. The accuracy of identification of an increased OEF was highest when using a PLD of 1525 ms and the middle region (area under the curve = 0.750; using a cutoff value of 31.27, sensitivity = 97.4%, specificity = 41.7%, negative predictive value = 92.6%, and positive predictive value = 67.9%). CONCLUSION ASL-CoV may help identify patients with increased OEF.
Collapse
|
19
|
Xiong Y, Ji L, He L, Chen L, Zhang X, Chen Z, Li X, Zhao H, Shirakawa M, Yuan C, Ma Y, Guo H. Effects of Levodopa Therapy on Cerebral Arteries and Perfusion in Parkinson's Disease Patients. J Magn Reson Imaging 2021; 55:943-953. [PMID: 34477268 DOI: 10.1002/jmri.27903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Levodopa is the most-commonly used therapy for Parkinson's Disease (PD). Imaging findings show increased cerebral blood flow (CBF) response to levodopa, but the artery morphological change is less studied. PURPOSE To investigate the effect of levodopa on cerebral arteries and CBF. STUDY TYPE Prospective. POPULATION 57 PD patients (56 ± 10 years, 26 males) and 17 age-matched healthy controls (AMC, 57 ± 9 years, 9 males) were scanned at baseline (OFF). Patients were rescanned 50 minutes after taking levodopa (ON). FIELD STRENGTH AND SEQUENCE 3 T; Simultaneous noncontrast angiography intraplaque imaging (SNAP) based on turbo field echo; Pseudo-continuous arterial spin labeling (PCASL) based on echo-planner imaging. ASSESSMENT The Unified Parkinson's Disease Rating Scale (UPDRS-III) was used to assess the disease severity. Length and radius of arteries were measured from SNAP images. CBF was calculated from PCASL images globally and regionally. STATISTICAL TESTS Mann Whitney U tests were conducted in comparing PD vs. AMC. Wilcoxon matched-pairs signed rank tests were used in comparing OFF vs. ON, and the more-affected vs. the less-affected hemisphere in PD. Linear regressions were performed to test the correlations of neuroimaging findings with behavioral changes. Significance threshold was P < 0.05 with Bonferroni correction. RESULTS PD patients were identified with significantly lower CBF (PD OFF Mean = 40.15 ± 5.99, AMC Mean = 43.48 ± 6.21 mL/100 g/min) and shortened total artery length (PD OFF Mean = 5851.07 ± 1393.45, AMC Mean = 7479.16 ± 1335.93 mm). Levodopa elevated CBF of PD brains (PD ON Mean = 41.48 ± 6.32 mL/100 g/min) and expanded radius of proximal arteries. Artery radius change significantly correlated with CBF change in corresponding territories (r = 0.559 for Internal Carotid Arteries, r = 0.448 for Basilar Artery, and r = 0.464 for Middle Cerebral Artery M1). Global CBF significantly related to UPDRS-III (r = -0.391) post-levodopa. DATA CONCLUSION Levodopa can increase CBF by dilating proximal arteries. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 4.
Collapse
Affiliation(s)
- Yuhui Xiong
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Lanxin Ji
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Le He
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Li Chen
- Vascular Imaging Laboratory, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Xue Zhang
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - Zhensen Chen
- Vascular Imaging Laboratory, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Xuesong Li
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, China
| | - Huilin Zhao
- Vascular Imaging Laboratory, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Manabu Shirakawa
- Vascular Imaging Laboratory, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Chun Yuan
- Vascular Imaging Laboratory, Department of Radiology, University of Washington, Seattle, WA, USA
| | - Yu Ma
- Department of Neurosurgery, Tsinghua University Yuquan Hospital, Beijing, China
| | - Hua Guo
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| |
Collapse
|
20
|
Mash LE, Linke AC, Gao Y, Wilkinson M, Olson MA, Jao Keehn RJ, Müller RA. Blood Oxygen Level-Dependent Lag Patterns Differ Between Rest and Task Conditions, but Are Largely Typical in Autism. Brain Connect 2021; 12:234-245. [PMID: 34102876 DOI: 10.1089/brain.2020.0910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background/Introduction: Autism spectrum disorder (ASD) is characterized by atypical functional connectivity (FC) within and between distributed brain networks. However, FC findings have often been inconsistent, possibly due to a focus on static FC rather than brain dynamics. Lagged connectivity analyses aim at evaluating temporal latency, and presumably neural propagation, between regions. This approach may, therefore, reveal a more detailed picture of network organization in ASD than traditional FC methods. Methods: The current study evaluated whole-brain lag patterns in adolescents with ASD (n = 28) and their typically developing peers (n = 22). Functional magnetic resonance imaging data were collected during rest and during a lexico-semantic decision task. Optimal lag was calculated for each pair of regions of interest by using cross-covariance, and mean latency projections were calculated for each region. Results: Latency projections did not regionally differ between groups, with the same regions emerging among the "earliest" and "latest." Although many of the longest absolute latencies were preserved across resting-state and task conditions, lag patterns overall were affected by condition, as many regions shifted toward zero-lag during task performance. Lag structure was also strongly associated with literature-derived estimates of arterial transit time. Discussion: Results suggest that lag patterns are broadly typical in ASD but undergo changes during task performance. Moreover, lag patterns appear to reflect a combination of neural and vascular sources, which should be carefully considered when interpreting lagged FC.
Collapse
Affiliation(s)
- Lisa E Mash
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, California, USA.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Annika C Linke
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, California, USA
| | - Yangfeifei Gao
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, California, USA.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Molly Wilkinson
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, California, USA.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Michael A Olson
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, California, USA
| | - R Joanne Jao Keehn
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, California, USA
| | - Ralph-Axel Müller
- Brain Development Imaging Laboratories, Department of Psychology, San Diego State University, San Diego, California, USA.,San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| |
Collapse
|
21
|
Age-dependent Intracranial Artery Morphology in Healthy Children. Clin Neuroradiol 2021; 32:49-56. [PMID: 34427700 DOI: 10.1007/s00062-021-01071-9] [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: 03/31/2021] [Accepted: 07/15/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Evaluation of intracranial artery morphology plays an important role in diagnosing a variety of neurovascular diseases. In addition to clinical symptoms, diagnosis currently relies on qualitative rather than quantitative evaluation of vascular imaging sequences, such as magnetic resonance angiography (MRA). However, there is a paucity of literature on normal arterial morphology in the pediatric population across brain development. We aimed to quantitatively assess normal, age-related changes in artery morphology in children. METHODS We performed retrospective analysis of pediatric MRA data obtained from a tertiary referral center. An MRA dataset from 98 children (49 boys/49 girls) aged 0.6-20 years (median = 11.5 years) with normal intracranial vasculature was retrospectively collected between 2011 and 2018. All arteries were automatically segmented to determine the vessel radius. Using an atlas-based approach, the average radius and density of arteries were measured in the three main cerebral vascular territories and the radius of five major arteries was determined at corresponding locations. RESULTS The radii of the major arteries as well as the average artery radius and density in the different vascular territories in the brain remained constant throughout childhood and adolescence (|r| < 0.369 in all cases). CONCLUSION This study presents the first automated evaluation of intracranial vessel morphology on MRA across childhood. Our results can serve as a framework for quantitative evaluation of cerebral vessel morphology in the setting of pediatric neurovascular diseases.
Collapse
|
22
|
van Dalen JW, Mutsaerts HJ, Petr J, Caan MW, van Charante EPM, MacIntosh BJ, van Gool WA, Nederveen AJ, Richard E. Longitudinal relation between blood pressure, antihypertensive use and cerebral blood flow, using arterial spin labelling MRI. J Cereb Blood Flow Metab 2021; 41:1756-1766. [PMID: 33325767 PMCID: PMC8217888 DOI: 10.1177/0271678x20966975] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Consistent cerebral blood flow (CBF) is fundamental to brain function. Cerebral autoregulation ensures CBF stability. Chronic hypertension can lead to disrupted cerebral autoregulation in older people, potentially leading to blood pressure levels interfering with CBF. This study tested whether low BP and AHD use are associated with contemporaneous low CBF, and whether longitudinal change in BP is associated with change in CBF, using arterial spin labelling (ASL) MRI, in a prospective longitudinal cohort of 186 community-dwelling older individuals with hypertension (77 ± 3 years, 53% female), 125 (67%) of whom with 3-year follow-up. Diastolic blood pressure, systolic blood pressure, mean arterial pressure, and pulse pressure were assessed as blood pressure parameters. As additional cerebrovascular marker, we evaluated the ASL signal spatial coefficient of variation (ASL SCoV), a measure of ASL signal heterogeneity that may reflect cerebrovascular health. We found no associations between any of the blood pressure measures and concurrent CBF nor between changes in blood pressure measures and CBF over three-year follow-up. Antihypertensive use was associated with lower grey matter CBF (-5.49 ml/100 g/min, 95%CI = -10.7|-0.27, p = 0.04) and higher ASL SCoV (0.32 SD, 95%CI = 0.12|0.52, p = 0.002). These results warrant future research on the potential relations between antihypertensive use and cerebral perfusion.
Collapse
Affiliation(s)
- Jan Willem van Dalen
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Henri Jmm Mutsaerts
- Department of Radiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jan Petr
- Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Matthan Wa Caan
- Department of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Eric P Moll van Charante
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Bradley J MacIntosh
- Department of Medical Biophysics, University of Toronto, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Willem A van Gool
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Aart J Nederveen
- Department of Radiology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Edo Richard
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| |
Collapse
|
23
|
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.
Collapse
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
| |
Collapse
|
24
|
Mouches P, Langner S, Domin M, Hill MD, Forkert ND. Influence of cardiovascular risk-factors on morphological changes of cerebral arteries in healthy adults across the life span. Sci Rep 2021; 11:12236. [PMID: 34112870 PMCID: PMC8192575 DOI: 10.1038/s41598-021-91669-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 05/27/2021] [Indexed: 11/09/2022] Open
Abstract
Cerebral artery morphological alterations have been associated with several cerebrovascular and neurological diseases, whereas these structures are known to be highly variable among healthy individuals. To date, the knowledge about the influence of cardiovascular risk factors on the morphology of cerebral arteries is rather limited. The aim of this work was to investigate the impact of cardiovascular risk factors on the regional cerebroarterial radius and density. Time-of-Flight magnetic resonance angiography from 1722 healthy adults (21-82 years) were used to extract region-specific measurements describing the main cerebral artery morphology. Multivariate statistical analysis was conducted to quantify the impact of cardiovascular risk factors, including clinical and life behavioural factors, on each region-specific artery measurement. Increased age, blood pressure, and markers of obesity were significantly associated with decreased artery radius and density in most regions, with aging having the greatest impact. Additionally, females showed significantly higher artery density while males showed higher artery radius. Smoking and alcohol consumption did not show any significant association with the artery morphology. The results of this study improve the understanding of the impact of aging, clinical factors, and life behavioural factors on cerebrovascular morphology and can help to identify potential risk factors for cerebrovascular and neurological diseases.
Collapse
Affiliation(s)
- Pauline Mouches
- Department of Radiology, Faculty of Medicine, University of Calgary, Calgary, Canada. .,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.
| | - Sönke Langner
- Institute for Diagnostic Radiology and Neuroradiology, University Medical Center Rostock, Rostock, Germany
| | - Martin Domin
- Functional Imaging Unit, Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - Michael D Hill
- Department of Radiology, Faculty of Medicine, University of Calgary, Calgary, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Nils D Forkert
- Department of Radiology, Faculty of Medicine, University of Calgary, Calgary, Canada.,Department of Clinical Neurosciences, University of Calgary, Calgary, Canada.,Hotchkiss Brain Institute, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| |
Collapse
|
25
|
Padmos RM, Terreros NA, Józsa TI, Závodszky G, Marquering HA, Majoie CBLM, Hoekstra AG. Modelling the leptomeningeal collateral circulation during acute ischaemic stroke. Med Eng Phys 2021; 91:1-11. [PMID: 34074460 DOI: 10.1016/j.medengphy.2021.03.003] [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: 11/24/2020] [Revised: 02/26/2021] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
A novel model of the leptomeningeal collateral circulation is created by combining data from multiple sources with statistical scaling laws. The extent of the collateral circulation is varied by defining a collateral vessel probability. Blood flow and pressure are simulated using a one-dimensional steady state blood flow model. The leptomeningeal collateral vessels provide significant flow during a stroke. The pressure drop over an occlusion predicted by the model ranges between 60 and 85 mmHg depending on the extent of the collateral circulation. The linear transport of contrast material was simulated in the circulatory network. The time delay of peak contrast over an occlusion is 3.3 s in the model, and 2.1 s (IQR 0.8-4.0 s) when measured in dynamic CTA data of acute ischaemic stroke patients. Modelling the leptomeningeal collateral circulation could lead to better estimates of infarct volume and patient outcome.
Collapse
Affiliation(s)
- Raymond M Padmos
- Computational Science Laboratory, Informatics Institute, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, the Netherlands.
| | - Nerea Arrarte Terreros
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, the Netherlands; Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
| | - Tamás I Józsa
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
| | - Gábor Závodszky
- Computational Science Laboratory, Informatics Institute, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, the Netherlands
| | - Henk A Marquering
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, the Netherlands; Department of Biomedical Engineering and Physics, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
| | - Charles B L M Majoie
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, Amsterdam, the Netherlands
| | - Alfons G Hoekstra
- Computational Science Laboratory, Informatics Institute, Faculty of Science, University of Amsterdam, Science Park 904, Amsterdam 1098 XH, the Netherlands
| |
Collapse
|
26
|
Vestergaard MB, Calvo OP, Hansen AE, Rosenbaum S, Larsson HBW, Henriksen OM, Law I. Validation of kinetic modeling of [ 15O]H 2O PET using an image derived input function on hybrid PET/MRI. Neuroimage 2021; 233:117950. [PMID: 33716159 DOI: 10.1016/j.neuroimage.2021.117950] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 02/23/2021] [Accepted: 03/05/2021] [Indexed: 11/15/2022] Open
Abstract
In present study we aimed to validate the use of image-derived input functions (IDIF) in the kinetic modeling of cerebral blood flow (CBF) measured by [15O]H2O PET by comparing with the accepted reference standard arterial input function (AIF). Additional comparisons were made to mean cohort AIF and CBF values acquired by methodologically independent phase-contrast mapping (PCM) MRI. Using hybrid PET/MRI an IDIF was generated by measuring the radiotracer concentration in the internal carotid arteries and correcting for partial volume effects using the intravascular volume measured from MRI-angiograms. Seven patients with carotid steno-occlusive disease and twelve healthy controls were examined at rest, after administration of acetazolamide, and, in the control group, during hyperventilation. Agreement between the techniques was examined by linear regression and Bland-Altman analysis. Global CBF values modeled using IDIF correlated with values from AIF across perfusion states in both patients (p<10-6, R2=0.82, 95% limits of agreement (LoA)=[-11.3-9.9] ml/100 g/min) and controls (p<10-6, R2=0.87, 95% LoA=[-17.1-13.7] ml/100 g/min). The reproducibility of gCBF using IDIF was identical to AIF (15.8%). Values from IDIF and AIF had equally good correlation to measurements by PCM MRI, R2=0.86 and R2=0.84, (p<10-6), respectively. Mean cohort AIF performed substantially worse than individual IDIFs (p<10-6, R2=0.63, LoA=[-12.8-25.3] ml/100 g/min). In the patient group, use of IDIF provided similar reactivity maps compared to AIF. In conclusion, global CBF values modeled using IDIF correlated with values modeled by AIF and similar perfusion deficits could be established in a patient group.
Collapse
Affiliation(s)
- Mark B Vestergaard
- Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark.
| | - Oriol P Calvo
- Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
| | - Adam E Hansen
- Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Sverre Rosenbaum
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - Henrik B W Larsson
- Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Otto M Henriksen
- Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
| | - Ian Law
- Department of Clinical Physiology, Nuclear Medicine, and PET, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
27
|
Roder C, Klose U, Hurth H, Brendle C, Tatagiba M, Ernemann U, Khan N, Hauser TK. Longitudinal Reproducibility of CO2-Triggered BOLD MRI for the Hemodynamic Evaluation of Adult Patients with Moyamoya Angiopathy. Cerebrovasc Dis 2021; 50:332-338. [PMID: 33556937 DOI: 10.1159/000513301] [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: 09/22/2020] [Accepted: 11/14/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND PURPOSE Hemodynamic evaluation of moyamoya patients is crucial to decide the treatment strategy. Recently, CO2-triggered BOLD MRI has been shown to be a promising tool for the hemodynamic evaluation of moyamoya patients. However, the longitudinal reliability of this technique in follow-up examinations is unknown. This study aims to analyze longitudinal follow-up data of CO2-triggered BOLD MRI to prove the reliability of this technique for long-term control examinations in moyamoya patients. METHODS Longitudinal CO2 BOLD MRI follow-up examinations of moyamoya patients with and without surgical revascularization have been analyzed for all 6 vascular territories retrospectively. If revascularization was performed, any directly (by the disease or the bypass) or indirectly (due to change of collateral flow after revascularization) affected territory was excluded based on angiography findings (group 1). In patients without surgical revascularization between the MRI examinations, all territories were analyzed (group 2). RESULTS Eighteen moyamoya patients with 39 CO2 BOLD MRI examinations fulfilled the inclusion criteria. The median follow-up between the 2 examinations was 12 months (range 4-29 months). For 106 vascular territories analyzed in group 1, the intraclass correlation coefficient was 0.784, p < 0.001, and for group 2 (84 territories), it was 0.899, p < 0.001. Within the total follow-up duration of 140 patient months, none of the patients experienced a new stroke. CONCLUSIONS CO2 BOLD MRI is a promising tool for mid- and long-term follow-up examinations of cerebral hemodynamics in moyamoya patients. Systematic prospective evaluation is required prior to making it a routine examination.
Collapse
Affiliation(s)
- Constantin Roder
- Center for Moyamoya and Cerebral Revascularization, Department of Neurosurgery, Eberhard Karls University Tübingen, Tübingen, Germany.,Interdisciplinary Center for Neurovascular Diseases Tübingen (ZNET), Tübingen, Germany
| | - Uwe Klose
- Department of Neuroradiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Helene Hurth
- Center for Moyamoya and Cerebral Revascularization, Department of Neurosurgery, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Cornelia Brendle
- Department of Neuroradiology, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Marcos Tatagiba
- Center for Moyamoya and Cerebral Revascularization, Department of Neurosurgery, Eberhard Karls University Tübingen, Tübingen, Germany.,Interdisciplinary Center for Neurovascular Diseases Tübingen (ZNET), Tübingen, Germany
| | - Ulrike Ernemann
- Department of Neuroradiology, Eberhard Karls University Tübingen, Tübingen, Germany.,Interdisciplinary Center for Neurovascular Diseases Tübingen (ZNET), Tübingen, Germany
| | - Nadia Khan
- Center for Moyamoya and Cerebral Revascularization, Department of Neurosurgery, Eberhard Karls University Tübingen, Tübingen, Germany, .,Moyamoya Center, University Children's Hospital Zürich, Zürich, Switzerland,
| | - Till-Karsten Hauser
- Department of Neuroradiology, Eberhard Karls University Tübingen, Tübingen, Germany
| |
Collapse
|
28
|
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: 19] [Impact Index Per Article: 6.3] [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.
Collapse
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
| |
Collapse
|
29
|
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.
Collapse
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
| |
Collapse
|
30
|
Hilal S, Mutsaerts HJ, Ferro DA, Petr J, Kuijf HJ, Biessels GJ, Chen C. The Effects of Intracranial Stenosis on Cerebral Perfusion and Cognitive Performance. J Alzheimers Dis 2021; 79:1369-1380. [DOI: 10.3233/jad-201131] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Intracranial stenosis (ICS) may contribute to cognitive dysfunction by decreased cerebral blood flow (CBF) which can be measured quantitatively by arterial spin labelling (ASL). Interpretation of CBF measurements with ASL, however, becomes difficult in patients with vascular disease due to prolonged arterial transit time (ATT). Recently, spatial coefficient of variation (sCoV) of ASL signal has been proposed that approximates ATT and utilized as a proxy marker for assessment of hemodynamic status of cerebral circulation. Objective: We investigate the association of ICS with CBF and sCoV parameters and its eventual effects on cognition in a memory clinic population. Methods: We included 381 patients (mean age = 72.3±7.9 years, women = 53.7%) who underwent 3T MRI and detailed neuropsychological assessment. ICS was defined as≥50% stenosis in any intracranial vessel on 3D Time-of-Flight MR Angiography. Gray matter sCoV and CBF were obtained from 2D EPI pseudo-continuous ASL images. Results: ICS was present in 58 (15.2%) patients. Patients with ICS had higher gray matter sCoV and lower CBF. The association with sCoV remained statistically significant after correction for cardiovascular risk factors. Moreover, ICS was associated with worse performance on visuoconstruction, which attenuated with higher sCoV. Mediation analysis showed that there was an indirect effect of ICS on visuoconstruction via sCoV. Conclusion: These findings suggest that compromised CBF as detected by higher sCoV is related to cognitive impairment among individuals diagnosed with ICS. We also showed that sCoV partially mediates the link between ICS and cognition. Therefore, sCoV may provide valuable hemodynamic information in patients with vascular disease.
Collapse
Affiliation(s)
- Saima Hilal
- Department of Pharmacology, National University of Singapore, Singapore
- Memory Aging and Cognition Center, National University Health System, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Henri J.M.M Mutsaerts
- Department of Radiology, VU University Medical Center, Amsterdam, the Netherlands
- Department of Radiology, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Doeschka A. Ferro
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Jan Petr
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - Hugo J. Kuijf
- Image Sciences Institute, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Geert Jan Biessels
- Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands
| | - Christopher Chen
- Department of Pharmacology, National University of Singapore, Singapore
- Memory Aging and Cognition Center, National University Health System, Singapore
| |
Collapse
|
31
|
Kaczmarz S, Göttler J, Petr J, Hansen MB, Mouridsen K, Zimmer C, Hyder F, Preibisch C. Hemodynamic impairments within individual watershed areas in asymptomatic carotid artery stenosis by multimodal MRI. J Cereb Blood Flow Metab 2021; 41:380-396. [PMID: 32237952 PMCID: PMC7812517 DOI: 10.1177/0271678x20912364] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Improved understanding of complex hemodynamic impairments in asymptomatic internal carotid artery stenosis (ICAS) is crucial to better assess stroke risks. Multimodal MRI is ideal for measuring brain hemodynamics and has the potential to improve diagnostics and treatment selections. We applied MRI-based perfusion and oxygenation-sensitive imaging in ICAS with the hypothesis that the sensitivity to hemodynamic impairments will improve within individual watershed areas (iWSA). We studied cerebral blood flow (CBF), cerebrovascular reactivity (CVR), relative cerebral blood volume (rCBV), relative oxygen extraction fraction (rOEF), oxygen extraction capacity (OEC) and capillary transit-time heterogeneity (CTH) in 29 patients with asymptomatic, unilateral ICAS (age 70.3 ± 7.0 y) and 30 age-matched healthy controls. In ICAS, we found significant impairments of CBF, CVR, rCBV, OEC, and CTH (strongest lateralization ΔCVR = -24%), but not of rOEF. Although the spatial overlap of compromised hemodynamic parameters within each patient varied in a complex manner, most pronounced changes of CBF, CVR and rCBV were detected within iWSAs (strongest effect ΔCVR = +117%). At the same time, CTH impairments were iWSA independent, indicating widespread dysfunction of capillary-level oxygen diffusivity. In summary, complementary MRI-based perfusion and oxygenation parameters offer deeper perspectives on complex microvascular impairments in individual patients. Furthermore, knowledge about iWSAs improves the sensitivity to hemodynamic impairments.
Collapse
Affiliation(s)
- Stephan Kaczmarz
- Department of Neuroradiology, School of Medicine, Technical University of Munich (TUM), Munich, Germany.,TUM Neuroimaging Center (TUM-NIC), Technical University of Munich (TUM), Munich, Germany.,MRRC, Yale University, New Haven, CT, USA
| | - Jens Göttler
- Department of Neuroradiology, School of Medicine, Technical University of Munich (TUM), Munich, Germany.,TUM Neuroimaging Center (TUM-NIC), Technical University of Munich (TUM), Munich, Germany.,MRRC, Yale University, New Haven, CT, USA.,Department of Radiology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | - Jan Petr
- PET Center, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Mikkel Bo Hansen
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Kim Mouridsen
- Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Claus Zimmer
- Department of Neuroradiology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| | | | - Christine Preibisch
- Department of Neuroradiology, School of Medicine, Technical University of Munich (TUM), Munich, Germany.,TUM Neuroimaging Center (TUM-NIC), Technical University of Munich (TUM), Munich, Germany.,Clinic for Neurology, School of Medicine, Technical University of Munich (TUM), Munich, Germany
| |
Collapse
|
32
|
Pirastru A, Pelizzari L, Bergsland N, Cazzoli M, Cecconi P, Baglio F, Laganà MM. Consistent Cerebral Blood Flow Covariance Networks across Healthy Individuals and Their Similarity with Resting State Networks and Vascular Territories. Diagnostics (Basel) 2020; 10:diagnostics10110963. [PMID: 33213074 PMCID: PMC7698477 DOI: 10.3390/diagnostics10110963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022] Open
Abstract
Cerebral blood flow (CBF) represents the local blood supply to the brain, and it can be considered a proxy for neuronal activation. Independent component analysis (ICA) can be applied to CBF maps to derive patterns of spatial covariance across subjects. In the present study, we aimed to assess the consistency of the independent components derived from CBF maps (CBF-ICs) across a cohort of 92 healthy individuals. Moreover, we evaluated the spatial similarity of CBF-ICs with respect to resting state networks (RSNs) and vascular territories (VTs). The data were acquired on a 1.5 T scanner using arterial spin labeling (ASL) and resting state functional magnetic resonance imaging. Similarity was assessed considering the entire ASL dataset. Consistency was evaluated by splitting the dataset into subsamples according to three different criteria: (1) random split of age and sex-matched subjects, (2) elderly vs. young, and (3) males vs. females. After standard preprocessing, ICA was performed. Both consistency and similarity were assessed by visually comparing the CBF-ICs. Then, the degree of spatial overlap was quantified with Dice Similarity Coefficient (DSC). Frontal, left, and right occipital, cerebellar, and thalamic CBF-ICs were consistently identified among the subsamples, independently of age and sex, with fair to moderate overlap (0.2 < DSC ≤ 0.6). These regions are functional hubs, and their involvement in many neurodegenerative pathologies has been observed. As slight to moderate overlap (0.2< DSC < 0.5) was observed between CBF-ICs and some RSNs and VTs, CBF-ICs may mirror a combination of both functional and vascular brain properties.
Collapse
Affiliation(s)
- Alice Pirastru
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (A.P.); (L.P.); (N.B.); (M.C.); (P.C.); (M.M.L.)
| | - Laura Pelizzari
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (A.P.); (L.P.); (N.B.); (M.C.); (P.C.); (M.M.L.)
| | - Niels Bergsland
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (A.P.); (L.P.); (N.B.); (M.C.); (P.C.); (M.M.L.)
- Buffalo Neuroimaging Analysis Center, Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY 14203, USA
| | - Marta Cazzoli
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (A.P.); (L.P.); (N.B.); (M.C.); (P.C.); (M.M.L.)
| | - Pietro Cecconi
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (A.P.); (L.P.); (N.B.); (M.C.); (P.C.); (M.M.L.)
| | - Francesca Baglio
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (A.P.); (L.P.); (N.B.); (M.C.); (P.C.); (M.M.L.)
- Correspondence: ; Tel.: +39-0240308844
| | - Maria Marcella Laganà
- IRCCS, Fondazione Don Carlo Gnocchi ONLUS, 20148 Milan, Italy; (A.P.); (L.P.); (N.B.); (M.C.); (P.C.); (M.M.L.)
| |
Collapse
|
33
|
Kwon H, Kim JW, Park M, Kim JW, Kim M, Suh SH, Chang YS, Ahn SJ, Lee JM. Brain Metastases From Lung Adenocarcinoma May Preferentially Involve the Distal Middle Cerebral Artery Territory and Cerebellum. Front Oncol 2020; 10:1664. [PMID: 32984041 PMCID: PMC7484698 DOI: 10.3389/fonc.2020.01664] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 07/28/2020] [Indexed: 11/13/2022] Open
Abstract
Although whole-brain radiation therapy (WBRT) is the mainstay of treatment for brain metastases (BMs), the concept of saving eloquent cortical lesions has been promoted. If BMs from lung cancer are spatially biased to certain regions, this approach can be justified more. We evaluated whether BMs from lung cancer show a preference for certain brain regions and if their distribution pattern differs according to the histologic subtype of the primary lung cancer. In this retrospective study, 562 BMs in 80 patients were analyzed (107 BMs from small cell carcinoma, 432 from adenocarcinoma, and 23 from squamous cell carcinoma). Kernel density estimation was performed to investigate whether BM spatial patterns differed among lung cancer subtypes. Further, we explored more detailed subregions where BMs from adenocarcinomas occur frequently using one-way analysis of variance. Finally, we divided our cohort into those with fewer (≤10) and more (>10) BMs and evaluated whether this biased pattern was maintained across limited and extensive stages. For small cell carcinoma, BMs were biased to the cerebellum, but this did not reach statistical significance. For adenocarcinoma, BMs were found more frequently near the distal middle cerebral artery (MCA) territory and cerebellum than in other arterial territories (p < 0.01). The precentral and postcentral gyri were the most significant subregions within the distal anterior cerebral artery (ACA) and MCA territories (p < 0.01). Crus I and Lobule VI were significant regions within the cerebellum (p < 0.01). Regardless of the number of BMs, the affinity to the distal MCA territory and cerebellum was maintained. The present data confirm that BMs from lung adenocarcinoma may preferentially involve the distal MCA territory and cerebellum.
Collapse
Affiliation(s)
- Hyeokjin Kwon
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Jun Won Kim
- Department of Radiation Oncology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Mina Park
- Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Jin Woo Kim
- Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Minseo Kim
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| | - Sang Hyun Suh
- Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Yoon Soo Chang
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Sung Jun Ahn
- Department of Radiology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, South Korea
| | - Jong-Min Lee
- Department of Biomedical Engineering, Hanyang University, Seoul, South Korea
| |
Collapse
|
34
|
Hara S, Hori M, Hagiwara A, Tsurushima Y, Tanaka Y, Maehara T, Aoki S, Nariai T. Myelin and Axonal Damage in Normal-Appearing White Matter in Patients with Moyamoya Disease. AJNR Am J Neuroradiol 2020; 41:1618-1624. [PMID: 32855183 DOI: 10.3174/ajnr.a6708] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 06/05/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE Although chronic ischemia is known to induce myelin and axonal damage in animal models, knowledge regarding patients with Moyamoya disease is limited. We aimed to investigate the presence of myelin and axonal damage in Moyamoya disease and their relationship with cognitive performance. MATERIALS AND METHODS Eighteen patients with Moyamoya disease (16-55 years of age) and 18 age- and sex-matched healthy controls were evaluated with myelin-sensitive MR imaging based on magnetization transfer saturation imaging and 2-shell diffusion MR imaging. The myelin volume fraction, which reflects the amount of myelin sheath; the g-ratio, which represents the ratio of the inner (axon) to the outer (axon plus myelin) diameter of the fiber; and the axon volume fraction, which reflects axonal components, were calculated and compared between the patients and controls. In the patients with Moyamoya disease, the relationship between these parameters and cognitive task-measuring performance speed was also evaluated. RESULTS Compared with the healthy controls, the patients with Moyamoya disease showed a significant decrease in the myelin and axon volume fractions (P < .05) in many WM regions, while the increases in the g-ratio values were not statistically significant. Correlations with cognitive performance were most frequently observed with the axon volume fraction (r = 0.52-0.54; P < .03 in the right middle and posterior cerebral artery areas) and were the strongest with the g-ratio values in the right posterior cerebral artery region (r = 0.64; P = .004). CONCLUSIONS Myelin-sensitive MR imaging and diffusion MR imaging revealed that myelin and axonal damage exist in patients with Moyamoya disease. The relationship with cognitive performance might be stronger with axonal damage than with myelin damage.
Collapse
Affiliation(s)
- S Hara
- From the Department of Neurosurgery (S.H., Y.T., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan .,Department of Radiology (S.H., M.H., A.H., Y.T., S.A.), Juntendo University, Tokyo, Japan
| | - M Hori
- Department of Radiology (S.H., M.H., A.H., Y.T., S.A.), Juntendo University, Tokyo, Japan.,Department of Diagnostic Radiology (M.H.), Toho University Omori Medical Center, Tokyo, Japan
| | - A Hagiwara
- Department of Radiology (S.H., M.H., A.H., Y.T., S.A.), Juntendo University, Tokyo, Japan
| | - Y Tsurushima
- Department of Radiology (S.H., M.H., A.H., Y.T., S.A.), Juntendo University, Tokyo, Japan.,Department of Radiology (Y.T.), Kenshinkai Tokyo Medical Clinic, Tokyo, Japan
| | - Y Tanaka
- From the Department of Neurosurgery (S.H., Y.T., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
| | - T Maehara
- From the Department of Neurosurgery (S.H., Y.T., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
| | - S Aoki
- Department of Radiology (S.H., M.H., A.H., Y.T., S.A.), Juntendo University, Tokyo, Japan
| | - T Nariai
- From the Department of Neurosurgery (S.H., Y.T., T.M., T.N.), Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
35
|
Ishida S, Kimura H, Isozaki M, Takei N, Fujiwara Y, Kanamoto M, Kosaka N, Matsuda T, Kidoya E. Robust arterial transit time and cerebral blood flow estimation using combined acquisition of Hadamard-encoded multi-delay and long-labeled long-delay pseudo-continuous arterial spin labeling: a simulation and in vivo study. NMR IN BIOMEDICINE 2020; 33:e4319. [PMID: 32424992 DOI: 10.1002/nbm.4319] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 04/03/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
Arterial transit time (ATT) prolongation causes an error of cerebral blood flow (CBF) measurement during arterial spin labeling (ASL). To improve the accuracy of ATT and CBF in patients with prolonged ATT, we propose a robust ATT and CBF estimation method for clinical practice. The proposed method consists of a three-delay Hadamard-encoded pseudo-continuous ASL (H-pCASL) with an additional-encoding and single-delay with long-labeled long-delay (1dLLLD) acquisition. The additional-encoding allows for the reconstruction of a single-delay image with long-labeled short-delay (1dLLSD) in addition to the normal Hadamard sub-bolus images. Five different images (normal Hadamard 3 delay, 1dLLSD, 1dLLLD) were reconstructed to calculate ATT and CBF. A Monte Carlo simulation and an in vivo study were performed to access the accuracy of the proposed method in comparison to normal 7-delay (7d) H-pCASL with equally divided sub-bolus labeling duration (LD). The simulation showed that the accuracy of CBF is strongly affected by ATT. It was also demonstrated that underestimation of ATT and CBF by 7d H-pCASL was higher with longer ATT than with the proposed method. Consistent with the simulation, the 7d H-pCASL significantly underestimated the ATT compared to that of the proposed method. This underestimation was evident in the distal anterior cerebral artery (ACA; P = 0.0394) and the distal posterior cerebral artery (PCA; 2 P = 0.0255). Similar to the ATT, the CBF was underestimated with 7d H-pCASL in the distal ACA (P = 0.0099), distal middle cerebral artery (P = 0.0109), and distal PCA (P = 0.0319) compared to the proposed method. Improving the SNR of each delay image (even though the number of delays is small) is crucial for ATT estimation. This is opposed to acquiring many delays with short LD. The proposed method confers accurate ATT and CBF estimation within a practical acquisition time in a clinical setting.
Collapse
Affiliation(s)
- Shota Ishida
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Makoto Isozaki
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Naoyuki Takei
- Global MR Applications and Workflow, GE Healthcare Japan, Hino, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Masayuki Kanamoto
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Nobuyuki Kosaka
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Tsuyoshi Matsuda
- Division of Ultra-high Field MRI, Institute for Biomedical Science, Iwate Medical University, Yahaba-cho, Shiwa-gun, Iwate, Japan
| | - Eiji Kidoya
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| |
Collapse
|
36
|
Zong X, Lian C, Jimenez J, Yamashita K, Shen D, Lin W. Morphology of perivascular spaces and enclosed blood vessels in young to middle-aged healthy adults at 7T: Dependences on age, brain region, and breathing gas. Neuroimage 2020; 218:116978. [PMID: 32447015 PMCID: PMC7485170 DOI: 10.1016/j.neuroimage.2020.116978] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 05/16/2020] [Accepted: 05/18/2020] [Indexed: 12/30/2022] Open
Abstract
Perivascular spaces (PVSs) are fluid-filled spaces surrounding penetrating blood vessels in the brain and are an integral pathway of the glymphatic system. A PVS and the enclosed blood vessel are commonly visualized as a single vessel-like complex (denoted as PVSV) in high-resolution MRI images. Quantitative characterization of the PVSV morphology in MRI images in healthy subjects may serve as a reference for detecting disease related PVS and/or blood vessel alterations in patients with brain diseases. To this end, we evaluated the age dependences, spatial heterogeneities, and dynamic properties of PVSV morphological features in 45 healthy subjects (21–55 years old), using an ultra-high-resolution three-dimensional transverse relaxation time weighted MRI sequence (0.41 × 0.41 × 0.4 mm3) at 7T. Quantitative PVSV parameters, including apparent diameter, count, volume fraction (VF), and relative contrast to noise ratio (rCNR) were calculated in the white matter and subcortical structures. Dynamic changes were induced by carbogen breathing which are known to induce vasodilation and increase the blood oxygenation level in the brain. PVSV count and VF significantly increased with age in basal ganglia (BG), so did rCNR in BG, midbrain, and white matter (WM). Apparent PVSV diameter also showed a positive association with age in the three brain regions, although it did not reach statistical significance. The PVSV VF and count showed large inter-subject variations, with coefficients of variation ranging from 0.17 to 0.74 after regressing out age and gender effects. Both apparent diameter and VF exhibited significant spatial heterogeneity, which cannot be explained solely by radio-frequency field inhomogeneities. Carbogen breathing significantly increased VF in BG and WM, and rCNR in thalamus, BG, and WM compared to air breathing. Our results are consistent with gradual dilation of PVSs with age in healthy adults. The PVSV morphology exhibited spatial heterogeneity and large inter-subject variations and changed during carbogen breathing compared to air breathing.
Collapse
Affiliation(s)
- Xiaopeng Zong
- Biomedical Research Imaging Center, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Chunfeng Lian
- Biomedical Research Imaging Center, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jordan Jimenez
- Biomedical Research Imaging Center, Chapel Hill, NC, USA
| | - Koji Yamashita
- Biomedical Research Imaging Center, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dinggang Shen
- Biomedical Research Imaging Center, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Weili Lin
- Biomedical Research Imaging Center, Chapel Hill, NC, USA; Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
37
|
Spatial coefficient of variation applied to arterial spin labeling MRI may contribute to predict surgical revascularization outcomes in pediatric moyamoya vasculopathy. Neuroradiology 2020; 62:1003-1015. [DOI: 10.1007/s00234-020-02446-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
|
38
|
Kazumata K, Tokairin K, Ito M, Uchino H, Sugiyama T, Kawabori M, Osanai T, Tha KK, Houkin K. Combined structural and diffusion tensor imaging detection of ischemic injury in moyamoya disease: relation to disease advancement and cerebral hypoperfusion. J Neurosurg 2020; 134:1155-1164. [PMID: 32244209 DOI: 10.3171/2020.1.jns193260] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 01/20/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The microstructural integrity of gray and white matter is decreased in adult moyamoya disease, suggesting covert ischemic injury as a mechanism of cognitive dysfunction. Establishing a microstructural brain imaging marker is critical for monitoring cognitive outcomes following surgical interventions. The authors of the present study determined the pathophysiological basis of altered microstructural brain injury in relation to advanced arterial occlusion, cerebral hypoperfusion, and cognitive function. METHODS The authors examined 58 patients without apparent brain lesions and 30 healthy controls by using structural MRI, as well as diffusion tensor imaging (DTI). Arterial occlusion in each hemisphere was classified as early or advanced stage based on MRA and posterior cerebral artery (PCA) involvement. Regional cerebral blood flow (rCBF) was measured with N-isopropyl-p-[123I]-iodoamphetamine SPECT. Furthermore, cognitive performance was examined using the Wechsler Adult Intelligence Scale, Third Edition and the Trail Making Test (TMT). Both voxel- and region of interest-based analyses were performed for groupwise comparisons, as well as correlation analysis, using parameters such as cognitive test scores; gray matter volume; fractional anisotropy (FA) of association fiber tracts, including the inferior frontooccipital fasciculus (IFOF) and superior longitudinal fasciculus (SLF); PCA involvement; and rCBF. RESULTS Compared to the early stages, advanced stages of arterial occlusion in the left hemisphere were associated with a lower Performance IQ (p = 0.031), decreased anterior cingulate volumes (p = 0.0001, uncorrected), and lower FA in the IFOF, cingulum, and forceps major (all p < 0.01, all uncorrected). There was no significant difference in rCBF between the early and the advanced stage. In patients with an advanced stage, PCA involvement was correlated with a significantly lower Full Scale IQ (p = 0.036), cingulate volume (p < 0.01, uncorrected), and FA of the left SLF (p = 0.0002, uncorrected) compared to those with an intact PCA. The rCBF was positively correlated with FA of the SLF, IFOF, and forceps major (r > 0.34, p < 0.05). Global gray matter volumes were moderately correlated with TMT part A (r = 0.40, p = 0.003). FA values in the left SLF were moderately associated with processing speed (r = 0.40, p = 0.002). CONCLUSIONS Although hemodynamic compensation may mask cerebral ischemia in advanced stages of adult moyamoya disease, the disease progression is detrimental to gray and white matter microstructure as well as cognition. In particular, additional PCA involvement in advanced disease stages may impair key neural substrates such as the cingulum and SLF. Thus, combined structural MRI and DTI are potentially useful for tracking the neural integrity of key neural substrates associated with cognitive function and detecting subtle anatomical changes associated with persistent ischemia, as well as disease progression.
Collapse
Affiliation(s)
- Ken Kazumata
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Kikutaro Tokairin
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Masaki Ito
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Haruto Uchino
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Taku Sugiyama
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Masahito Kawabori
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Toshiya Osanai
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| | - Khin Khin Tha
- 2Clinical Research and Medical Innovation Center, Hokkaido University Hospital, Sapporo, Japan
| | - Kiyohiro Houkin
- 1Department of Neurosurgery, Hokkaido University Graduate School of Medicine; and
| |
Collapse
|
39
|
Nishida S, Aso T, Takaya S, Takahashi Y, Kikuchi T, Funaki T, Yoshida K, Okada T, Kunieda T, Togashi K, Fukuyama H, Miyamoto S. Resting-state Functional Magnetic Resonance Imaging Identifies Cerebrovascular Reactivity Impairment in Patients With Arterial Occlusive Diseases: A Pilot Study. Neurosurgery 2020; 85:680-688. [PMID: 30247676 DOI: 10.1093/neuros/nyy434] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 08/16/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The development of noninvasive approaches for identifying hypoperfused brain tissue at risk is of major interest. Recently, the temporal-shift (TS) maps estimated from resting-state blood oxygenation level-dependent (BOLD) signals have been proposed for determining hemodynamic state. OBJECTIVE To examine the equivalency of the TS map and the cerebrovascular reactivity (CVR) map derived from acetazolamide-challenged single-photon emission computed tomography (SPECT) in identifying hemodynamic impairment in patients with arterial occlusive diseases. METHODS Twenty-three patients with arterial occlusive diseases who underwent SPECT were studied. With a recursive TS analysis of low-frequency fluctuation of the BOLD signal, a TS map relative to the global signal was created for each patient. The voxel-by-voxel correlation coefficient was calculated to examine the image similarity between TS and SPECT-based cerebral blood flow (CBF) or CVR maps in each patient. Furthermore, simple linear regression analyses were performed to examine the quantitative relationship between the TS of BOLD signals and CVR in each cerebrovascular territory. RESULTS The within-patient, voxel-by-voxel comparison revealed that the TS map was more closely correlated with SPECT-CVR map ([Z(r)] = 0.42 ± 0.18) than SPECT-CBF map ([Z(r)] = 0.058 ± 0.11; P < .001, paired t-test). The regression analysis showed a significant linear association between the TS of BOLD signals and CVR in the anterior circulation where the reduction of CVR was evident in the patient group. CONCLUSION BOLD TS analysis has potential as a noninvasive alternative to current methods based on CVR for identification of tissue at risk of ischemic stroke.
Collapse
Affiliation(s)
- Sei Nishida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan.,Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan
| | - Toshihiko Aso
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan.,Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan
| | - Shigetoshi Takaya
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan.,Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan.,Senri Rehabilitation Hospital, Mino City, Osaka Prefecture, Japan
| | - Yuki Takahashi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan.,Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan
| | - Takayuki Kikuchi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan
| | - Takeshi Funaki
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan
| | - Tomohisa Okada
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan.,Department of Radiology, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan
| | - Takeharu Kunieda
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan.,Department of Neurosurgery, Ehime University Graduate School of Medicine, Toon City, Ehime Prefecture, Japan
| | - Kaori Togashi
- Department of Radiology, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan
| | - Hidenao Fukuyama
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto City, Kyoto Prefecture, Japan
| |
Collapse
|
40
|
Fahlström M, Lewén A, Enblad P, Larsson EM, Wikström J. High Intravascular Signal Arterial Transit Time Artifacts Have Negligible Effects on Cerebral Blood Flow and Cerebrovascular Reserve Capacity Measurement Using Single Postlabel Delay Arterial Spin-Labeling in Patients with Moyamoya Disease. AJNR Am J Neuroradiol 2020; 41:430-436. [PMID: 32115416 DOI: 10.3174/ajnr.a6411] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 12/24/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Arterial spin-labeling-derived CBF values may be affected by arterial transit time artefacts. Thus, our aim was to assess to what extent arterial spin-labeling-derived CBF and cerebrovascular reserve capacity values in major vascular regions are overestimated due to the arterial transit time artifacts in patients with Moyamoya disease. MATERIALS AND METHODS Eight patients with Moyamoya disease were included before or after revascularization surgery. CBF maps were acquired using a 3D pseudocontinuous arterial spin-labeling sequence, before and 5, 15, and 25 minutes after an IV acetazolamide injection and were registered to each patient's 3D-T1-weighted images. Vascular regions were defined by spatial normalization to a Montreal Neurological Institute-based vascular regional template. The arterial transit time artifacts were defined as voxels with high signal intensity corresponding to the right tail of the histogram for a given vascular region, with the cutoff selected by visual inspection. Arterial transit time artifact maps were created and applied as masks to exclude arterial transit time artifacts on CBF maps, to create corrected CBF maps. The cerebrovascular reserve capacity was calculated as CBF after acetazolamide injection relative to CBF at baseline for corrected and uncorrected CBF values, respectively. RESULTS A total of 16 examinations were analyzed. Arterial transit time artifacts were present mostly in the MCA, whereas the posterior cerebral artery was generally unaffected. The largest differences between corrected and uncorrected CBF and cerebrovascular reserve capacity values, reported as patient group average ratio and percentage point difference, respectively, were 0.978 (95% CI, 0.968-0.988) and 1.8 percentage points (95% CI, 0.3-3.2 percentage points). Both were found in the left MCA, 15 and 5 minutes post-acetazolamide injection, respectively. CONCLUSIONS Arterial transit time artifacts have negligible overestimation effects on calculated vascular region-based CBF and cerebrovascular reserve capacity values derived from single-delay 3D pseudocontinuous arterial spin-labeling.
Collapse
Affiliation(s)
- M Fahlström
- From the Departments of Surgical Sciences (M.F., E.-M.L., J.W.) and Neuroscience (A.L., P.E.), Uppsala University, Uppsala, Sweden.
| | - A Lewén
- From the Departments of Surgical Sciences (M.F., E.-M.L., J.W.) and Neuroscience (A.L., P.E.), Uppsala University, Uppsala, Sweden
| | - P Enblad
- From the Departments of Surgical Sciences (M.F., E.-M.L., J.W.) and Neuroscience (A.L., P.E.), Uppsala University, Uppsala, Sweden
| | - E-M Larsson
- From the Departments of Surgical Sciences (M.F., E.-M.L., J.W.) and Neuroscience (A.L., P.E.), Uppsala University, Uppsala, Sweden
| | - J Wikström
- From the Departments of Surgical Sciences (M.F., E.-M.L., J.W.) and Neuroscience (A.L., P.E.), Uppsala University, Uppsala, Sweden
| |
Collapse
|
41
|
Bolar DS, Gagoski B, Orbach DB, Smith E, Adalsteinsson E, Rosen BR, Grant PE, Robertson RL. Comparison of CBF Measured with Combined Velocity-Selective Arterial Spin-Labeling and Pulsed Arterial Spin-Labeling to Blood Flow Patterns Assessed by Conventional Angiography in Pediatric Moyamoya. AJNR Am J Neuroradiol 2019; 40:1842-1849. [PMID: 31694821 PMCID: PMC6975103 DOI: 10.3174/ajnr.a6262] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/21/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Imaging CBF is important for managing pediatric moyamoya. Traditional arterial spin-labeling MR imaging detects delayed transit thorough diseased arteries but is inaccurate for measuring perfusion because of these delays. Velocity-selective arterial spin-labeling is insensitive to transit delay and well-suited for imaging Moyamoya perfusion. This study assesses the accuracy of a combined velocity-selective arterial spin-labeling and traditional pulsed arterial spin-labeling CBF approach in pediatric moyamoya, with comparison to blood flow patterns on conventional angiography. MATERIALS AND METHODS Twenty-two neurologically stable pediatric patients with moyamoya and 5 asymptomatic siblings without frank moyamoya were imaged with velocity-selective arterial spin-labeling, pulsed arterial spin-labeling, and DSA (patients). Qualitative comparison was performed, followed by a systematic comparison using ASPECTS-based scoring. Quantitative pulsed arterial spin-labeling CBF and velocity-selective arterial spin-labeling CBF for the middle cerebral artery, anterior cerebral artery, and posterior cerebral artery territories were also compared. RESULTS Qualitatively, velocity-selective arterial spin-labeling perfusion maps reflect the DSA parenchymal phase, regardless of postinjection timing. Conversely, pulsed arterial spin-labeling maps reflect the DSA appearance at postinjection times closer to the arterial spin-labeling postlabeling delay, regardless of vascular phase. ASPECTS comparison showed excellent agreement (88%, κ = 0.77, P < .001) between arterial spin-labeling and DSA, suggesting velocity-selective arterial spin-labeling and pulsed arterial spin-labeling capture key perfusion and transit delay information, respectively. CBF coefficient of variation, a marker of perfusion variability, was similar for velocity-selective arterial spin-labeling in patient regions of delayed-but-preserved perfusion compared to healthy asymptomatic sibling regions (coefficient of variation = 0.30 versus 0.26, respectively, Δcoefficient of variation = 0.04), but it was significantly different for pulsed arterial spin-labeling (coefficient of variation = 0.64 versus 0.34, Δcoefficient of variation = 0.30, P < .001). CONCLUSIONS Velocity-selective arterial spin-labeling offers a powerful approach to image perfusion in pediatric moyamoya due to transit delay insensitivity. Coupled with pulsed arterial spin-labeling for transit delay information, a volumetric MR imaging approach capturing key DSA information is introduced.
Collapse
Affiliation(s)
- D S Bolar
- From the Department of Radiology (D.S.B.)
- Center for Functional Magnetic Resonance Imaging (D.S.B.), UC San Diego, La Jolla, California
| | - B Gagoski
- Fetal Neonatal Neuroimaging and Developmental Science Center (B.G., P.E.G.)
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
| | - D B Orbach
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
- Division of Neurointerventional Radiology (D.B.O.)
| | - E Smith
- Department of Neurosurgery (E.S.)
| | - E Adalsteinsson
- Department of Electrical Engineering & Computer Science (E.A.), Massachusetts Institute of Technology, Cambridge, Massachusetts
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging (E.A., B.R.R.), Charlestown, Massachusetts
| | - B R Rosen
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging (E.A., B.R.R.), Charlestown, Massachusetts
| | - P E Grant
- Fetal Neonatal Neuroimaging and Developmental Science Center (B.G., P.E.G.)
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
- Division of Newborn Medicine (P.E.G.), Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - R L Robertson
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
| |
Collapse
|
42
|
de Rooij SR, Mutsaerts HJMM, Petr J, Asllani I, Caan MWA, Groot P, Nederveen AJ, Schwab M, Roseboom TJ. Late-life brain perfusion after prenatal famine exposure. Neurobiol Aging 2019; 82:1-9. [PMID: 31376728 DOI: 10.1016/j.neurobiolaging.2019.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/29/2019] [Accepted: 06/30/2019] [Indexed: 01/10/2023]
Abstract
Early nutritional deprivation may cause irreversible damage to the brain and seems to affect cognitive function in older age. We investigated whether prenatal undernutrition was associated with brain perfusion differences in older age. We acquired Arterial spin labeling scans in 118 Dutch famine birth cohort members. Using linear regression analyses, cerebral blood flow was compared between exposed and unexposed groups in gray matter (GM) and white matter (WM), perfusion territories, the neurodegeneration-related regions anterior and posterior cingulate cortex and precuneus. Furthermore, we compared the GM/WM ratio and the spatial coefficient of variation as a proxy of overall cerebrovascular health. The WM arterial spin labeling signal and the GM/WM ratio were significantly lower and higher, respectively, among exposed participants (-2.5 mL/100 g/min [95% CI: -4.3 to -0.8; p = 0.01] and 0.48 [0.19 to 0.76; p = 0.002], respectively). Exposed men had lower cerebral blood flow in anterior and posterior cingulate cortices (-8.0 mL/100 g/min [-15.1 to -0.9; p = 0.03]; -11.4 mL/100 g/min [-19.6 to -3.2; p = 0.02]) and higher spatial coefficient of variation (0.05 [0.00 to 0.09; p = 0.05]). The latter seemed largely mediated by higher 2h-glucose levels at age 50. Our findings suggest that prenatal undernutrition affects brain perfusion parameters providing further evidence for life-long effects of undernutrition during early brain development.
Collapse
Affiliation(s)
- Susanne R de Rooij
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, the Netherlands.
| | | | - Jan Petr
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Dresden, Germany; Department of Biomedical Engineering, Rochester Institute of Technology, College of Engineering, Rochester, NY, USA
| | - Iris Asllani
- Department of Biomedical Engineering, Rochester Institute of Technology, College of Engineering, Rochester, NY, USA
| | - Matthan W A Caan
- Department of Biomedical Engineering & Physics, Amsterdam UMC, the Netherlands
| | - Paul Groot
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, the Netherlands
| | - Aart J Nederveen
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, the Netherlands
| | - Matthias Schwab
- Hans Berger Department of Neurology, Jena University Hospital, Jena, Germany
| | - Tessa J Roseboom
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, the Netherlands; Department of Obstetrics and Gynaecology, Amsterdam UMC, the Netherlands
| |
Collapse
|
43
|
Ponticorvo S, Manara R, Pfeuffer J, Cappiello A, Cuoco S, Pellecchia MT, Saponiero R, Troisi D, Cassandro C, John M, Scarpa A, Cassandro E, Di Salle F, Esposito F. Cortical pattern of reduced perfusion in hearing loss revealed by ASL-MRI. Hum Brain Mapp 2019; 40:2475-2487. [PMID: 30715769 DOI: 10.1002/hbm.24538] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/21/2019] [Accepted: 01/25/2019] [Indexed: 02/05/2023] Open
Abstract
Age-related hearing loss (HL) can be related to brain dysfunction or structural damage and may result in cerebral metabolic/perfusion abnormalities. Arterial spin labeling (ASL) magnetic resonance imaging (MRI) allows investigating noninvasively brain perfusion changes. Pseudocontinuous ASL and T1-weighted MRI (at 3 T) and neuropsychological testing (Montreal Cognitive Assessment) were performed in 31 HL (age range = 47-77 years, mean age ± SD = 63.4 ± 8.4 years, pure-tone average [PTA] HL > 50 dB) and 28 normal hearing (NH; age range = 48-78 years, mean age ± SD = 59.7 ± 7.4 years) subjects. Cerebral blood flow (CBF) and gray matter volume (GMV) were analyzed in the cortical volume to assess perfusion and structural group differences. Two HL subjects showing cognitive impairment were excluded from group comparisons. No significant differences in either global or local atrophy were detected between groups but the HL group exhibited significant regional effects of reduced perfusion within the bilateral primary auditory cortex, with maximal CBF difference (-17.2%) in the right lateral Heschl's gyrus. For the whole sample of HL and NH subjects (n = 59 = 31 HL + 28 NH), the regional CBF was correlated positively to the regional GMV (p = 0.020). In HL subjects (n = 31), the regional CBF was correlated negatively to the audiogram steepness (frequency range: 2-4 kHz, right ear: p = 0.022, left ear: p = 0.015). The observed cortical pattern of perfusion reduction suggests that neuronal metabolism can be related to HL before the recognition of brain structural damage. This also illustrates the potential of ASL-MRI to contribute early functional markers of reduced central processing associated with HL.
Collapse
Affiliation(s)
- Sara Ponticorvo
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Renzo Manara
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Josef Pfeuffer
- MR Application Development, Siemens Healthcare GmbH, Erlangen, Germany
| | - Arianna Cappiello
- Department of Neurosciences and Craniofacial Disorders, Scuola Medica Salernitana, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Sofia Cuoco
- Department of Neurosciences and Craniofacial Disorders, Scuola Medica Salernitana, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Maria Teresa Pellecchia
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.,Department of Neurosciences and Craniofacial Disorders, Scuola Medica Salernitana, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Renato Saponiero
- Department of Diagnostic Imaging, Scuola Medica Salernitana, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Donato Troisi
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.,Department of Neurosciences and Craniofacial Disorders, Scuola Medica Salernitana, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Claudia Cassandro
- Department of Neurosciences and Craniofacial Disorders, Scuola Medica Salernitana, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Marta John
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy
| | - Alfonso Scarpa
- Department of Neurosciences and Craniofacial Disorders, Scuola Medica Salernitana, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Ettore Cassandro
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.,Department of Neurosciences and Craniofacial Disorders, Scuola Medica Salernitana, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Francesco Di Salle
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.,Department of Diagnostic Imaging, Scuola Medica Salernitana, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| | - Fabrizio Esposito
- Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Salerno, Italy.,Department of Diagnostic Imaging, Scuola Medica Salernitana, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
| |
Collapse
|
44
|
Hauser TK, Seeger A, Bender B, Klose U, Thurow J, Ernemann U, Tatagiba M, Meyer PT, Khan N, Roder C. Hypercapnic BOLD MRI compared to H 215O PET/CT for the hemodynamic evaluation of patients with Moyamoya Disease. NEUROIMAGE-CLINICAL 2019; 22:101713. [PMID: 30743136 PMCID: PMC6370561 DOI: 10.1016/j.nicl.2019.101713] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 01/14/2019] [Accepted: 02/03/2019] [Indexed: 11/30/2022]
Abstract
Background and purpose Patients with Moyamoya Disease (MMD) need hemodynamic evaluation of vascular territories at risk of stroke. Today's investigative standards include H215O PET/CT with pharmacological challenges with acetazolamide (ACZ). Recent developments suggest that CO2-triggered blood‑oxygen-level-dependent (BOLD) functional MRI might provide comparable results to current standard methods for evaluation of territorial hemodynamics, while being a more widely available and easily implementable method. This study examines results of a newly developed quantifiable analysis algorithm for CO2-triggered BOLD MRI in Moyamoya patients and correlates the results with H215O PET/CT with ACZ challenge to assess comparability between both modalities. Methods CO2-triggered BOLD MRI was performed and compared to H215O PET/CT with ACZ challenge in patients with angiographically proven MMD. Images of both modalities were analyzed retrospectively in a blinded, standardized fashion by visual inspection, as well as with a semi-quantitative analysis using stimuli-induced approximated regional perfusion-weighted data and BOLD-signal changes with reference to cerebellum. Results 20 consecutive patients fulfilled the inclusion criteria, a total of 160 vascular territories were analyzed retrospectively. Visual analysis (4-step visual rating system) of standardized, color-coded cerebrovascular reserve/reactivity maps showed a very strong correlation (Spearman's rho = 0.9, P < 0.001) between both modalities. Likewise, comparison of approximated regional perfusion changes across vascular territories (normalized to cerebellar change) reveal a highly significant correlation between both methods (Pearson's r = 0.71, P < 0.001). Conclusions The present analysis indicates that CO2-triggered BOLD MRI is a very promising tool for the hemodynamic evaluation of MMD patients with results comparable to those seen in H215O PET/CT with ACZ challenge. It therefore holds future potential in becoming a routine examination in the pre- and postoperative evaluation of MMD patients after further prospective evaluation. Non-invasive cerebrovascular reactivity measurement with BOLD MRI. CO2-triggered BOLD MRI correlates strongly with H215O PET/CT with ACZ challenge Widely-available tool for the hemodynamic evaluation of Moyamoya patients.
Collapse
Affiliation(s)
| | - Achim Seeger
- Department of Neuroradiology, Eberhard Karls University Tübingen, Germany
| | - Benjamin Bender
- Department of Neuroradiology, Eberhard Karls University Tübingen, Germany
| | - Uwe Klose
- Department of Neuroradiology, Eberhard Karls University Tübingen, Germany
| | - Johannes Thurow
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ulrike Ernemann
- Department of Neuroradiology, Eberhard Karls University Tübingen, Germany
| | - Marcos Tatagiba
- Department of Neurosurgery, Eberhard Karls University Tübingen, Germany
| | - Philipp T Meyer
- Department of Nuclear Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Nadia Khan
- Department of Neurosurgery, Eberhard Karls University Tübingen, Germany; Moyamoya Center, Division of Pediatric Neurosurgery, University Children's Hospital Zürich, Switzerland.
| | - Constantin Roder
- Department of Neurosurgery, Eberhard Karls University Tübingen, Germany
| |
Collapse
|
45
|
Ibaraki M, Nakamura K, Toyoshima H, Takahashi K, Matsubara K, Umetsu A, Pfeuffer J, Kuribayashi H, Kinoshita T. Spatial coefficient of variation in pseudo-continuous arterial spin labeling cerebral blood flow images as a hemodynamic measure for cerebrovascular steno-occlusive disease: A comparative 15O positron emission tomography study. J Cereb Blood Flow Metab 2019; 39:173-181. [PMID: 29869933 PMCID: PMC6311663 DOI: 10.1177/0271678x18781667] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Pseudo-continuous arterial spin labeling (pCASL) is a completely non-invasive method of cerebral perfusion measurement. However, cerebral blood flow (CBF) quantification is hampered by arterial transit artifacts characterized by bright vascular signals surrounded by decreased signals in tissue regions, which commonly appear in patients with reduced cerebral perfusion pressure. The spatial coefficient of variation (CoV) of pCASL CBF images has been proposed as an alternative region-of-interest (ROI)-based hemodynamic measure to predict prolonged arterial transit time (ATT). This retrospective study investigates the utility of spatial CoV by comparison with 15O positron emission tomography (PET). For patients with cerebrovascular steno-occlusive disease ( n = 17), spatial CoV was positively correlated with ATT independently measured by pulsed arterial spin labeling ( r = 0.597, p < 0.001), confirming its role as an ATT-like hemodynamic measure. Comparisons with 15O PET demonstrated that spatial CoV was positively correlated with vascular mean transit time ( r = 0.587, p < 0.001) and negatively correlated with both resting CBF ( r = -0.541, p = 0.001) and CBF response to hypercapnia ( r = -0.373, p = 0.030). ROI-based spatial CoV calculated from single time-point pCASL can potentially detect subtle perfusion abnormalities in clinical settings.
Collapse
Affiliation(s)
- Masanobu Ibaraki
- 1 Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, Akita, Japan
| | - Kazuhiro Nakamura
- 1 Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, Akita, Japan
| | - Hideto Toyoshima
- 1 Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, Akita, Japan
| | - Kazuhiro Takahashi
- 1 Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, Akita, Japan
| | - Keisuke Matsubara
- 1 Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, Akita, Japan
| | - Atsushi Umetsu
- 1 Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, Akita, Japan
| | | | | | - Toshibumi Kinoshita
- 1 Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, Akita, Japan
| |
Collapse
|
46
|
Tortora D, Severino M, Pacetti M, Morana G, Mancardi MM, Capra V, Cama A, Pavanello M, Rossi A. Noninvasive Assessment of Hemodynamic Stress Distribution after Indirect Revascularization for Pediatric Moyamoya Vasculopathy. AJNR Am J Neuroradiol 2018; 39:1157-1163. [PMID: 29674415 DOI: 10.3174/ajnr.a5627] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/14/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Indirect revascularization surgery is an effective treatment in children with Moyamoya vasculopathy. In the present study, we hypothesized that DSC-PWI may reliably assess the evolution of CBF-related parameters after revascularization surgery, monitoring the outcome of surgical pediatric patients with Moyamoya vasculopathy. Thus, we aimed to evaluate differences in DSC-PWI parameters, including the hemodynamic stress distribution, in surgical and nonsurgical children with Moyamoya vasculopathy and to correlate them with long-term postoperative outcome. MATERIALS AND METHODS Pre- and postoperative DSC parameters of 28 patients (16 females; mean age, 5.5 ± 4.8 years) treated with indirect revascularization were compared with those obtained at 2 time points in 10 nonsurgical patients (6 females; mean age, 6.9 ± 4.7 years). We calculated 4 normalized CBF-related parameters and their percentage variance: mean normalized CBF of the MCA territory, mean normalized CBF of the proximal MCA territory, mean normalized CBF of cortical the MCA territory, and hemodynamic stress distribution. The relationship between perfusion parameters and postoperative outcomes (poor, fair, good, excellent) was explored using 1-way analysis of covariance (P < .05). RESULTS A significant decrease of the mean normalized CBF of the proximal MCA territory and hemodynamic stress distribution and an increase of the mean normalized CBF of the cortical MCA territory were observed after revascularization surgery (P < .001). No variations were observed in nonsurgical children. Postoperative hemodynamic stress distribution and its percentage change were significantly different in outcome groups (P < .001). CONCLUSIONS DSC-PWI indices show postoperative hemodynamic changes that correlate with clinical outcome after revascularization surgery in children with Moyamoya disease.
Collapse
Affiliation(s)
- D Tortora
- From the Neuroradiology (D.T., M.S., G.M., A.R.)
| | - M Severino
- From the Neuroradiology (D.T., M.S., G.M., A.R.)
| | - M Pacetti
- Neurosurgery (M.P., V.C., A.C., M.P.)
| | - G Morana
- From the Neuroradiology (D.T., M.S., G.M., A.R.)
| | - M M Mancardi
- Neuropsychiatry Units (M.M.M.), Istituto Giannina Gaslini, Genoa, Italy
| | - V Capra
- Neurosurgery (M.P., V.C., A.C., M.P.)
| | - A Cama
- Neurosurgery (M.P., V.C., A.C., M.P.)
| | | | - A Rossi
- From the Neuroradiology (D.T., M.S., G.M., A.R.)
| |
Collapse
|
47
|
Huang CW, Hsu SW, Chang YT, Huang SH, Huang YC, Lee CC, Chang WN, Lui CC, Chen NC, Chang CC. Cerebral Perfusion Insufficiency and Relationships with Cognitive Deficits in Alzheimer's Disease: A Multiparametric Neuroimaging Study. Sci Rep 2018; 8:1541. [PMID: 29367598 PMCID: PMC5784155 DOI: 10.1038/s41598-018-19387-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 11/28/2017] [Indexed: 12/30/2022] Open
Abstract
Micro- or macro-circulatory insufficiency has a negative impact in patients with Alzheimer’s disease (AD). This study used arterial spin-labeled magnetic resonance imaging (ASL-MRI) and ethylcysteinate dimer single-photon emission computed tomography (ECD-SPECT) in 50 patients with AD and 30 age-matched controls to investigate how hypoperfusion patterns were associated with gray matter atrophy and clinical data. All participants completed 3DT1-MRI, ECD-SPECT and ASL-MRI examinations. Medial temporal cortex (MTC) volumes were correlated with regional signals showing significantly lower relative cerebral blood flow (rCBF) in ASL-MRI or perfusion index (PI) in ECD-SPECT. Neurobehavioral scores served as the outcome measures. Regions with lower PI showed spatial similarities with atrophy in the medial, anterior and superior temporal lobes, posterior cingulate cortex and angular gyrus, while regions showing lower rCBF were localized to the distal branches of posterior cerebral artery territories (posterior parietal and inferior temporal lobe) and watershed areas (angular gyrus, precuneus, posterior cingulate gyrus and middle frontal cortex). rCBF values in watershed areas correlated with MTC volumes and language composite scores. Precuneus and angular gyrus hypoperfusion were associated with the corresponding cortical atrophy. Macro- or micro-vasculature perfusion integrities and cortical atrophy determined the overall perfusion imaging topography and contributed differently to the clinical outcomes.
Collapse
Affiliation(s)
- Chi-Wei Huang
- Department of Neurology, Cognition and Aging Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shih-Wei Hsu
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Ya-Ting Chang
- Department of Neurology, Cognition and Aging Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shu-Hua Huang
- Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yung-Cheng Huang
- Department of Nuclear Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chen-Chang Lee
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Wen-Neng Chang
- Department of Neurology, Cognition and Aging Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chun-Chung Lui
- Department of Radiology, Division of medical imaging, E-Da Cancer Hospital and I-Shou University, Kaohsiung, Taiwan
| | - Na-Ching Chen
- Department of Neurology, Cognition and Aging Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chiung-Chih Chang
- Department of Neurology, Cognition and Aging Center, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| |
Collapse
|
48
|
Mutsaerts HJ, Petr J, Václavů L, van Dalen JW, Robertson AD, Caan MW, Masellis M, Nederveen AJ, Richard E, MacIntosh BJ. The spatial coefficient of variation in arterial spin labeling cerebral blood flow images. J Cereb Blood Flow Metab 2017; 37:3184-3192. [PMID: 28058975 PMCID: PMC5584689 DOI: 10.1177/0271678x16683690] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Macro-vascular artifacts are a common arterial spin labeling (ASL) finding in populations with prolonged arterial transit time (ATT) and result in vascular regions with spuriously increased cerebral blood flow (CBF) and tissue regions with spuriously decreased CBF. This study investigates whether there is an association between the spatial signal distribution of a single post-label delay ASL CBF image and ATT. In 186 elderly with hypertension (46% male, 77.4 ± 2.5 years), we evaluated associations between the spatial coefficient of variation (CoV) of a CBF image and ATT. The spatial CoV and ATT metrics were subsequently evaluated with respect to their associations with age and sex - two demographics known to influence perfusion. Bland-Altman plots showed that spatial CoV predicted ATT with a maximum relative error of 7.6%. Spatial CoV was associated with age (β = 0.163, p = 0.028) and sex (β = -0.204, p = 0.004). The spatial distribution of the ASL signal on a standard CBF image can be used to infer between-participant ATT differences. In the absence of ATT mapping, the spatial CoV may be useful for the clinical interpretation of ASL in patients with cerebrovascular pathology that leads to prolonged transit of the ASL signal to tissue.
Collapse
Affiliation(s)
- Henri Jmm Mutsaerts
- 1 Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.,2 Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Jan Petr
- 3 PET Center, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Lena Václavů
- 2 Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Jan W van Dalen
- 2 Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Andrew D Robertson
- 1 Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Matthan W Caan
- 2 Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Mario Masellis
- 1 Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| | - Aart J Nederveen
- 2 Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands
| | - Edo Richard
- 4 Department of Neurology, Academic Medical Center, Amsterdam, the Netherlands.,5 Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Bradley J MacIntosh
- 1 Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada
| |
Collapse
|
49
|
Shirzadi Z, Stefanovic B, Chappell MA, Ramirez J, Schwindt G, Masellis M, Black SE, MacIntosh BJ. Enhancement of automated blood flow estimates (ENABLE) from arterial spin-labeled MRI. J Magn Reson Imaging 2017; 47:647-655. [DOI: 10.1002/jmri.25807] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 06/20/2017] [Indexed: 11/06/2022] Open
Affiliation(s)
- Zahra Shirzadi
- Department of Medical Biophysics; University of Toronto; Toronto ON Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
| | - Bojana Stefanovic
- Department of Medical Biophysics; University of Toronto; Toronto ON Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
| | - Michael A. Chappell
- Institute of Biomedical Engineering, Department of Engineering Science; University of Oxford; Oxford UK
- Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences; University of Oxford; Oxford UK
| | - Joel Ramirez
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
| | - Graeme Schwindt
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Department of Family and Community Medicine; University of Toronto; Toronto ON Canada
| | - Mario Masellis
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre; University of Toronto; Toronto ON Canada
| | - Sandra E. Black
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre; University of Toronto; Toronto ON Canada
| | - Bradley J. MacIntosh
- Department of Medical Biophysics; University of Toronto; Toronto ON Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
- Hurvitz Brain Sciences, Sunnybrook Research Institute; University of Toronto; Toronto ON Canada
| |
Collapse
|
50
|
Robertson AD, Matta G, Basile VS, Black SE, Macgowan CK, Detre JA, MacIntosh BJ. Temporal and Spatial Variances in Arterial Spin-Labeling Are Inversely Related to Large-Artery Blood Velocity. AJNR Am J Neuroradiol 2017; 38:1555-1561. [PMID: 28619834 DOI: 10.3174/ajnr.a5257] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Accepted: 04/10/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE The relationship between extracranial large-artery characteristics and arterial spin-labeling MR imaging may influence the quality of arterial spin-labeling-CBF images for older adults with and without vascular pathology. We hypothesized that extracranial arterial blood velocity can explain between-person differences in arterial spin-labeling data systematically across clinical populations. MATERIALS AND METHODS We performed consecutive pseudocontinuous arterial spin-labeling and phase-contrast MR imaging on 82 individuals (20-88 years of age, 50% women), including healthy young adults, healthy older adults, and older adults with cerebral small vessel disease or chronic stroke infarcts. We examined associations between extracranial phase-contrast hemodynamics and intracranial arterial spin-labeling characteristics, which were defined by labeling efficiency, temporal signal-to-noise ratio, and spatial coefficient of variation. RESULTS Large-artery blood velocity was inversely associated with labeling efficiency (P = .007), temporal SNR (P < .001), and spatial coefficient of variation (P = .05) of arterial spin-labeling, after accounting for age, sex, and group. Correction for labeling efficiency on an individual basis led to additional group differences in GM-CBF compared to correction using a constant labeling efficiency. CONCLUSIONS Between-subject arterial spin-labeling variance was partially explained by extracranial velocity but not cross-sectional area. Choosing arterial spin-labeling timing parameters with on-line knowledge of blood velocity may improve CBF quantification.
Collapse
Affiliation(s)
- A D Robertson
- From the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (A.D.R., G.M., S.E.B., B.J.M.) .,Hurvitz Brain Sciences (A.D.R., S.E.B., B.J.M.), Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - G Matta
- From the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (A.D.R., G.M., S.E.B., B.J.M.)
| | - V S Basile
- Division of Neurology, Department of Medicine (V.S.B., S.E.B.), University of Toronto, Toronto, Ontario, Canada.,Mackenzie Health (V.S.B.), Richmond Hill, Ontario, Canada
| | - S E Black
- From the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (A.D.R., G.M., S.E.B., B.J.M.).,Hurvitz Brain Sciences (A.D.R., S.E.B., B.J.M.), Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Division of Neurology, Department of Medicine (V.S.B., S.E.B.), University of Toronto, Toronto, Ontario, Canada.,L.C. Campbell Cognitive Neurology Research Unit (S.E.B.), Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - C K Macgowan
- Hospital for Sick Children (C.K.M.), Toronto, Ontario, Canada.,Department of Medical Biophysics (C.K.M., B.J.M.), University of Toronto, Toronto, Ontario, Canada
| | - J A Detre
- Department of Neurology (J.A.D.), University of Pennsylvania, Philadelphia, Pennsylvania
| | - B J MacIntosh
- From the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery (A.D.R., G.M., S.E.B., B.J.M.).,Hurvitz Brain Sciences (A.D.R., S.E.B., B.J.M.), Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada.,Department of Medical Biophysics (C.K.M., B.J.M.), University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|