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Lu P, Hong R, Tian G, Liu X, Sha Y, Zhang J, Wang X. Diffusional kurtosis imaging in differentiating nonarteritic anterior ischemic optic neuropathy from acute optic neuritis. Neuroradiology 2024; 66:797-807. [PMID: 38383677 DOI: 10.1007/s00234-024-03301-6] [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: 11/12/2023] [Accepted: 01/27/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE We aimed to determine the feasibility of using DKI to characterize pathological changes in nonarteritic anterior ischemic optic neuropathy (NAION) and to differentiate it from acute optic neuritis (ON). METHODS Orbital DKI was performed with a 3.0 T scanner on 75 patients (51 with NAION and 24 with acute ON) and 15 healthy controls. NAION patients were further divided into early and late groups. The mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), mean diffusivity (MD), fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) were calculated to perform quantitative analyses among groups; and receiver operating characteristic curve analyses were also performed to determine their effectiveness of differential diagnosis. In addition, correlation coefficients were calculated to explore the correlations of the DKI-derived data with duration of disease. RESULTS The MK, RK, and AK in the affected nerves with NAION were significantly higher than those in the controls, while the trend of FA, RD, and AD was a decline; in acute ON patients, except for RD, which increased, all DKI-derived kurtosis and diffusion parameters were significantly lower than controls (all P < 0.008). Only AK and MD had statistical differences between the early and late groups. Except for MD (early group) and FA, all other DKI-derived parameters were higher in NAION than in acute ON; and parameters in the early group showed better diagnostic efficacy in differentiating NAION from acute ON. Correlation analysis showed that time was negatively correlated with MK, RK, AK, and FA and positively correlated with MD, RD, and AD (all P < 0.05). CONCLUSION DKI is helpful for assessing the specific pathologic abnormalities resulting from ischemia in NAION by comparison with acute ON. Early DKI should be performed to aid in the diagnosis and evaluation of NAION.
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Affiliation(s)
- Ping Lu
- Department of Radiology, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215006, China
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, 26 Daoqian Street, Suzhou, 215002, China
| | - Rujian Hong
- Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Guohong Tian
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Xilan Liu
- Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Yan Sha
- Department of Radiology, Eye & ENT Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Jibin Zhang
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, 26 Daoqian Street, Suzhou, 215002, China
| | - Ximing Wang
- Department of Radiology, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215006, China.
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Wu L, Lu D, Sun PZ. Comparison of model-free Lorentzian and spinlock model-based fittings in quantitative CEST imaging of acute stroke. Magn Reson Med 2023; 90:1958-1968. [PMID: 37335834 PMCID: PMC10538953 DOI: 10.1002/mrm.29772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 05/14/2023] [Accepted: 06/01/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE CEST MRI detects complex tissue changes following acute stroke. Our study aimed to test if spinlock model-based fitting of the quasi-steady-state (QUASS)-reconstructed equilibrium CEST MRI improves the determination of multi-pool signal changes over the commonly-used model-free Lorentzian fitting in acute stroke. THEORY AND METHODS Multiple three-pool CEST Z-spectra were simulated using Bloch-McConnell equations for a range of T1 , relaxation delay, and saturation times. The multi-pool CEST signals were solved from the simulated Z-spectra to test the accuracy of routine Lorentzian (model-free) and spinlock (model-based) fittings without and with QUASS reconstruction. In addition, multiparametric MRI scans were obtained in rat models of acute stroke, including relaxation, diffusion, and CEST Z-spectrum. Finally, we compared model-free and model-based per-pixel CEST quantification in vivo. RESULTS The spinlock model-based fitting of QUASS CEST MRI provided a nearly T1 -independent determination of multi-pool CEST signals, advantageous over the fittings of apparent CEST MRI (model-free and model-based). In vivo data also demonstrated that the spinlock model-based QUASS fitting captured significantly different changes in semisolid magnetization transfer (-0.9 ± 0.8 vs. 0.3 ± 0.8%), amide (-1.1 ± 0.4 vs. -0.5 ± 0.2%), and guanidyl (1.0 ± 0.4 vs. 0.7 ± 0.3%) signals over the model-free Lorentzian analysis. CONCLUSION Our study demonstrated that spinlock model-based fitting of QUASS CEST MRI improved the determination of the underlying tissue changes following acute stroke, promising further clinical translation of quantitative CEST imaging.
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Affiliation(s)
- Limin Wu
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Dongshuang Lu
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Phillip Zhe Sun
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Emory National Primate Research Center, Emory University, Atlanta GA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta GA
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Pavilla A, Gambarota G, Signaté A, Arrigo A, Saint-Jalmes H, Mejdoubi M. Intravoxel incoherent motion and diffusion kurtosis imaging at 3T MRI: Application to ischemic stroke. Magn Reson Imaging 2023; 99:73-80. [PMID: 36669596 DOI: 10.1016/j.mri.2023.01.018] [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: 09/23/2022] [Revised: 10/25/2022] [Accepted: 01/14/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND PURPOSE The DKI-IVIM model that incorporates DKI (diffusional kurtosis imaging) into the IVIM (Intravoxel Incoherent Motion) concept was investigated to assess its utility for both enhanced diffusion characterization and perfusion measurements in ischemic stroke at 3 T. METHODS Fifteen stroke patients (71 ± 11 years old) were enrolled and DKI-IVIM analysis was performed using 9 b-values from 0 to 1500 s/mm2 chosen with the Cramer-Rao-Lower-Bound optimization approach. Pseudo-diffusion coefficient D*, perfusion fraction f, blood flow-related parameter fD*, the diffusion coefficient D and an additional parameter, the kurtosis, K were determined in the ischemic lesion and controlateral normal tissue based on a region of interest approach. The apparent diffusion coefficient (ADC) and arterial spin labelling (ASL) cerebral blood flow (CBF) parameters were also assessed and parametric maps were obtained for all parameters. RESULTS Significant differences were observed for all diffusion parameters with a significant decrease for D (p < 0.0001), ADC (p < 0.0001), and a significant increase for K (p < 0.0001) in the ischemic lesions of all patients. f decreased significantly in these regions (p = 0.0002). The fD* increase was not significant (p = 0.56). The same significant differences were found with a motion correction except for fD* (p = 0.47). CBF significantly decreased in the lesions. ADC was significantly positively correlated with D (p < 0.0001) and negatively with K (p = 0.0002); K was also negatively significantly correlated with D (p = 0.01). CONCLUSIONS DKI-IVIM model enables for simultaneous cerebral perfusion and enhanced diffusion characterization in an acceptable clinically acquisition time for the ischemic stroke diagnosis with the additional kurtosis factor estimation, that may better reflect the microstructure heterogeneity.
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Affiliation(s)
- Aude Pavilla
- Univ-Rennes, INSERM, LTSI - UMR 1099, F-35000 Rennes, France; Département de Neuroradiologie, CHU Martinique, F-97261 Fort de France, France.
| | | | - Aissatou Signaté
- Département de Neuroradiologie, CHU Martinique, F-97261 Fort de France, France
| | - Alessandro Arrigo
- Département de Neuroradiologie, CHU Martinique, F-97261 Fort de France, France
| | | | - Mehdi Mejdoubi
- Département de Neuroradiologie, CHU Martinique, F-97261 Fort de France, France
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Sun H, Wu Y, Liu N, Long M, Liu G, Sun PZ, Yin J. Tissue perfusion of the kurtosis/diffusion mismatch differs from the central core and peripheral regions in acute cerebral infarction patients. Acta Radiol 2023; 64:1155-1165. [PMID: 35765208 DOI: 10.1177/02841851221109678] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite its wide adoption in stroke imaging, the diffusion-weighted imaging (DWI) lesion is heterogeneous. The emerging diffusion kurtosis imaging (DKI) has been postulated to resolve the graded DWI lesion. PURPOSE To determine the perfusion characteristics of the central infarction core, kurtosis/diffusion mismatch, and peripheral regions. MATERIAL AND METHODS Patients with acute ischemic stroke underwent DWI, DKI, and perfusion-weighted imaging (PWI) scans. The patients were divided into mean kurtosis (MK)/mean diffusivity (MD) match and mismatch groups. Perfusion parameters were measured in the MK/MD lesion and peripheral areas in the MK/MD match group. We also analyzed perfusion status in the MK/MD lesion mismatch area for the mismatch group. RESULTS A total of 40 eligible patients (24 MK/MD match and 16 MK/MD mismatch) were enrolled in the final data analysis. The MTT and TTP progressively decreased, while the cerebral blood flow (CBF) and cerebral blood volume (CBV) increased from the central to peripheral areas. In addition, CBF in the MK/MD mismatch region was significantly higher than that in the central region (P < 0.05), but similar to the peripheral region. Furthermore, CBV in the MK/MD mismatch region did not differ significantly from that of the central region, but both were significantly lower than that of the peripheral area (P < 0.05). CONCLUSION The MK/MD mismatch region had blood flow similar to the peripheral region but with a reduced blood volume, indicating that it was less ischemic from the infarction core, albeit insufficient collateral circulation.
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Affiliation(s)
- Haizhen Sun
- Department of Radiology, Tianjin Medical University Chu Hsien-I Memorial Hospital & Tianjin Institute of Endocrinology, Tianjin, PR China
- NHC Key Laboratory of Hormones and Development (Tianjin Medical University), Tianjin Key Laboratory of Metabolic Diseases, Tianjin, PR China
| | - Yalin Wu
- The First Central Clinical College of Tianjin Medical University, Tianjin, PR China
| | - Na Liu
- The First Central Clinical College of Tianjin Medical University, Tianjin, PR China
| | - Miaomiao Long
- Department of Radiology, 66571Tianjin First Central Hospital, Tianjin Medical Imaging Institution, Tianjin, PR China
| | - Guoping Liu
- Department of Neurology, 66571Tianjin First Central Hospital, Tianjin, PR China
| | - Phillip Zhe Sun
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, USA
- Department of Radiology and Imaging Sciences, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Jianzhong Yin
- Department of Radiology, 66571Tianjin First Central Hospital, Tianjin Medical Imaging Institution, Tianjin, PR China
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Sun PZ. Quasi-steady-state amide proton transfer (QUASS APT) MRI enhances pH-weighted imaging of acute stroke. Magn Reson Med 2022; 88:2633-2644. [PMID: 36178234 PMCID: PMC9529238 DOI: 10.1002/mrm.29408] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 02/01/2023]
Abstract
PURPOSE Chemical exchange saturation transfer (CEST) imaging measurement depends not only on the labile proton concentration and pH-dependent exchange rate but also on experimental conditions, including the relaxation delay and radiofrequency (RF) saturation time. Our study aimed to extend a quasi-steady-state (QUASS) solution to a modified multi-slice CEST MRI sequence and test if it provides enhanced pH imaging after acute stroke. METHODS Our study derived the QUASS solution for a modified multislice CEST MRI sequence with an unevenly segmented RF saturation between image readout and signal averaging. Numerical simulation was performed to test if the generalized QUASS solution corrects the impact of insufficiently long relaxation delay, primary and secondary saturation times, and multi-slice readout. In addition, multiparametric MRI scans were obtained after middle cerebral artery occlusion, including relaxation and CEST Z-spectrum, to evaluate the performance of QUASS CEST MRI in a rodent acute stroke model. We also performed Lorentzian fitting to isolate multi-pool CEST contributions. RESULTS The QUASS analysis enhanced pH-weighted magnetization transfer asymmetry contrast over the routine apparent CEST measurements in both contralateral normal (-3.46% ± 0.62% (apparent) vs. -3.67% ± 0.66% (QUASS), P < 0.05) and ischemic tissue (-5.53% ± 0.68% (apparent) vs. -5.94% ± 0.73% (QUASS), P < 0.05). Lorentzian fitting also showed significant differences between routine and QUASS analysis of ischemia-induced changes in magnetization transfer, amide, amine, guanidyl CEST, and nuclear Overhauser enhancement (-1.6 parts per million) effects. CONCLUSION Our study demonstrated that generalized QUASS analysis enhanced pH MRI contrast and improved quantification of the underlying CEST contrast mechanism, promising for further in vivo applications.
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Affiliation(s)
- Phillip Zhe Sun
- Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
- Imaging Center, Emory National Primate Research Center, Emory University, Atlanta GA
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta GA
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Oxygen Challenge Imaging Reveals Differences in Metabolic Activity Between Kurtosis Lesion and Diffusion/Kurtosis Lesion Mismatch in a Rodent Model of Acute Stroke. J Comput Assist Tomogr 2022; 46:792-799. [PMID: 36103679 DOI: 10.1097/rct.0000000000001333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Accurate identification of potentially salvageable tissues is critical for improving acute stroke treatment. A previous study showed that the kurtosis lesion exhibited insignificant response after prompt reperfusion treatment, while the diffusion/kurtosis lesion mismatch could recover after reperfusion. We hypothesized that these 2 regions are in different metabolic states. MATERIALS AND METHODS Transient oxygen challenge (OC) is a procedure that uses oxygen as a metabolic bio-tracer and has been performed to explore metabolic activity in tissues. We combined OC with multiparameter magnetic resonance imaging (including diffusion kurtosis imaging and T2* mapping sequences) to study metabolic activity in the ischemic brain of Sprague Dawley rats. RESULTS Oxygen challenge image analysis revealed changes in T2* values, most significantly in the mean diffusivity (MD)/mean kurtosis (MK) lesion mismatch (22.3 ± 1.6%) and least significantly in the MK lesions (6.6 ± 0.6%). The MD images acquired within 138 ± 9 minutes after ischemia showed a larger ischemic lesion (45.5 ± 3.0% of the total area) than the MK images (33.2 ± 4.2% of the total area). The change rate of the MK value (53.0 ± 4.4%) was higher than that of the MD value (37.5 ± 3.2%). CONCLUSIONS The present study shows that MK lesion and MD/MK lesion mismatch exhibited different metabolic activity states. The MK lesion presented metabolic-related values close to the ischemic core, while at least part of the MD/MK mismatch area was comparable with ischemic penumbra metabolic activity. These findings are important to support image-guided individualized stroke therapies.
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Jiang YY, Zhong ZL, Zuo M. Three-dimensional arterial spin labeling and diffusion kurtosis imaging in evaluating perfusion and infarct area size in acute cerebral ischemia. World J Clin Cases 2022; 10:5586-5594. [PMID: 35979093 PMCID: PMC9258361 DOI: 10.12998/wjcc.v10.i17.5586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/01/2022] [Accepted: 04/09/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Early thrombolytic therapy is crucial to treat acute cerebral infarction, especially since the onset of thrombolytic therapy takes 1-6 h. Therefore, early diagnosis and evaluation of cerebral infarction is important.
AIM To investigate the diagnostic value of magnetic resonance multi-delay three-dimensional arterial spin labeling (3DASL) and diffusion kurtosis imaging (DKI) in evaluating the perfusion and infarct area size in patients with acute cerebral ischemia.
METHODS Eighty-four patients who experienced acute cerebral ischemia from March 2019 to February 2021 were included. All patients in the acute stage underwent magnetic resonance-based examination, and the data were processed by the system’s own software. The apparent diffusion coefficient (ADC), average diffusion coefficient (MD), axial diffusion (AD), radial diffusion (RD), average kurtosis (MK), radial kurtosis (fairly RK), axial kurtosis (AK), and perfusion parameters post-labeling delays (PLD) in the focal area and its corresponding area were compared. The correlation between the lesion area of cerebral infarction under MK and MD and T2-weighted imaging (T2WI) was analyzed.
RESULTS The DKI parameters of focal and control areas in the study subjects were compared. The ADC, MD, AD, and RD values in the lesion area were significantly lower than those in the control area. The MK, RK, and AK values in the lesion area were significantly higher than those in the control area. The MK/MD value in the infarct lesions was used to determine the matching situation. MK/MD < 5 mm was considered matching and MK/MD ≥ 5 mm was considered mismatching. PLD1.5s and PLD2.5s perfusion parameters in the central, peripheral, and control areas of the infarct lesions in MK/MD-matched and -unmatched patients were not significantly different. PLD1.5s and PLD2.5s perfusion parameter values in the central area of the infarct lesions in MK/MD-matched and -unmatched patients were significantly lower than those in peripheral and control areas. The MK and MD maps showed a lesion area of 20.08 ± 5.74 cm2 and 22.09 ± 5.58 cm2, respectively. T2WI showed a lesion area of 19.76 ± 5.02 cm2. There were no significant differences in the cerebral infarction lesion areas measured using the three methods. MK, MD, and T2WI showed a good correlation.
CONCLUSION DKI parameters showed significant difference between the focal and control areas in patients with acute ischemic cerebral infarction. 3DASL can effectively determine the changes in perfusion levels in the lesion area. There was a high correlation between the area of the infarct lesions diagnosed by DKI and T2WI.
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Affiliation(s)
- Yan-Yan Jiang
- Department of Magnetic Resonance, Wuhan Asia General Hospital, Wuhan 430056, Hubei Province, China
| | - Zhi-Lin Zhong
- Department of Radiology, Wuhan Yaxin General Hospital, Wuhan 430056, Hubei Province, China
| | - Min Zuo
- Department of Radiology, Wuhan Hanyang Hospital, Wuhan University of Science and Technology, Wuhan 430050, Hubei Province, China
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Ma Z, Zhao X, Wang X, Ren Q, Zhang S, Lu L, Wang K, Lv Q, Cheng J. Evaluation of crossed cerebellar diaschisis after cerebral infarction in MCAO rats based on DKI. Eur J Clin Invest 2022; 52:e13716. [PMID: 34846725 DOI: 10.1111/eci.13716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/06/2021] [Accepted: 11/13/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To observe the expression of N-methyl-D-aspartate (NMDA), apoptosis and the effect on neurological function recovery in rat model with middle cerebral artery occlusion (MCAO). Diffusion kurtosis imaging (DKI) was used to evaluate crossed cerebellar diaschisis (CCD) and to provide experimental and theoretical basis for the clinical treatment. MATERIALS AND METHODS The MCAO models were established in rats. Eighty-four rats were randomly and evenly divided into 7 groups, including control group, 6-h group, 12-h group, 24-h group, 48-h group, 7-day group and 14-day group. The rats were scanned by MRI at the above time points. Then, rats were sacrificed for H&E staining, immunohistochemical staining and TUNEL staining to detect the expression of NMDA in the core infarct area and cerebellum. At the end, the discussion of relationships between molecular biology and MRI parameters (ADC derived from DWI, and MD, MK and FA derived from DKI) was performed. RESULTS The values of MD, ADC and FA in MCAO rats were all lower than those in the control group. All MRI parameters of the contralateral cerebellum were lower than those of the ipsilateral cerebellum (p < .05). The parameters reached the lowest value at 12 h, except that the MK reached the highest at 12 h. The expression of NMDA showed a fluctuation along time in the MCAO group. Overall, it is higher in the MCAO group than in the control group, reaching the maximum at 24 h (p < .05). At the same time, the expression of NMDA in the contralateral cerebellum was higher than in the ipsilateral cerebellum. CONCLUSION It is found that NMDA and DKI of CCD have the same changing trend, which indicates that the intervention of NMDA receptor apoptosis may become a new target for the treatment of cerebral infarction, and MRI parameters can predict the occurrence and development of CCD.
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Affiliation(s)
- Zhen Ma
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiao Wang
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qi Ren
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Shuo Zhang
- Department of Medical Imaging, The 988 Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Zhengzhou, China
| | - Lin Lu
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Kaiyu Wang
- GE Healthcare, MR Research China, Beijing, China
| | - Qingqing Lv
- Department of Medical Imaging, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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DiBella EVR, Sharma A, Richards L, Prabhakaran V, Majersik JJ, HashemizadehKolowri SK. Beyond Diffusion Tensor MRI Methods for Improved Characterization of the Brain after Ischemic Stroke: A Review. AJNR Am J Neuroradiol 2022; 43:661-669. [PMID: 35272983 PMCID: PMC9089249 DOI: 10.3174/ajnr.a7414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 11/08/2021] [Indexed: 12/22/2022]
Abstract
Ischemic stroke is a worldwide problem, with 15 million people experiencing a stroke annually. MR imaging is a valuable tool for understanding and assessing brain changes after stroke and predicting recovery. Of particular interest is the use of diffusion MR imaging in the nonacute stage 1-30 days poststroke. Thousands of articles have been published on the use of diffusion MR imaging in stroke, including several recent articles reviewing the use of DTI for stroke. The goal of this work was to survey and put into context the recent use of diffusion MR imaging methods beyond DTI, including diffusional kurtosis, generalized fractional anisotropy, spherical harmonics methods, and neurite orientation and dispersion models, in patients poststroke. Early studies report that these types of beyond-DTI methods outperform DTI metrics either in being more sensitive to poststroke changes or by better predicting outcome motor scores. More and larger studies are needed to confirm the improved prediction of stroke recovery with the beyond-DTI methods.
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Affiliation(s)
- E V R DiBella
- From the Departments of Radiology and Imaging Sciences (E.V.R.D., A.S., S.K.H.)
| | - A Sharma
- From the Departments of Radiology and Imaging Sciences (E.V.R.D., A.S., S.K.H.)
| | - L Richards
- Occupational and Recreational Therapies (L.R.)
| | - V Prabhakaran
- Department of Radiology (V.P.), University of Wisconsin, Madison, Wisconsin
| | - J J Majersik
- Neurology (J.J.M.), University of Utah, Salt Lake City, Utah
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Sun PZ. Consistent depiction of the acidic ischemic lesion with APT MRI-Dual RF power evaluation of pH-sensitive image in acute stroke. Magn Reson Med 2022; 87:850-858. [PMID: 34590730 PMCID: PMC8627494 DOI: 10.1002/mrm.29029] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/31/2021] [Accepted: 09/09/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE Amide proton transfer-weighted (APTw) MRI provides a non-invasive pH-sensitive image, complementing perfusion and diffusion imaging for refined stratification of ischemic tissue. Although the commonly used magnetization transfer (MT) asymmetry (MTRasym ) calculation reasonably corrects the direct RF saturation effect, it is susceptible to the concomitant semisolid macromolecular MT contribution. Therefore, this study aimed to compare the performance of MTRasym and magnetization transfer and relaxation-normalized APT (MRAPT) analyses under 2 representative experimental conditions. METHODS Multiparametric MRI scans were performed in a rodent model of acute stroke, including relaxation, diffusion, and Z spectral images under 2 representative RF levels of 0.75 and 1.5 µT. Both MTRasym and MRAPT values in the ischemic diffusion lesion and the contralateral normal areas were compared using correlation and Bland-Altman tests. In addition, the acidic lesion volumes were compared. RESULTS MRAPT measurements from the diffusion lesion under the 2 conditions were highly correlated (R2 = 0.97) versus MTRasym measures (R2 = 0.58). The pH lesion sizes determined from MRAPT analysis were in good agreement (178 ± 43 mm3 vs. 186 ± 55 mm3 for B1 of 0.75 and 1.5 µT, respectively). CONCLUSIONS The study demonstrated that MRAPT analysis could be generalized to moderately different RF amplitudes, providing a more consistent depiction of acidic lesions than the MTRasym analysis.
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Affiliation(s)
- Phillip Zhe Sun
- Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA,Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta GA,Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta GA,Corresponding Author: Phillip Zhe Sun, Ph.D., Department of Radiology and Imaging Sciences, Emory University School of Medicine, 954 Gatewood Road NE, Atlanta, GA 30329, Phone: (404) 727-7786; (404) 712-1667,
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11
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Cheung J, Doerr M, Hu R, Sun PZ. Refined Ischemic Penumbra Imaging with Tissue pH and Diffusion Kurtosis Magnetic Resonance Imaging. Transl Stroke Res 2021; 12:742-753. [PMID: 33159656 PMCID: PMC8102648 DOI: 10.1007/s12975-020-00868-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 10/14/2020] [Accepted: 10/18/2020] [Indexed: 12/19/2022]
Abstract
Imaging has played a vital role in our mechanistic understanding of acute ischemia and the management of acute stroke patients. The most recent DAWN and DEFUSE-3 trials showed that endovascular therapy could be extended to a selected group of late-presenting stroke patients with the aid of imaging. Although perfusion and diffusion MRI have been commonly used in stroke imaging, the approximation of their mismatch as the penumbra is oversimplified, particularly in the era of endovascular therapy. Briefly, the hypoperfusion lesion includes the benign oligemia that does not proceed to infarction. Also, with prompt and effective reperfusion therapy, a portion of the diffusion lesion is potentially reversible. Therefore, advanced imaging that provides improved ischemic tissue characterization may enable new experimental stroke therapeutics and eventually further individualize stroke treatment upon translation to the clinical setting. Specifically, pH imaging captures tissue of altered metabolic state that demarcates the hypoperfused lesion into ischemic penumbra and benign oligemia, which remains promising to define the ischemic penumbra's outer boundary. On the other hand, diffusion kurtosis imaging (DKI) differentiates the most severely damaged and irreversibly injured diffusion lesion from the portion of diffusion lesion that is potentially reversible, refining the inner boundary of the penumbra. Altogether, the development of advanced imaging has the potential to not only transform the experimental stroke research but also aid clinical translation and patient management.
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Affiliation(s)
- Jesse Cheung
- Emory College of Arts and Sciences, Emory University, Atlanta, GA, 30329, USA
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
| | - Madeline Doerr
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, 30329, USA
- Dartmouth College, Hanover, NH, 03755, USA
| | - Ranliang Hu
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton RD NE, Atlanta, GA, 30322, USA
| | - Phillip Zhe Sun
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, 30329, USA.
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton RD NE, Atlanta, GA, 30322, USA.
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Nagaraja N. Diffusion weighted imaging in acute ischemic stroke: A review of its interpretation pitfalls and advanced diffusion imaging application. J Neurol Sci 2021; 425:117435. [PMID: 33836457 DOI: 10.1016/j.jns.2021.117435] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/08/2021] [Accepted: 04/02/2021] [Indexed: 12/28/2022]
Abstract
Diffusion weighted imaging (DWI) is a widely used imaging technique to evaluate patients with stroke. It can detect brain ischemia within minutes of stroke onset. However, DWI has few potential pitfalls that should be recognized during interpretation. DWI lesion could be reversible in the early hours of stroke and the entire lesion may not represent ischemic core. False negative DWI could lead to diagnosis of DWI negative stroke or to a missed stroke diagnosis. Ischemic stroke mimics can occur on DWI with non-cerebrovascular neurological conditions. In this article, the history of DWI, its clinical applications, and potential pitfalls for use in acute ischemic stroke are reviewed. Advanced diffusion imaging techniques with reference to Diffusion Kurtosis Imaging and Diffusion Tensor Imaging that has been studied to evaluate ischemic core are discussed.
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Affiliation(s)
- Nandakumar Nagaraja
- Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA.
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Foo LS, Larkin JR, Sutherland BA, Ray KJ, Yap WS, Hum YC, Lai KW, Manan HA, Sibson NR, Tee YK. Study of common quantification methods of amide proton transfer magnetic resonance imaging for ischemic stroke detection. Magn Reson Med 2021; 85:2188-2200. [PMID: 33107119 DOI: 10.1002/mrm.28565] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To assess the correlation and differences between common amide proton transfer (APT) quantification methods in the diagnosis of ischemic stroke. METHODS Five APT quantification methods, including asymmetry analysis and its variants as well as two Lorentzian model-based methods, were applied to data acquired from six rats that underwent middle cerebral artery occlusion scanned at 9.4T. Diffusion and perfusion-weighted images, and water relaxation time maps were also acquired to study the relationship of these conventional imaging modalities with the different APT quantification methods. RESULTS The APT ischemic area estimates had varying sizes (Jaccard index: 0.544 ≤ J ≤ 0.971) and had varying correlations in their distributions (Pearson correlation coefficient: 0.104 ≤ r ≤ 0.995), revealing discrepancies in the quantified ischemic areas. The Lorentzian methods produced the highest contrast-to-noise ratios (CNRs; 1.427 ≤ CNR ≤ 2.002), but generated APT ischemic areas that were comparable in size to the cerebral blood flow (CBF) deficit areas; asymmetry analysis and its variants produced APT ischemic areas that were smaller than the CBF deficit areas but larger than the apparent diffusion coefficient deficit areas, though having lower CNRs (0.561 ≤ CNR ≤ 1.083). CONCLUSION There is a need to further investigate the accuracy and correlation of each quantification method with the pathophysiology using a larger scale multi-imaging modality and multi-time-point clinical study. Future studies should include the magnetization transfer ratio asymmetry results alongside the findings of the study to facilitate the comparison of results between different centers and also the published literature.
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Affiliation(s)
- Lee Sze Foo
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | - James R Larkin
- Department of Oncology, Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - Brad A Sutherland
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Acute Stroke Programme, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Kevin J Ray
- Department of Oncology, Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - Wun-She Yap
- Department of Electrical and Electronic Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | - Yan Chai Hum
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
| | - Khin Wee Lai
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Jalan Universiti, Kuala Lumpur, Malaysia
| | - Hanani Abdul Manan
- Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Nicola R Sibson
- Department of Oncology, Cancer Research UK and Medical Research Council Oxford Institute for Radiation Oncology, University of Oxford, Oxford, United Kingdom
| | - Yee Kai Tee
- Department of Mechatronics and Biomedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Kajang, Selangor, Malaysia
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Xiao J, He X, Tian J, Chen H, Liu J, Yang C. Diffusion kurtosis imaging and pathological comparison of early hypoxic-ischemic brain damage in newborn piglets. Sci Rep 2020; 10:17242. [PMID: 33057162 PMCID: PMC7560608 DOI: 10.1038/s41598-020-74387-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 09/28/2020] [Indexed: 12/28/2022] Open
Abstract
To investigate the application value of magnetic resonance diffusion kurtosis imaging (DKI) in hypoxic–ischemic brain damage (HIBD) in newborn piglets and to compare imaging and pathological results. Of 36 piglets investigated, 18 were in the experimental group and 18 in the control group. The HIBD model was established in newborn piglets by ligating the bilateral common carotid arteries and placing them into hypoxic chamber. All piglets underwent conventional MRI and DKI scans at 3, 6, 9, 12, 16, and 24 h postoperatively. Mean kurtosis (MK) and mean diffusivity (MD) maps were constructed. Then, the lesions were examined using light and electron microscopy and compared with DKI images. The MD value of the lesion area gradually decreased and the MK value gradually increased in the experimental group with time. The lesion areas gradually expanded with time; MK lesions were smaller than MD lesions. Light microscopy revealed neuronal swelling in the MK- and MD-matched and mismatched regions. Electron microscopy demonstrated obvious mitochondrial swelling and autophagosomes in the MK- and MD-matched region but normal mitochondrial morphology or mild swelling in the mismatched region. DKI can accurately evaluate early ischemic–hypoxic brain injury in newborn piglets.
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Affiliation(s)
- Juan Xiao
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, No. 467 Zhongshan Road, Shahekou District, Dalian, Liaoning, China
| | - Xiaoning He
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, No. 467 Zhongshan Road, Shahekou District, Dalian, Liaoning, China
| | - Juan Tian
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, No. 467 Zhongshan Road, Shahekou District, Dalian, Liaoning, China
| | - Honghai Chen
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, No. 467 Zhongshan Road, Shahekou District, Dalian, Liaoning, China
| | - Jing Liu
- Dalian Medical University, No. 9, West Section, South Lvshun Road, Dalian, Liaoning, China
| | - Chao Yang
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, No. 467 Zhongshan Road, Shahekou District, Dalian, Liaoning, China.
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15
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Wu L, Jiang L, Sun PZ. Investigating the origin of pH-sensitive magnetization transfer ratio asymmetry MRI contrast during the acute stroke: Correction of T 1 change reveals the dominant amide proton transfer MRI signal. Magn Reson Med 2020; 84:2702-2712. [PMID: 32416012 DOI: 10.1002/mrm.28313] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 03/22/2020] [Accepted: 04/17/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Amide proton transfer (APT) MRI is promising to serve as a surrogate metabolic imaging biomarker of acute stroke. Although the magnetization transfer ratio asymmetry (MTRasym ) has been used commonly, the origin of pH-weighted MRI effect remains an area of investigation, including contributions from APT, semisolid MT contrast asymmetry, and nuclear Overhauser enhancement effects. Our study aimed to determine the origin of pH-weighted MTRasym contrast following acute stroke. METHODS Multiparametric MRI, including T1 , T2 , diffusion and Z-spectrum, were performed in rats after middle cerebral artery occlusion. We analyzed the conventional Z-spectrum I Δ ω I 0 and the apparent exchange spectrum R ex Δ ω , being the difference between the relaxation-scaled inverse Z-spectrum and the intrinsic spinlock relaxation rate R 1 · cos 2 θ · I 0 I Δ ω - R 1 ρ Δ ω . The ischemia-induced change was calculated as the spectral difference between the diffusion lesion and the contralateral normal area. RESULTS The conventional Z-spectrum signal change at -3.5 ppm dominates that at +3.5 ppm (-1.16 ± 0.39% vs. 0.76 ± 0.26%, P < .01) following acute stroke. In comparison, the magnitude of ΔRex change at 3.5 ppm becomes significantly larger than that at -3.5 ppm (-2.80 ± 0.40% vs. -0.94 ± 0.80%, P < .001), with their SNR being 7.0 and 1.2, respectively. We extended the magnetization transfer and relaxation normalized APT concept to the apparent exchange-dependent relaxation image, documenting an enhanced pH contrast between the ischemic lesion and the intact tissue, over that of MTRasym . CONCLUSION Our study shows that after the relaxation-effect correction, the APT effect is the dominant contributing factor to pH-weighted MTRasym following acute stroke.
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Affiliation(s)
- Limin Wu
- Neuroscience Center and Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, USA
| | - Liang Jiang
- Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Southwestern Medical University, Luzhou, Sichuan, China.,Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA
| | - Phillip Zhe Sun
- Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, USA.,Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.,Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts, USA
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Barrick TR, Spilling CA, Ingo C, Madigan J, Isaacs JD, Rich P, Jones TL, Magin RL, Hall MG, Howe FA. Quasi-diffusion magnetic resonance imaging (QDI): A fast, high b-value diffusion imaging technique. Neuroimage 2020; 211:116606. [DOI: 10.1016/j.neuroimage.2020.116606] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/22/2019] [Accepted: 02/02/2020] [Indexed: 12/11/2022] Open
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Sun PZ. Demonstration of magnetization transfer and relaxation normalized pH-specific pulse-amide proton transfer imaging in an animal model of acute stroke. Magn Reson Med 2020; 84:1526-1533. [PMID: 32080897 DOI: 10.1002/mrm.28223] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/12/2020] [Accepted: 01/29/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE pH-weighted amide proton transfer (APT) MRI is promising to serve as a new surrogate metabolic imaging biomarker for refined ischemic tissue demarcation. APT MRI with pulse-RF irradiation (pulse-APT) is an alternative to the routine continuous wave (CW-) APT MRI that overcomes the RF duty cycle limit. Our study aimed to generalize the recently developed pH-specific magnetization transfer and relaxation-normalized APT (MRAPT) analysis to pulse-APT MRI in acute stroke imaging. METHODS Multiparametric MRI, including CW- and pulse-APT MRI scans, were performed following middle cerebral artery occlusion in rats. We calculated pH-sensitive MTRasym and pH-specific MRAPT contrast between the ipsilateral diffusion lesion and contralateral normal area. RESULTS An inversion pulse of 10 to 15 ms maximizes the pH-sensitive MRI contrast for pulse-APT MRI. The contrast-to-noise ratio of pH-specific MRAPT effect between the contralateral normal area and ischemic lesion from both methods are comparable (3.25 ± 0.65 vs. 3.59 ± 0.40, P > .05). pH determined from both methods were in good agreement, with their difference within 0.1. CONCLUSIONS Pulse-APT MRI provides highly pH-specific mapping for acute stroke imaging.
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Affiliation(s)
- Phillip Zhe Sun
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA.,Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA
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Sun PZ. Fast correction of B 0 field inhomogeneity for pH-specific magnetization transfer and relaxation normalized amide proton transfer imaging of acute ischemic stroke without Z-spectrum. Magn Reson Med 2019; 83:1688-1697. [PMID: 31631414 DOI: 10.1002/mrm.28040] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 09/17/2019] [Accepted: 09/23/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE The magnetization transfer and relaxation normalized amide proton transfer (MRAPT) analysis is promising to provide a highly pH-specific mapping of tissue acidosis, complementing commonly used CEST asymmetry analysis. We aimed to develop a fast B0 inhomogeneity correction algorithm for acute stroke magnetization transfer and relaxation normalized amide proton transfer imaging without Z-spectral interpolation. METHODS The proposed fast field inhomogeneity correction describes B0 artifacts with linear regression. We compared the new algorithm with the routine interpolation correction approach in CEST imaging of a dual-pH phantom. The fast B0 correction was further evaluated in amide proton transfer imaging of normal and acute stroke rats. RESULTS Our phantom data showed that the proposed fast B0 inhomogeneity correction significantly improved pH MRI contrast, recovering over 80% of the pH MRI contrast-to-noise-ratio difference between the raw magnetization transfer ratio asymmetry and that using the routine interpolation-based B0 correction approach. In normal rat brains, the proposed fast B0 correction improved pH-specific MRI uniformity across the intact tissue, with the ratio of magnetization transfer and relaxation normalized amide proton transfer ratio being 10% of that without B0 inhomogeneity correction. In acute stroke rats, fast B0 inhomogeneity-corrected pH MRI reveals substantially improved pH lesion conspicuity, particularly in regions with nonnegligible B0 inhomogeneity. The pH MRI contrast-to-noise ratio between the ipsilateral diffusion lesion and contralateral normal tissue improved significantly with fast B0 correction (from 1.88 ± 0.48 to 2.20 ± 0.44, P < .01). CONCLUSIONS Our study established an expedient B0 inhomogeneity correction algorithm for fast pH imaging of acute ischemia.
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Affiliation(s)
- Phillip Zhe Sun
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.,Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, Georgia.,Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia
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Wang E, Wu Y, Cheung JS, Igarashi T, Wu L, Zhang X, Sun PZ. Mapping tissue pH in an experimental model of acute stroke - Determination of graded regional tissue pH changes with non-invasive quantitative amide proton transfer MRI. Neuroimage 2019; 191:610-617. [PMID: 30753926 DOI: 10.1016/j.neuroimage.2019.02.022] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 02/05/2019] [Accepted: 02/08/2019] [Indexed: 12/20/2022] Open
Abstract
pH-weighted amide proton transfer (APT) MRI is sensitive to tissue pH change during acute ischemia, complementing conventional perfusion and diffusion stroke imaging. However, the currently used pH-weighted magnetization transfer (MT) ratio asymmetry (MTRasym) analysis is of limited pH specificity. To overcome this, MT and relaxation normalized APT (MRAPT) analysis has been developed that to homogenize the background signal, thus providing highly pH conspicuous measurement. Our study aimed to calibrate MRAPT MRI toward absolute tissue pH mapping and determine regional pH changes during acute stroke. Using middle cerebral artery occlusion (MCAO) rats, we performed lactate MR spectroscopy and multi-parametric MRI. MRAPT MRI was calibrated against a region of interest (ROI)-based pH spectroscopy measurement (R2 = 0.70, P < 0.001), showing noticeably higher correlation coefficient than the simplistic MTRasym index. Capitalizing on this, we mapped brain tissue pH and semi-automatically segmented pH lesion, in addition to routine perfusion and diffusion lesions. Tissue pH from regions of the contralateral normal, perfusion/diffusion lesion mismatch and diffusion lesion was found to be 7.03 ± 0.04, 6.84 ± 0.10, 6.52 ± 0.19, respectively. Most importantly, we delineated the heterogeneous perfusion/diffusion lesion mismatch into perfusion/pH and pH/diffusion lesion mismatches, with their pH being 7.01 ± 0.04 and 6.71 ± 0.12, respectively (P < 0.05). To summarize, our study calibrated pH-sensitive MRAPT MRI toward absolute tissue pH mapping, semi-automatically segmented and determined graded tissue pH changes in ischemic tissue and demonstrated its feasibility for refined demarcation of heterogeneous metabolic disruption following acute stroke.
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Affiliation(s)
- Enfeng Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA; Department of Radiology, 3rd Affiliated Hospital, Zhengzhou University, Henan, China
| | - Yin Wu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA; Paul C. Lauterbur Research Centre for Biomedical Imaging, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, Guangdong, China
| | - Jerry S Cheung
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Takahiro Igarashi
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Limin Wu
- Neuroscience Center and Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Xiaoan Zhang
- Department of Radiology, 3rd Affiliated Hospital, Zhengzhou University, Henan, China
| | - Phillip Zhe Sun
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
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Ji Y, Lu D, Wu L, Qiu B, Song YQ, Sun PZ. Preliminary evaluation of accelerated microscopic diffusional kurtosis imaging (μDKI) in a rodent model of epilepsy. Magn Reson Imaging 2018; 56:90-95. [PMID: 30352270 DOI: 10.1016/j.mri.2018.10.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 10/15/2018] [Accepted: 10/18/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE Our study aimed to develop accelerated microscopic diffusional kurtosis imaging (μDKI) and preliminarily evaluated it in a rodent model of chronic epilepsy. METHODS We investigated two μDKI acceleration schemes of reduced sampling density and angular range in a phantom and wild-type rats, and further tested μDKI method in pilocarpine-induced epilepsy rats using a 4.7 Tesla MRI. Single slice average μDapp and μKapp maps were derived, and Nissl staining was obtained. RESULTS The kurtosis maps from two accelerated μDKI sampling schemes (sampling density and range) are very similar to that using fully sampled data (SSIM > 0.95). For the epileptic models, μDKI showed noticeably different contrast from those obtained with conventional DKI. Specifically, the average μKapp was significantly less than that of the average of Kapp (0.15 ± 0.01 vs. 0.47 ± 0.02) in the ventricle. CONCLUSIONS Our study demonstrated the feasibility of accelerated in vivo μDKI. Our work revealed that μDKI provides complementary information to conventional DKI method, suggesting that advanced DKI sequences are promising to elucidate tissue microstructure in neurological diseases.
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Affiliation(s)
- Yang Ji
- Center for Biomedical Engineering, Department of Electronic Science and Technology, University of Science and Technology of China, Hefei, China; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States of America
| | - Dongshuang Lu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States of America
| | - Limin Wu
- Neuroscience Center, Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States of America
| | - Bensheng Qiu
- Center for Biomedical Engineering, Department of Electronic Science and Technology, University of Science and Technology of China, Hefei, China
| | - Yi-Qiao Song
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States of America; Schlumberger-Doll Research Center, Cambridge, MA, United States of America
| | - Phillip Zhe Sun
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States of America; Yerkes Imaging Center, Yerkes National Primate Research Center, Emory University, Atlanta, GA, United States of America; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, United States of America.
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