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Anderson JFI, Higson L, Wu MH, Seal ML, Yang JYM. Cerebral microhaemorrhage count is related to processing speed, but not level of symptom reporting, independently of age, psychological status and premorbid functioning, after first-ever mild traumatic brain injury. Brain Imaging Behav 2023; 17:608-618. [PMID: 37386315 PMCID: PMC10733206 DOI: 10.1007/s11682-023-00788-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2023] [Indexed: 07/01/2023]
Abstract
Cerebral microhaemorrhage is a commonly identified neuropathological consequence of mild traumatic brain injury (mTBI) and can be identified in vivo using susceptibility weighted imaging (SWI). This study aimed to determine whether SWI-detected microhaemorrhages are more common in individuals after a single, first-ever, mTBI event relative to trauma controls (TC) and to investigate whether a linear relationship exists between microhaemorrhage numbers and cognition or symptom reporting in the post-acute period after injury, independently of age, psychological status and premorbid level of functioning. Microhaemorrhagic lesions were identified by expert clinical examination of SWI for 78 premorbidly healthy adult participants who were admitted to hospital after a traumatic injury and had suffered a first-ever mTBI (n = 47) or no head strike (n = 31). Participants underwent objective cognitive examination of processing speed, attention, memory, and executive function as well as self-reported post-concussion symptomatology. Bootstrapping analyses were used as data were not normally distributed. Analyses revealed that the mTBI group had significantly more microhaemorrhages than the TC group (Cohen's d = 0.559). These lesions were only evident in 28% of individuals. The mTBI participants demonstrated a significant linear association between number of microhaemorrhages and processing speed, independently of age, psychological status, or premorbid level of functioning. This study shows that a single mTBI causes cerebral microhaemorrhages to occur in a minority of premorbidly healthy individuals. Greater microhaemorrhage count is independently associated with slower processing speed, but not symptom reporting, during the post-acute injury period.
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Affiliation(s)
- Jacqueline F I Anderson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia.
- Psychology Department, The Alfred hospital, Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Lana Higson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Michelle H Wu
- Medical Imaging, The Royal Children's Hospital, Melbourne, VIC, 3052, Australia
| | - Marc L Seal
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Joseph Yuan-Mou Yang
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, VIC, 3052, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC, 3010, Australia
- Neuroscience research, Murdoch Children's Research Institute, Melbourne, VIC, 3052, Australia
- Neuroscience Advanced Clinical Imaging Service (NACIS), Department of Neurosurgery, The Royal Children's Hospital, Melbourne, VIC, 3052, Australia
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Trattnig S, Hangel G, Robinson SD, Juras V, Szomolanyi P, Dal-Bianco A. Ultrahigh-field MRI: where it really makes a difference. Radiologie (Heidelb) 2023:10.1007/s00117-023-01184-x. [PMID: 37584681 DOI: 10.1007/s00117-023-01184-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/30/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Currently, two major magnetic resonance (MR) vendors provide commercial 7‑T scanners that are approved by the Food and Drug Administration (FDA) for clinical application. There is growing interest in ultrahigh-field MRI because of the improved clinical results in terms of morphological detail, as well as functional and metabolic imaging capabilities. MATERIALS AND METHODS The 7‑T systems benefit from a higher signal-to-noise ratio, which scales supralinearly with field strength, a supralinear increase in the blood oxygenation level dependent (BOLD) contrast for functional MRI and susceptibility weighted imaging (SWI), and the chemical shift increases linearly with field strength with consequently higher spectral resolution. RESULTS In multiple sclerosis (MS), 7‑T imaging enables visualization of cortical lesions, the central vein sign, and paramagnetic rim lesions, which may be beneficial for the differential diagnosis between MS and other neuroinflammatory diseases in challenging and inconclusive clinical presentations and are seen as promising biomarkers for prognosis and treatment monitoring. The recent development of high-resolution proton MR spectroscopic imaging in clinically reasonable scan times has provided new insights into tumor metabolism and tumor grading as well as into early metabolic changes that may precede inflammatory processes in MS. This technique also improves the detection of epileptogenic foci in the brain. Multi-nuclear clinical applications, such as sodium imaging, have shown great potential for the evaluation of repair tissue quality after cartilage transplantation and in the monitoring of newly developed cartilage regenerative drugs for osteoarthritis. CONCLUSION For special clinical applications, such as SWI in MS, MR spectroscopic imaging in tumors, MS and epilepsy, and sodium imaging in cartilage repair, 7T may become a new standard.
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Affiliation(s)
- Siegfried Trattnig
- High-Field MR Center - 7T MR, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria.
| | - Gilbert Hangel
- High-Field MR Center - 7T MR, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria
| | - Simon D Robinson
- High-Field MR Center - 7T MR, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria
| | - Vladimir Juras
- High-Field MR Center - 7T MR, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria
| | - Pavol Szomolanyi
- High-Field MR Center - 7T MR, Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Lazarettgasse 14, 1090, Vienna, Austria
- Department of Imaging Methods, Institute of Measurement Science, Slovak Academy of Sciences, Dubravska cesta 9, 84104, Bratislava, Slovakia
| | - Assunta Dal-Bianco
- Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
- Medical University of Vienna, Comprehensive Center for Clinical Neurosciences & Mental Health, Vienna, Austria
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Martínez Camblor L, Peña Suárez JM, Martínez-Cachero García M, Santamarta Liébana E, Rodríguez Castro J, Saiz Ayala A. Cerebral microbleeds. Utility of SWI sequences. Radiologia (Engl Ed) 2023; 65:362-375. [PMID: 37516489 DOI: 10.1016/j.rxeng.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/12/2022] [Indexed: 07/31/2023]
Abstract
OBJECTIVES Define the concept of cerebral microbleeds (CMBs) and describe the most useful MRI sequences for detecting this finding. Review the entities that most frequently present with CMBs and that may benefit from the use of susceptibility-weighted imaging (SWI) sequences. CONCLUSIONS SWI is a useful MRI sequence for the detection and characterization of microhemorrhages, venous structures and other sources of susceptibility in imaging. SWI is particularly sensitive to local magnetic field inhomogeneities generated by certain substances and is superior to T2* GRE sequences for this assessment. CMBs may be seen in different neurologic conditions, in certain infrequent clinical contexts and have a key role as a biomarker status in gliomas (ITTS) and as a marker of inflammatory activity in multiple sclerosis.
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Affiliation(s)
- L Martínez Camblor
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | - J M Peña Suárez
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - E Santamarta Liébana
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J Rodríguez Castro
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A Saiz Ayala
- Servicio de Radiodiagnóstico, Hospital Universitario Central de Asturias, Oviedo, Spain
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Meng H, Zhang D, Sun Q. The applied value in brain gray matter nuclei of patients with early-stage Parkinson's disease : a study based on multiple magnetic resonance imaging techniques. Head Face Med 2023; 19:25. [PMID: 37386479 DOI: 10.1186/s13005-023-00371-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 06/19/2023] [Indexed: 07/01/2023] Open
Abstract
PURPOSE This study compares the observation efficiency of brain gray matter nuclei of patients with early-stage Parkinson's disease among various Magnetic Resonance Imaging techniques, which include susceptibility weighted imaging (SWI), quantitative susceptibility imaging (QSM), diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI). Based on the findings, this study suggests an efficient combination of scanning techniques for brain gray matter nuclei observation, aiming to provide an opportunity to advance the understanding of clinical diagnosis of early-stage Parkinson's disease. METHODS Forty examinees, including twenty patients who were clinically diagnosed with early Parkinson's disease with a course of 0.5-6 years (PD group) and twenty healthy controls (HC group), underwent head MRI examination. Philips 3.0T (tesla) MR machine was used to measure the imaging indexes of gray matter nuclei in patients with early Parkinson's disease. SWI, QSM, DTI and DKI were used for diagnosis. SPSS (Statistical Product and Service Solutions) 21.0 was used for data analysis. RESULTS When SWI was used, fifteen PD patients and six healthy volunteers were diagnosed correctly. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic coincidence rate about the diagnosis of nigrosome-1 on imaging were 75.0%, 30.0%, 51.7%, 54.5% and 52.5% respectively. By contrast, when QSM was used, 19 PD patients and 11 healthy volunteers were diagnosed correctly. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic coincidence rate about the diagnosis of Nigrosome-one on imaging were 95.0%, 55.0%, 67.9%, 91.7% and 75.0% respectively. The mean kurtosis (MK) value within both the substantia nigra and thalamus, together with the mean diffusivity (MD) within both the substantia nigra and the head of caudate nucleus in PD group was greater than that of HC group. The susceptibility values within the substantia nigra, red nucleus, head of caudate nucleus and putamen of PD group was greater than that of HC group. The MD value in substantia nigra reveals the optimal diagnostic efficiency to distinguish the HC group and the PD group, followed by the MK value in substantia nigra. Specifically, the maximum area under ROC curve (AUC) of the MD value was 0.823, the sensitivity 70.0%, the specificity 85.0%, and the diagnostic threshold 0.414. The area under ROC curve (AUC) of the MK value was 0.695, the sensitivity 95.0%, the specificity 50.0%, and the diagnostic threshold was 0.667. Both of them were statistically significant. CONCLUSIONS In the early diagnosis of Parkinson's disease, QSM is more efficient than SWI in observing nigrosome-1 in substantia nigra. In the early diagnosis of Parkinson's disease, MD and MK values of substantia nigra in DKI parameters have higher diagnostic efficiency. The combined scanning of DKI and QSM has the highest diagnostic efficiency and provides imaging basis for clinical diagnosis of early Parkinson's disease.
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Affiliation(s)
- Heng Meng
- Department of Radiology, Affiliated Hospital of BeiHua University, Jilin, 132011, China
| | - Duo Zhang
- Department of Radiology, Affiliated Hospital of BeiHua University, Jilin, 132011, China.
| | - Qiyuan Sun
- Department of Radiology, Affiliated Hospital of BeiHua University, Jilin, 132011, China
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Branson HM, Martinez-Rios C. Conventional MR Imaging in Trauma Management in Pediatrics. Neuroimaging Clin N Am 2023; 33:251-260. [PMID: 36965943 DOI: 10.1016/j.nic.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
Traumatic brain injury (TBI) is a major cause of death and disability in children across the world. The aim of initial brain trauma management of pediatric patients is to diagnose the extent of TBI and to determine if immediate neurosurgical intervention is required. A noncontrast computed tomography is the recommended diagnostic imaging choice for all patients with acute moderate to severe TBI. This article outlines the current use of conventional MR imaging in the management of pediatric head trauma and discusses potential future recommendations.
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Affiliation(s)
- Helen M Branson
- Department of Diagnostic Imaging, SickKids, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada.
| | - Claudia Martinez-Rios
- Department of Diagnostic Imaging, SickKids, University of Toronto, 555 University Avenue, Toronto, Ontario M5G1X8, Canada; Department of Medical Imaging, CHEO, University of Ottawa, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada
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Lequin M, Groenendaal F, Dudink J, Govaert P. Susceptibility weighted imaging can be a sensitive sequence to detect brain damage in neonates with kernicterus: a case report. BMC Neurol 2023; 23:104. [PMID: 36906546 PMCID: PMC10007770 DOI: 10.1186/s12883-023-03125-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 02/15/2023] [Indexed: 03/13/2023] Open
Abstract
BACKGROUND Kernicterus in the acute phase is difficult to diagnose. It depends on a high signal on T1 at the globus pallidum and subthalamic nucleus level. Unfortunately, these areas also show a relatively high signal on T1 in neonates as an expression of early myelination. Therefore, a less myelin-dependent sequence, like SWI, may be more sensitive to detecting damage in the globus pallidum area. CASE PRESENTATION A term baby developed jaundice on day three following an uncomplicated pregnancy and delivery. Total bilirubin peaked at 542 μmol/L on day four. Phototherapy was started, and an exchange transfusion was performed. ABR showed absent responses on day 10. MRI on day eight demonstrated abnormal high signal globus pallidus on T1w, isointense on T2w, without diffusion restriction, and high signal on SWI at globus pallidal and subthalamus level and phase image at globus pallidal level. These findings were consistent with the challenging diagnosis of kernicterus. On follow-up, the infant presented with sensorineural hearing loss and had a work-up for cochlear implant surgery. At 3 months of age, the follow-up MR shows normalization of the T1 and SWI signals and a high signal on T2. CONCLUSIONS SWI seems more sensitive to injury than the T1w and lacks the disadvantage of the T1w sequence, where early myelin confers a high signal.
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Affiliation(s)
- Maarten Lequin
- UMC Utrecht: Universitair Medisch Centrum, Utrecht, Netherlands.
| | | | - Jeroen Dudink
- UMC Utrecht: Universitair Medisch Centrum, Utrecht, Netherlands
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Han MJ, Park SY, Hwang S, Kim SJ. Clinical significance of asymmetric hypointense signals in minimum intensity projections of brain magnetic resonance imaging in children with primary headache. Neuroradiology 2023; 65:415-422. [PMID: 36319857 DOI: 10.1007/s00234-022-03076-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE This study aimed to observe the changes of venous continuity using the susceptibility weighted imaging-minimum intensity projection (SWI-MinIP) images in children with primary headache. METHODS The headache types were classified following the International Headache Society's diagnostic criteria. Patients with secondary headaches were excluded. The presence of asymmetric vasculature in SWI-MinIP images was visually assessed. Moreover, the relationship between headache patterns and asymmetric hypointense signals was analyzed. RESULTS In this single-center, retrospective study from 2016 to 2020, among 251 cases of primary headache (male/female, 108/143; mean age, 11.4 ± 4.0 years), 137 (54.6%), 75 (29.9%), and 39 (15.5%) patients had migraine, tension-type headache, and other primary headaches, respectively. On SWI-MinIP images, 14 (5.6%) patients showed an asymmetric venous pattern. All patients with SWI-MinIP asymmetry were included in the migraine group, accounting for 10.2% of patients with migraine. Five (35.7%) and nine (64.3%) patients were included in the aura and non-aura groups, respectively, without a significant difference in the frequency of asymmetric hypointense signals between the two groups (p = 0.325). All 14 patients with asymmetric hypervascularity had brain MRI within 12 h of headache onset. Ten (71.4%) of the 14 patients showed consistency between the laterality of headache and the hemisphere of predominant vascularity in SWI-MinIP. CONCLUSION Patients with migraine had increased cerebral venous perfusion in the most involved region of the headache on the SWI-MinIP view on a 3.0 T scanner, which can be used as a qualitative indicator with low sensitivity and high specificity for the diagnosis of primary headache in the acute phase (< 12 h).
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Affiliation(s)
- Min Jeong Han
- Department of Pediatrics, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea.,Research Institute of Clinical Medicine of Jeonbuk National University, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea.,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea
| | - So Yeon Park
- Department of Pediatrics, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea
| | - Seungbae Hwang
- Research Institute of Clinical Medicine of Jeonbuk National University, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea.,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea.,Department of Radiology, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea
| | - Sun Jun Kim
- Department of Pediatrics, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea. .,Research Institute of Clinical Medicine of Jeonbuk National University, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea. .,Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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.
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Ma L, Li J, Azamuddin M, Zheng S, Wang W, Wang P. Detection of tumour boundary in metastatic liver disease with 2D multibreath-hold susceptibility-weighted imaging. Magn Reson Imaging 2022; 92:26-32. [PMID: 35623417 DOI: 10.1016/j.mri.2022.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/05/2022] [Accepted: 05/19/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the feasibility of susceptibility weighted imaging (SWI) in detecting tumour boundaries in metastatic liver disease (MLD) without contrast agent, and whether SWI can provide pathophysiologic information for preoperative evaluation. METHODS Thirty patients with MLD underwent tumour resection. All patients underwent conventional MRI (T1-weighted and T2-weighted imaging), contrast-enhanced (CE) MRI and multibreath-hold 2D SWI. The conspicuity of the tumour boundary was assessed using a 4-grade scale. The detection rate of tumour boundaries and areas were reviewed and measured. The longest dimension was used to estimate the tumour size from the MR image. The conspicuity of the tumour boundary and area were compared using a nonparametric multi-group comparison (Friedman M). The McNemar test was applied to examine differences in the detection rate of tumour boundaries. RESULTS Among four different MRI sequences, SWI exhibited increased conspicuity of the tumour boundary than the conventional MRI (P < 0.001). SWI (91.8%) and CE-MRI (64.4%) exhibited higher detection rates of the tumour boundary than T1WI and T2WI (6.8% and 12.3% respectively). Longer tumour maximum diameters were measured with SWI (29.1 ± 17.2 mm) and CE-MRI (28.2 ± 16.8) compared to conventional MRI (P < 0.05). CONCLUSION 2D multibreath-hold SWI enables enhanced noninvasive detection of tumour boundaries in patients with MLD compared with conventional MRI and CE-MRI without using an exogenous contrast agent. SWI has the potential to become a preoperative assessment standard that complements conventional MRI.
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Affiliation(s)
- Liang Ma
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China; Department of Radiology, Children's Hospital of Fudan University, National Children's Medical Center, No. 399, Wanyuan Road, Minhang District, Shanghai 201102, China
| | - Jinglu Li
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China
| | - Mohammed Azamuddin
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China
| | - Shaoqiang Zheng
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China
| | - Wei Wang
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China.
| | - Peijun Wang
- Department of Medical Imaging, Tongji Hospital, Tongji University, No. 389, Xincun Road, Putuo District, Shanghai 200065, China.
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Koschmieder K, Paul MM, van den Heuvel TLA, van der Eerden AW, van Ginneken B, Manniesing R. Automated detection of cerebral microbleeds via segmentation in susceptibility-weighted images of patients with traumatic brain injury. Neuroimage Clin 2022; 35:103027. [PMID: 35597029 DOI: 10.1016/j.nicl.2022.103027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 04/21/2022] [Accepted: 04/24/2022] [Indexed: 12/24/2022]
Abstract
Cerebral microbleeds (CMBs) are a recognised biomarker of traumatic axonal injury (TAI). Their number and location provide valuable information in the long-term prognosis of patients who sustained a traumatic brain injury (TBI). Accurate detection of CMBs is necessary for both research and clinical applications. CMBs appear as small hypointense lesions on susceptibility-weighted magnetic resonance imaging (SWI). Their size and shape vary markedly in cases of TBI. Manual annotation of CMBs is a difficult, error-prone, and time-consuming task. Several studies addressed the detection of CMBs in other neuropathologies with convolutional neural networks (CNNs). In this study, we developed and contrasted a classification (Patch-CNN) and two segmentation (Segmentation-CNN, U-Net) approaches for the detection of CMBs in TBI cases. The models were trained using 45 datasets, and the best models were chosen according to 16 validation sets. Finally, the models were evaluated on 10 TBI and healthy control cases, respectively. Our three models outperform the current status quo in the detection of traumatic CMBs, achieving higher sensitivity at low false positive (FP) counts. Furthermore, using a segmentation approach allows for better precision. The best model, the U-Net, achieves a detection rate of 90% at FP counts of 17.1 in TBI patients and 3.4 in healthy controls.
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Vo DT, Phan CC, Le HGN, Vo TP, Mai UTT, Le HK, Ha TBT. Diffuse axonal injury: a case report and MRI findings. Radiol Case Rep 2021; 17:91-94. [PMID: 34765068 PMCID: PMC8571536 DOI: 10.1016/j.radcr.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 10/02/2021] [Indexed: 01/24/2023] Open
Abstract
Diffuse axonal injury (DAI) is one of the most severe types of primary traumatic brain injury. In recent years, MR imaging has been gaining popularity as an adjunctive imaging method in patients with DAI. In this case report, we describe MRI findings of an 11-year-old male patient diagnosed with DAI and discuss the role of different sequences in the evaluation of DAI.
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Affiliation(s)
- Duc Tan Vo
- Department of Radiology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam,Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam
| | - Chien Cong Phan
- Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam,Corresponding author.
| | - Hy Gia Nguyen Le
- Department of Radiology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | - Truc Phuong Vo
- Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam
| | - Uyen Tu Thi Mai
- Department of Diagnostic Imaging, Tu Du Hospital, Ho Chi Minh City, Vietnam
| | - Hang Kim Le
- Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam
| | - Tram Bich Thi Ha
- Department of Radiology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam,Department of Diagnostic Imaging, University Medical Centre, Ho Chi Minh City, Vietnam
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12
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Grasso D, Castorani G, Borreggine C, Simeone A, De Blasi R. Cerebral amyloid angiopathy related inflammation: A little known but not to be underestimated disease. Radiol Case Rep 2021; 16:2514-2521. [PMID: 34257791 PMCID: PMC8260958 DOI: 10.1016/j.radcr.2021.05.080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/30/2021] [Accepted: 05/31/2021] [Indexed: 11/17/2022] Open
Abstract
Cerebral amyloid angiopathy related inflammation (CAA-ri) is a rare encephalopathy resulting from perivascular inflammation after β-βamyloid (A) deposition in cerebral vessels leading to progressive dementia, focal neurological signs, seizures and intracerebral hemorrhages. This condition is characterized on magnetic resonance imaging (MRI) by patchy or confluent T2/fluid attenuation inversion recovery (FLAIR) hyperintensities in the cortex and subcortical white matter located mainly in the same areas of pre-existing multiple microhemorrhages. In this report of 2 cases of “probable” CAA-ri women aged 71 and 68, we propose a review on the pathophysiological, clinical, radiological, therapeutic and prognostic aspects of this little-known and poor outcome condition. Even though an apparently favorable initial evolution after steroid and/or immunosuppressive treatment, CAA-ri course is unpredictable and often associated with low survival rates. We suggest the importance of timely and proper clinico-radiological evaluation in suspected CAA-ri cases, in order to start an appropriate treatment even without the brain biopsy.
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Affiliation(s)
- Daniela Grasso
- IRCCS Ospedale Casa Sollievo della Sofferenza, Department of Diagnostic Imaging, San Giovanni Rotondo, Italy
- Corresponding author.
| | - Giulia Castorani
- University of Foggia Postgraduate Medical School, Diagnostic Imaging, Foggia, Italy
| | - Carmela Borreggine
- IRCCS Ospedale Casa Sollievo della Sofferenza, Department of Diagnostic Imaging, San Giovanni Rotondo, Italy
| | - Annalisa Simeone
- IRCCS Ospedale Casa Sollievo della Sofferenza, Department of Diagnostic Imaging, San Giovanni Rotondo, Italy
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Nathoo N, Wu Y, Rogers JA, Yong VW, Dunn JF. Susceptibility weighted imaging detects prominent veins that precede or coincide with maximal motor disability in a model of multiple sclerosis: A pilot study. Mult Scler Relat Disord 2021; 54:103124. [PMID: 34243102 DOI: 10.1016/j.msard.2021.103124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 06/20/2021] [Accepted: 06/26/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Susceptibility weighted imaging (SWI) has detected veins in the center of white matter lesions and alterations in veins themselves in multiple sclerosis (MS) and experimental autoimmune encephalomyelitis (EAE). However, the relationship between SWI-detected venous alterations and disease progression is unclear. The objective of this study was to assess alterations in the lumbar spinal cord veins in EAE mice over the disease course using serial SWI. METHODS EAE mice (n = 8) underwent imaging for SWI using a 9.4T Bruker Avance console at baseline, 7 days (pre-motor dysfunction), 12 days (typical motor dysfunction onset), and 16-18 days (typical peak disease) post-immunization. Naïve controls were imaged alongside EAE mice (n = 3). SWI hypointensities were counted by two subjects and compared between time points. RESULTS SWI hypointensities appeared before motor dysfunction onset in most EAE mice. The ratio of SWI hypointensities to baseline was highly variable for EAE mice (0.45-6.75) while less so for controls (0.80-1.31). The time point for the maximum number of SWI hypointensities always preceded or coincided with maximum motor disability. CONCLUSION Venous alterations are detected before the onset of motor disability in some EAE mice using SWI which may relate to inflammation and/or tissue hypoxia.
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Affiliation(s)
- Nabeela Nathoo
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Ying Wu
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
| | - James A Rogers
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - V Wee Yong
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
| | - Jeff F Dunn
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada; Experimental Imaging Centre, University of Calgary, Calgary, Alberta, Canada.
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Chai C, Wang H, Chu Z, Li J, Qian T, Mark Haacke E, Xia S, Shen W. Reduced regional cerebral venous oxygen saturation is a risk factor for the cognitive impairment in hemodialysis patients: a quantitative susceptibility mapping study. Brain Imaging Behav 2021; 14:1339-1349. [PMID: 30511117 DOI: 10.1007/s11682-018-9999-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The purpose of this study was to noninvasively evaluate the changes of regional cerebral venous oxygen saturation (rSvO2) in hemodialysis patients using quantitative susceptibility mapping (QSM) and investigate the relationship with clinical risk factors and neuropsychological testing. Fifty four (54) hemodialysis patients and 54 age, gender and education matched healthy controls (HCs) were recruited in this prospective study. QSM data were reconstructed from the original phase data of susceptibility weighted imaging to measure the susceptibility of cerebral regional major veins in all subjects and calculate their rSvO2. The differences in rSvO2 between hemodialysis patients and HCs were investigated using analysis of covariance adjusting for age and gender as covariates. Stepwise multiple regression and correlation analysis were performed between the cerebral rSvO2 and clinical factors including neuropsychological testing. The SvO2 of the bilateral cortical, thalamostriate, septal, cerebral internal and basal veins in hemodialysis patients was significantly lower than that in HCs (p < 0.001, Bonferroni corrected). The cerebral rSvO2 in all these veins was reduced by 1.67% to 2.30%. The hematocrit, iron, glucose, pre-and post-dialysis diastolic blood pressure (DBP) were independent predictive factors for the cerebral rSvO2 (all P < 0.05). The Mini-Mental State Examination and Montreal Cognitive Assessment (MoCA) scores were both lower in patients than those in HCs (both P < 0.05). The SvO2 of the left cerebral internal vein correlated with MoCA scores (r = 0.492; P = 0.02, FDR corrected). In conclusion, our study indicated that the cerebral rSvO2 was reduced in hemodialysis patients, which was the risk factor for neurocognitive impairment. The hematocrit, iron, glucose, pre-and post-dialysis DBP were independent risk factors for the cerebral rSvO2.
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Affiliation(s)
- Chao Chai
- Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Huiying Wang
- School of Graduates, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Zhiqiang Chu
- Department of Hemodialysis, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Jinping Li
- Department of Hemodialysis, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Tianyi Qian
- MR collaboration, Siemens Healthcare, Northeast Asia, Beijing, 100102, China
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, 48202, USA
| | - Shuang Xia
- Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China.
| | - Wen Shen
- Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China.
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15
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Nada A, Leiva-Salinas C, Mahdi E, Mahmoud E, Ahsan H, Cousins JP. Multi-parametric magnetic resonance imaging evaluation of cerebral amyloid angiopathy related inflammation: Case series and review of literature. Clin Imaging 2021; 78:38-44. [PMID: 33740578 DOI: 10.1016/j.clinimag.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/04/2021] [Accepted: 03/05/2021] [Indexed: 10/21/2022]
Abstract
Cerebral amyloid angiopathy related inflammation is a rare disorder in the spectrum of cerebral amyloid angiopathy which is characterized by vascular and/or perivascular inflammation related to Aβ deposits. Clinically, the patient typically presents with acute to subacute encephalitis-like symptoms with focal neurological deficits, rapidly cognitive decline, and/or seizures. Typical magnetic resonance imaging findings include asymmetric mass-like non-enhancing white matter hyperintensity with scattered microhemorrhages. Additionally, in these cases diffusion weighted imaging, perfusion weighted imaging and magnetic resonance spectroscopy help to exclude neoplastic processes and could determine the correct diagnosis.
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Affiliation(s)
- Ayman Nada
- Department of Radiology, University of Missouri Health Care, One Hospital Drive, Columbia, MO, United States of America.
| | - Carlos Leiva-Salinas
- Department of Radiology, University of Missouri Health Care, One Hospital Drive, Columbia, MO, United States of America.
| | - Eman Mahdi
- Department of Radiology, University of Missouri Health Care, One Hospital Drive, Columbia, MO, United States of America.
| | - Esmat Mahmoud
- Department of Diagnostic and Interventional Radiology, National Cancer Institute, Cairo University, Egypt
| | - Humera Ahsan
- Department of Radiology, University of Missouri Health Care, One Hospital Drive, Columbia, MO, United States of America.
| | - Joseph Paul Cousins
- Department of Radiology, University of Missouri Health Care, One Hospital Drive, Columbia, MO, United States of America.
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Hou ZB, Zhao F, Zhang B, Zhang CZ. Study on clinical application of susceptibility weighted imaging ombined with diffusion weighted imaging in patients with Liver Cirrhosis complicated with small Hepatocellular Carcinoma. Pak J Med Sci 2021; 37:800-804. [PMID: 34104168 PMCID: PMC8155423 DOI: 10.12669/pjms.37.3.3822] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Objectives To evaluate the clinical value of susceptibility weighted imaging (SWI) combined with diffusion weighted imaging (DWI) in patients with liver cirrhosis complicated with small hepatocellular carcinoma (SHCC). Methods A total of 40 patients with liver cirrhosis and 44 nodules were treated with conventional nuclear magnetic scanning (T1WI, T2WI) and SWI combined with DWI; the results were judged by two senior physicians; the t test, χ2 test, rank sum test, and other methods were used for contrastive analysis of the pathological results of different scanning methods after operation or puncture. Results Contrast analysis of the different MRI scanning methods and pathological results showed that among the 32 nodules of small hepatocellular carcinoma, 24 cases were diagnosed by conventional MRI, with the coincidence rate being 75%, 30 cases were diagnosed by SWI DWI, with the coincidence rate being 96%; significant difference was found between the two groups (p=0. 04). Significant differences were found in the specificity, sensitivity and accuracy of different scanning methods in the diagnosis of small hepatocellular carcinoma (specificity, accuracy, p=0.04; sensitivity p=0.01). The SWI of small hepatocellular carcinoma nodules showed hyperintensity, and the degree of iron deposition was low. Significant difference was found between small hepatocellular carcinoma nodules and other nodules (comparison of SWI signal degree, p=0.01; comparison of iron deposition degree, p=0.00). Conclusion The SWI of small hepatocellular carcinoma nodules showed hyperintensity, and the degree of iron deposition was low. The coincidence rate of SWI+DWI scanning is higher than that of conventional scanning methods in the diagnosis of small hepatocellular carcinoma, and the difference in specificity, sensitivity and accuracy has obvious advantages. SWI+DWI scanning can improve the detection rate of liver cirrhosis complicated with small hepatocellular carcinoma.
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Affiliation(s)
- Zhi-Bo Hou
- Zhi-bo Hou, Medical Imaging Center, Peking University Shougang Hospital, Beijing, 100144, China
| | - Fei Zhao
- Fei Zhao, Department of Imaging, Aerospace Center Hospital, Beijing, 100049, China
| | - Bin Zhang
- Bin Zhang, Medical Imaging Center, Peking University Shougang Hospital, Beijing, 100144, China
| | - Chun-Zhu Zhang
- Chun-zhu Zhang, Department of Radiology, Eye Hospital, China Academy of Chinese Medical Sciences, Beijing, 100040, China
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Buch S, Subramanian K, Jella PK, Chen Y, Wu Z, Shah K, Bernitsas E, Ge Y, Haacke EM. Revealing vascular abnormalities and measuring small vessel density in multiple sclerosis lesions using USPIO. Neuroimage Clin 2020; 29:102525. [PMID: 33338965 PMCID: PMC7750444 DOI: 10.1016/j.nicl.2020.102525] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND PURPOSE Multiple Sclerosis (MS) is a progressive, inflammatory, neuro-degenerative disease of the central nervous system (CNS) characterized by a wide range of histopathological features including vascular abnormalities. In this study, an ultra-small superparamagnetic iron oxide (USPIO) contrast agent, Ferumoxytol, was administered to induce an increase in susceptibility for both arteries and veins to help better reveal the cerebral microvasculature. The purpose of this work was to examine the presence of vascular abnormalities and vascular density in MS lesions using high-resolution susceptibility weighted imaging (SWI). METHODS Six subjects with relapsing remitting MS (RRMS, age = 47.3 ± 11.8 years with 3 females and 3 males) and fourteen age-matched healthy controls were scanned at 3 T with SWI acquired before and after the infusion of Ferumoxytol. Composite data was generated by registering the FLAIR data to the high resolution SWI data in order to highlight the vascular information in MS lesions. Both the central vein sign (CVS) and, a new measure, the multiple vessel sign (MVS) were identified, along with any vascular abnormalities, in the lesions on pre- and post-contrast SWI-FLAIR fusion data. The small vessel density within the periventricular normal-appearing white matter (NAWM) and the periventricular lesions were compared for all subjects. RESULTS Averaged across two independent raters, a total of 530 lesions were identified across all patients. The total number of lesions with vascularity on pre- and post-contrast data were 287 and 488, respectively. The lesions with abnormal vascular behavior were broken up into following categories: small lesions appearing only at the vessel boundary; dilated vessels within the lesions; and developmental venous angiomas. These vessel abnormalities observed within lesions increased from 55 on pre-contrast data to 153 on post-contrast data. Finally, across all the patients, the periventricular lesional vessel density was significantly higher (p < 0.05) than that of the periventricular NAWM. CONCLUSIONS By inducing a super-paramagnetic susceptibility in the blood using Ferumoxytol, the vascular abnormalities in the RRMS patients were revealed and small vessel densities were obtained. This approach has the potential to monitor the venous vasculature present in MS lesions, catalogue their characteristics and compare the vascular structures spatially to the presence of lesions. These enhanced vascular features may provide new insight into the pathophysiology of MS.
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Affiliation(s)
- Sagar Buch
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | | | - Pavan K Jella
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, Detroit, MI, USA
| | - Zhen Wu
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Kamran Shah
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | | | - Yulin Ge
- Center for Biomedical Imaging, Department of Radiology, NYU Grossman School of Medicine, New York, NY, USA
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, USA; Department of Neurology, Wayne State University, Detroit, MI, USA.
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18
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Hu J, Zhao Y, Li M, Liu J, Wang F, Weng Q, Wang X, Cao D. Machine learning-based radiomics analysis in predicting the meningioma grade using multiparametric MRI. Eur J Radiol 2020; 131:109251. [PMID: 32916409 DOI: 10.1016/j.ejrad.2020.109251] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/25/2020] [Accepted: 08/10/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE To investigate the prediction performance of radiomic models based on multiparametric MRI in predicting the meningioma grade. METHOD In all, 229 low-grade [Grade I] and 87 high-grade [Grade II/III] patients with pathologically diagnosed meningiomas were enrolled. Radiomic features from conventional MRI (cMRI), ADC maps and SWI were extracted based on the volume of entire tumor. Classification performance of different radiomic models (cMRI, ADC, SWI, cMRI + ADC, cMRI + SWI, ADC + SWI, and cMRI + ADC + SWI models) was evaluated by a nested LOOCV approach, combining the LASSO feature selection and RF classifier that was trained (1) without subsampling, and (2) with the synthetic minority over-sampling technique (SMOTE). The prediction performance of radiomic models was assessed using ROC curve and AUC of them was compared using Delong's test. RESULTS The cMRI + ADC + SWI model demonstrated the best performance without or with subsampling, which AUCs were 0.84 and 0.81, respectively. Following the cMRI + ADC + SWI model, the AUC range of the other models was 0.75-0.80 without subsampling, and was 0.71-0.79 with subsampling. Although the cMRI + ADC model and cMRI + SWI model showed higher AUCs than the cMRI model without subsampling (0.77 vs 0.80, P = 0.037 and 0.77 vs 0.80, P = 0.009, respectively), there was no significant difference among these models with subsampling (0.78 vs 0.77, P = 0.552 and 0.78 vs 0.79, P = 0.246, respectively). CONCLUSIONS Multiparametric radiomic model based on cMRI, ADC map and SWI yielded the best prediction performance in predicting the meningioma grade, which might offer potential guidance in clinical decision-making.
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Affiliation(s)
- Jianping Hu
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Yijing Zhao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Mengcheng Li
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Jianyi Liu
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Feng Wang
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Qiang Weng
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xingfu Wang
- Department of Pathology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Dairong Cao
- Department of Radiology, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
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Buch S, Wang Y, Park MG, Jella PK, Hu J, Chen Y, Shah K, Ge Y, Haacke EM. Subvoxel vascular imaging of the midbrain using USPIO-Enhanced MRI. Neuroimage 2020; 220:117106. [PMID: 32615253 DOI: 10.1016/j.neuroimage.2020.117106] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/26/2020] [Accepted: 06/25/2020] [Indexed: 12/23/2022] Open
Abstract
There is an urgent need for better detection and understanding of vascular abnormalities at the micro-level, where critical vascular nourishment and cellular metabolic changes occur. This is especially the case for structures such as the midbrain where both the feeding and draining vessels are quite small. Being able to monitor and diagnose vascular changes earlier will aid in better understanding the etiology of the disease and in the development of therapeutics. In this work, thirteen healthy volunteers were scanned with a dual echo susceptibility weighted imaging (SWI) sequence, with a resolution of 0.22 × 0.44 × 1 mm3 at 3T. Ultra-small superparamagnetic iron oxides (USPIO) were used to induce an increase in susceptibility in both arteries and veins. Although the increased vascular susceptibility enhances the visibility of small subvoxel vessels, the accompanying strong signal loss of the large vessels deteriorates the local tissue contrast. To overcome this problem, the SWI data were acquired at different time points during a gradual administration (final concentration = 4 mg/kg) of the USPIO agent, Ferumoxytol, and the data was processed to combine the SWI data dynamically, in order to see through these blooming artifacts. The major vessels and their tributaries (such as the collicular artery, peduncular artery, peduncular vein and the lateral mesencephalic vein) were identified on the combined SWI data using arterio-venous maps. Dynamically combined SWI data was then compared with previous histological work to validate that this protocol was able to detect small vessels on the order of 50 μm-100 μm. A complex division-based phase unwrapping was also employed to improve the quality of quantitative susceptibility maps by reducing the artifacts due to aliased voxels at the vessel boundaries. The smallest detectable vessel size was then evaluated by revisiting numerical simulations, using estimated true susceptibilities for the basal vein and the posterior cerebral artery in the presence of Ferumoxytol. These simulations suggest that vessels as small as 50 μm should be visible with the maximum dose of 4 mg/kg.
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Affiliation(s)
- Sagar Buch
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Ying Wang
- Department of Radiology, Wayne State University, Detroit, MI, USA; Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA
| | - Min-Gyu Park
- Department of Neurology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Republic of Korea
| | - Pavan K Jella
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Jiani Hu
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Yongsheng Chen
- Department of Neurology, Wayne State University, Detroit, MI, USA
| | - Kamran Shah
- Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Yulin Ge
- Center for Biomedical Imaging, Department of Radiology, New York University School of Medicine, New York, NY, USA
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, USA; Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA.
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Ni R, Zarb Y, Kuhn GA, Müller R, Yundung Y, Nitsch RM, Kulic L, Keller A, Klohs J. SWI and phase imaging reveal intracranial calcifications in the P301L mouse model of human tauopathy. MAGMA 2020; 33:769-81. [PMID: 32468149 DOI: 10.1007/s10334-020-00855-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/12/2020] [Accepted: 05/19/2020] [Indexed: 12/14/2022]
Abstract
Objective Brain calcifications are associated with several neurodegenerative diseases. Here, we describe the occurrence of intracranial calcifications as a new phenotype in transgenic P301L mice overexpressing four repeat tau, a model of human tauopathy. Materials and methods Thirty-six P301L mice (Thy1.2) and ten age-matched non-transgenic littermates of different ages were assessed. Gradient echo data were acquired in vivo and ex vivo at 7 T and 9.4 T for susceptibility-weighted imaging (SWI) and phase imaging. In addition, ex vivo micro-computed tomography (μCT) was performed. Histochemistry and immunohistochemistry were used to investigate the nature of the imaging lesions. Results SW images revealed regional hypointensities in the hippocampus, cortex, caudate nucleus, and thalamus of P301L mice, which in corresponding phase images indicated diamagnetic lesions. Concomitantly, µCT detected hyperdense lesions, though fewer lesions were observed compared to MRI. Diamagnetic susceptibility lesions in the hippocampus increased with age. The immunochemical staining of brain sections revealed osteocalcin-positive deposits. Furthermore, intra-neuronal and vessel-associated osteocalcin-containing nodules co-localized with phosphorylated-tau (AT8 and AT100) in the hippocampus, while vascular osteocalcin-containing nodules were detected in the thalamus in the absence of phosphorylated-tau deposition. Discussion SWI and phase imaging sensitively detected intracranial calcifications in the P301L mouse model of human tauopathy. Electronic supplementary material The online version of this article (10.1007/s10334-020-00855-3) contains supplementary material, which is available to authorized users.
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Ueno H, Kikumto M, Takebayashi Y, Ishibashi H, Takahashi T, Yasutomi H, Umemoto K, Nakamichi K, Saijo M, Ichinohe T, Maruyama H. Pomalidomide-associated progressive multifocal leukoencephalopathy in multiple myeloma: cortical susceptibility-weighted imaging hypointense findings prior to clinical deterioration. J Neurovirol 2020; 26:452-455. [PMID: 32394398 DOI: 10.1007/s13365-020-00845-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/13/2020] [Accepted: 04/22/2020] [Indexed: 02/07/2023]
Abstract
Although there are several case reports of progressive multifocal leukoencephalopathy (PML) in multiple myeloma (MM), there are few reports of cases associated with pomalidomide. Here, we report the case of a 69-year-old female who had received 41 cycles of pomalidomide and dexamethasone treatment for relapsed/refractory IgG-κ MM presented with right-hand weakness; she was diagnosed as pomalidomide-associated PML. Fluid-attenuated inversion recovery (FLAIR) on admission showed high signals in the bilateral front-parietal lobe white matter, with multiple punctate lesions in the vicinity of the main lesions. These punctate pattern findings on FLAIR were similar to that of natalizumab-associated PML. Susceptibility weighted imaging (SWI) showed hypointense rims within the cortex at unaffected sites, in the initial stages. Subsequently, the clinical manifestations deteriorated, and the FLAIR images showed new hyperintense white matter lesions at the sites where cortical SWI hypointense rims were detected on the initial MRI examination. Our patient's serial MRI findings suggest that cortical SWI hypointense rims appear prior to the visible demyelinating white matter lesions in patients with PML.
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Affiliation(s)
- Hiroki Ueno
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan.
| | - Mai Kikumto
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Yoshiko Takebayashi
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Haruka Ishibashi
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Tetsuya Takahashi
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
| | - Hiroko Yasutomi
- Department of Diagnostic Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kasane Umemoto
- Department of Clinical Neurology, Naito Clinic, Hiroshima, Japan
| | - Kazuo Nakamichi
- Department of Virology 1, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masayuki Saijo
- Department of Virology 1, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tatsuo Ichinohe
- Department of Hematology and Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan
| | - Hirofumi Maruyama
- Department of Clinical Neuroscience and Therapeutics, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8551, Japan
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Chawla S, Ge Y, Wuerfel J, Asadollahi S, Mohan S, Paul F, Sinnecker T, Kister I. Longitudinal ultra-high field MRI of brain lesions in neuromyelitis optica spectrum disorders. Mult Scler Relat Disord 2020; 42:102066. [PMID: 32272444 DOI: 10.1016/j.msard.2020.102066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 02/19/2020] [Accepted: 03/20/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND In neuromyelitis optica spectrum disorder (NMOSD), clinical disability in NMOSD patients is relapse-related and progressive phase is rare. This observation raises the question whether there is any radiographic disease activity. The aim of present study was to determine the longitudinal changes in cerebral lesion number, lesion size, lesion-to-venule relationship, and morphological patterns of lesions in NMOSD using multiparametric 7T MR imaging. We also aimed to assess brain volume changes in NMOSD. METHODS A cohort of 22 patients with NMOSD underwent high-resolution 3D-susceptibility weighted imaging (SWI) and 2D-gradient-echo (GRE-T2*) weighted imaging on 7T MRI of brain at baseline and after ~2.8 years of follow-up. Morphologic imaging characteristics, and signal intensity patterns of lesions were recorded at both time points. Lesions were classified as "iron-laden" if they demonstrated hypointense signal on GRE-T2* images and/or SWI as well as hyperintense signal on quantitative susceptibility mapping (QSM). Lesions were considered "non-iron-laden" if they were hyperintense on GRE-T2*/SWI and isointense or hyperintense on QSM. Additionally, fractional brain parenchymal volume (fBPV) was computed at both time points. RESULTS A total of 169 lesions were observed at baseline. At follow-up, 6 new lesions were found in 5 patients. In one patient, a single lesion could not be detected on the follow-up scan. No appreciable change in lesion size and vessel-lesion relationship was observed at follow up. All lesions demonstrated hyperintense signal intensity on GRE-T2* weighted images and isointense signal on QSM at both time points. Therefore, these lesions were considered as non-associated with iron pathology. Additionally, no significant change in brain volume was observed: fBPV 0.78 ± 0.06 at baseline vs. 0.77 ± 0.05 at follow up, p>0.05. CONCLUSION Cerebral lesions in NMOSD patients remain 'inert' and do not show any substantial variations in morphological characteristics during a 2-3-year follow-up period.
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Affiliation(s)
- Sanjeev Chawla
- Center for Advanced Imaging Innovation and Research (CAI2R), Bernard and Irene Schwartz Center for Biomedical Imaging, United States; Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.
| | - Yulin Ge
- Center for Advanced Imaging Innovation and Research (CAI2R), Bernard and Irene Schwartz Center for Biomedical Imaging, United States
| | - Jens Wuerfel
- MIAC AG and Department of Biomedical Engineering, University of Basel, Switzerland; NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Shadi Asadollahi
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Suyash Mohan
- Department of Radiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States
| | - Friedemann Paul
- NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tim Sinnecker
- NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ilya Kister
- Department of Neurology, New York University School of Medicine, Prague, New York, NY 10016, United States
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Orman G, Valand HA, Huisman TAGM. Advanced multimodality neuroimaging of a giant, thrombosed MCA aneurysm complicated by an acute stroke in a pediatric patient. Radiol Case Rep 2020; 15:292-297. [PMID: 31956390 PMCID: PMC6962640 DOI: 10.1016/j.radcr.2019.12.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/11/2019] [Accepted: 12/20/2019] [Indexed: 12/04/2022] Open
Abstract
A 17-year-old boy presented to our quaternary hospital because of acute mental status changes following prolonged gastrointestinal illness resulting in dehydration. Neuroimaging studies with computed tomography and magnetic resonance imaging (MRI) revealed a giant thrombosed aneurysm of the left middle cerebral artery (MCA) with acute left MCA stroke. An ischemic penumbra was identified based upon the mismatch between diffusion weighted (DWI) and susceptibility weighted (SWI) MRI matching with the perfusion weighted imaging (PWI). On follow-up MRI, the core of ischemia as identified by DWI progressed into the ischemic penumbra identified by SWI. The patient had permanent moderate right hemiparesis and aphasia on last follow-up. In conclusion, thrombosis is a rare complication of a giant aneurysm in children. Advanced neuroimaging using the combination of DWI and noncontrast enhanced SWI is a valuable alternative or possibly adjunct to PWI to identify tissue at risk for progressing stroke.
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Affiliation(s)
- Gunes Orman
- Texas Children's Hospital, Edward B. Singleton Department of Radiology, 6701 Fannin Street, Houston, TX 77030, USA
| | - Hardik A Valand
- Johns Hopkins Hospital, Charlotte R. Bloomberg Children's Center, Division of Pediatric Radiology and Pediatric Neuroradiology, Baltimore, MD, USA.,American University of Integrative Science, Tucker, GA, USA
| | - Thierry A G M Huisman
- Texas Children's Hospital, Edward B. Singleton Department of Radiology, 6701 Fannin Street, Houston, TX 77030, USA.,Johns Hopkins Hospital, Charlotte R. Bloomberg Children's Center, Division of Pediatric Radiology and Pediatric Neuroradiology, Baltimore, MD, USA
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Darwish EAF, Abdelhameed-El-Nouby M, Geneidy E. Mapping the ischemic penumbra and predicting stroke progression in acute ischemic stroke: the overlooked role of susceptibility weighted imaging. Insights Imaging 2020; 11:6. [PMID: 31930428 PMCID: PMC6955386 DOI: 10.1186/s13244-019-0810-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 10/25/2019] [Indexed: 12/15/2022] Open
Abstract
Objectives Asymmetrically prominent veins (APVs) detected on susceptibility weighted imaging (SWI) in acute stroke patients are assumed to signify compromised cerebral perfusion. We aimed to explore the role of APVs in identifying the ischemic penumbra and predicting stroke progression in acute stroke patients Methods Twenty patients with a middle cerebral artery ischemic infarction presenting within 24 h of symptoms onset underwent SWI following our standard MR stroke protocol imaging sequences which included diffusion-weighted imaging (DWI). Follow-up (FUP) FLAIR images were obtained at least 5 days after the initial MRI study. The Alberta Stroke Program Early CT Score (ASPECTS) was used to determine the initial infarct size, extent of APVs and final infarct size on initial DWI, SWI, and FUP images respectively. For each patient, SWI was compared with DWI images to determine match/mismatch of their respective ASPECTS values and calculate mismatch scores, whereas acute DWI findings were compared with follow-up images to identify infarct growth (IG) and calculate infarction growth scores (IGS). Results IG occurred in 6/10 patients with a positive DWI-SWI mismatch and in none of the patients without a positive DWI-SWI mismatch. A positive DWI/SWI mismatch was significantly associated with IG (χ2 = 8.57, p = 0.0138, Cramer’s V = 0.65). A significant inverse correlation was found between SWI ASPECTS and IGS (rs = − 0.702, p = 0.001). DWI-SWI mismatch scores were strongly correlated with IGS. (rs = 0.788, p = 0.000) Conclusion A positive DWI-SWI mismatch is an indicator of the ischemic penumbra and a predictor of infarct expansion if left untreated.
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Affiliation(s)
- Eman A F Darwish
- Department of Radiology, Faculty of Medicine, Ain Shams University, Abbassiya, Cairo, 11566, Egypt.
| | | | - Eman Geneidy
- Department of Radiology, Faculty of Medicine, Ain Shams University, Abbassiya, Cairo, 11566, Egypt
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25
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Li SJ, Ren YD, Li J, Cao B, Ma C, Qin SS, Li XR. The role of iron in Parkinson's disease monkeys assessed by susceptibility weighted imaging and inductively coupled plasma mass spectrometry. Life Sci 2019; 240:117091. [PMID: 31760102 DOI: 10.1016/j.lfs.2019.117091] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 01/18/2023]
Abstract
Mounting evidences indicated that elevated iron levels in the substantia nigra (SN) have been concerned as the underlying mechanisms of neurodegenerative diseases, including Parkinson's disease (PD). The present study used the 1-Methyl-4-phenyl-1, 2, 3, 6 -tetrahydropyridine (MPTP)-treated cynomolgus monkeys for PD to evaluate the usability of SWI for assessing iron deposition in the cerebral nuclei of PD. The results showed that susceptibility-weighted imaging (SWI) phase values of the ipsilateral (MPTP-lesion side) SN of MPTP-treated monkeys were lower than those in the contralateral SN of MPTP-treated monkeys and the same side of Control monkeys, suggesting that iron deposition were elevated in the affected side SN of MPTP-treated monkeys. Whereas MPTP has not effects on the SWI phase values in other detected brain regions of monkeys, including red nucleus (RN), putamen (PUT) and caudate nucleus (CA). Furthermore, ICP-MS results showed that MPTP increased the iron levels in MPTP injection side, but no in the ipsilateral striatum. Additionally, MPTP treatment did not affect the calcium and manganese levels in the detected brain regions of monkeys. However, Pearson correlation analysis results indicated that there were not relationship between SWI phase values in MPTP-lesion side of SN with the behavioral score, tyrosine hydroxylase (TH)-positive cells number and iron levels in the MPTP-lesion side of midbrain. Taken together, the results confirm the involvement of SN iron accumulations in the MPTP-treated monkey models for PD, and indirectly verify the usability of SWI for the measurement of iron deposition in the cerebral nuclei of PD.
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Affiliation(s)
- Shao-Jun Li
- Department of Toxicology, School of Public Health, Guangxi Medical University, No. 22, Shuangyong Road, Nanning 530021, Guangxi Province, China
| | - Yan-De Ren
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China.
| | - Jin Li
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi Province, China
| | - Bin Cao
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Chi Ma
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Shan-Shan Qin
- Department of Radiology, the Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Xiang-Rong Li
- Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning 530021, Guangxi Province, China.
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Cheng Z, He N, Huang P, Li Y, Tang R, Sethi SK, Ghassaban K, Yerramsetty KK, Palutla VK, Chen S, Yan F, Haacke EM. Imaging the Nigrosome 1 in the substantia nigra using susceptibility weighted imaging and quantitative susceptibility mapping: An application to Parkinson's disease. Neuroimage Clin 2019; 25:102103. [PMID: 31869769 PMCID: PMC6933220 DOI: 10.1016/j.nicl.2019.102103] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 10/14/2019] [Accepted: 11/18/2019] [Indexed: 10/31/2022]
Abstract
Parkinson's disease (PD) is a clinically heterogeneous chronic progressive neuro-degenerative disease with loss of dopaminergic neurons in the nigrosome 1 (N1) territory of the substantia nigra pars compacta (SNpc). To date, there has been a major effort to identify changes in the N1 territory by monitoring increases of iron in the SNpc. However, there is no standard protocol being used to visualize or characterize the N1 territory. Therefore, the purpose of this study was to create a robust high quality, rapid imaging protocol, determine a slice by slice characterization of the appearance of N1 (the "N1 sign") and evaluate the loss of the N1 sign in order to differentiate healthy controls (HCs) from patients with PD. Firstly, one group of 10 HCs was used to determine the choice of imaging parameters. Secondly, another group of 80 HCs was used to characterize the appearance of the N1 sign and train the raters. In this step, the magnitude, susceptibility weighted images (SWI), quantitative susceptibility maps (QSM) and true SWI (tSWI) images were all reviewed using data from a 3D gradient recalled echo sequence. A resolution of 0.67 mm × 0.67 mm × 1.34 mm was chosen based on the ability to cover all the basal ganglia, midbrain and dentate nucleus with good signal-to-noise with echo times of 11 ms and 20 ms. Thirdly, 80 Parkinsonism and related disorders patients [idiopathic Parkinson's disease (IPD): 57; atypical parkinsonian syndromes (APs): 14; essential tremor (ET): 9] and one additional group of 80 age-matched HCs were blindly analyzed for the presence or absence of the N1 sign for a differential diagnosis. From the first group of 80 HCs, all of the 76 (100%) cases (4 were excluded due to motion artifacts) showed the N1 sign in one form or another after reviewing the first 5 caudal slices of the SN. For the second group of 80 HCs, 78 (97.5%) showed the N1 sign in at least 2 slices. Of the 80 Parkinsonism and related disorders patients, 32 (56.1%, 32/57) IPD and 6 (42.9%, 6/14) APs showed a bilateral loss of the N1 sign, 12 (21.1%, 12/57) IPD and 6 (42.9%, 6/14) APs showed the N1 sign unilaterally and 13 (22.8%, 13/57) IPD and 2 (14.2%, 2/14) APs showed the N1 sign bilaterally. Also, all 9 (100%, 9/9) ET patients showed the N1 sign bilaterally. The mean total structure and mean high susceptibility region for the SN for both IPD and APs patients with bilateral loss of N1 were higher than those of the HCs (p < 0.002). In conclusion, the N1 sign can be consistently visualized using tSWI with a resolution of at least 0.67 mm × 0.67 mm × 1.34 mm and can be seen in 95% of HCs.
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Affiliation(s)
- Zenghui Cheng
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Pei Huang
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Yan Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Rongbiao Tang
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Sean K. Sethi
- Magnetic Resonance Innovations, Inc, 30200 Telegraph Road, Bingham Farms, MI, 48025, USA
- Department of Radiology, Wayne State University, 42 W. Warren Ave. Detroit, MI, 48202, USA
| | - Kiarash Ghassaban
- Department of Radiology, Wayne State University, 42 W. Warren Ave. Detroit, MI, 48202, USA
- Department of Biomedical Engineering, Wayne State University, 42 W. Warren Ave. Detroit, MI, 48202, USA
| | - Kiran Kumar Yerramsetty
- MR Medical Imaging Innovations India Pvt. Ltd, Flat No.401, Plot No.397, SAI HOUSE, Ayyappa Society, Madhapur, Hyderabad, Telangana, 500081, India
| | - Vinay Kumar Palutla
- MR Medical Imaging Innovations India Pvt. Ltd, Flat No.401, Plot No.397, SAI HOUSE, Ayyappa Society, Madhapur, Hyderabad, Telangana, 500081, India
| | - Shengdi Chen
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
| | - E. Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
- Department of Neurology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Ruijin Er Road, Shanghai, 200025, China
- Magnetic Resonance Innovations, Inc, 30200 Telegraph Road, Bingham Farms, MI, 48025, USA
- Department of Radiology, Wayne State University, 42 W. Warren Ave. Detroit, MI, 48202, USA
- Department of Biomedical Engineering, Wayne State University, 42 W. Warren Ave. Detroit, MI, 48202, USA
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He N, Sethi SK, Zhang C, Li Y, Chen Y, Sun B, Yan F, Haacke EM. Visualizing the lateral habenula using susceptibility weighted imaging and quantitative susceptibility mapping. Magn Reson Imaging 2019; 65:55-61. [PMID: 31655137 DOI: 10.1016/j.mri.2019.09.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 09/03/2019] [Accepted: 09/15/2019] [Indexed: 12/22/2022]
Abstract
The habenulae consist of a pair of small nuclei which bridge the limbic forebrain and midbrain monoaminergic centers. They are implicated in major depressive disorders due to abnormal phasic response when provoked by a conditioned stimulus. The lateral habenula (Lhb) is believed to be involved in dopamine metabolism and is now a target for deep brain stimulation, a treatment which has shown promising anti-depression effects. We imaged the habenulae with susceptibility weighted imaging (SWI) and quantitative susceptibility mapping (QSM) in order to localize the lateral habenula. Fifty-six healthy controls were recruited for this study. For the quantitative assessment, we traced the structure to compute volume from magnitude images and mean susceptibility bilaterally for the habenula on QSM. Thresholding methods were used to delineate the Lhb habenula on QSM. SWI, true SWI (tSWI), and QSM data were subjectively reviewed for increased Lhb contrast. SWI, QSM, and tSWI showed bilateral signal changes in the posterior location of the habenulae relative to the anterior location, which may indicate increased putative iron content within the Lhb. This signal behavior was shown in 41/44 (93%) subjects. In summary, it is possible to localize the lateral component of the habenula using SWI and QSM at 3 T.
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Affiliation(s)
- Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Sean K Sethi
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA; The MRI Institute for Biomedical Research, Bingham Farms, MI, USA; Department of Radiology, Wayne State University, Detroit, MI, USA
| | - Chencheng Zhang
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan Li
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yongsheng Chen
- Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Bomin Sun
- Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - E Mark Haacke
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA; The MRI Institute for Biomedical Research, Bingham Farms, MI, USA; Department of Radiology, Wayne State University, Detroit, MI, USA
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Haacke EM, Chen Y, Utriainen D, Wu B, Wang Y, Xia S, He N, Zhang C, Wang X, Lagana MM, Luo Y, Fatemi A, Liu S, Gharabaghi S, Wu D, Sethi SK, Huang F, Sun T, Qu F, Yadav BK, Ma X, Bai Y, Wang M, Cheng J, Yan F. STrategically Acquired Gradient Echo (STAGE) imaging, part III: Technical advances and clinical applications of a rapid multi-contrast multi-parametric brain imaging method. Magn Reson Imaging 2019; 65:15-26. [PMID: 31629075 DOI: 10.1016/j.mri.2019.09.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 09/11/2019] [Accepted: 09/15/2019] [Indexed: 12/15/2022]
Abstract
One major thrust in radiology today is image standardization with a focus on rapidly acquired quantitative multi-contrast information. This is critical for multi-center trials, for the collection of big data and for the use of artificial intelligence in evaluating the data. Strategically acquired gradient echo (STAGE) imaging is one such method that can provide 8 qualitative and 7 quantitative pieces of information in 5 min or less at 3 T. STAGE provides qualitative images in the form of proton density weighted images, T1 weighted images, T2* weighted images and simulated double inversion recovery (DIR) images. STAGE also provides quantitative data in the form of proton spin density, T1, T2* and susceptibility maps as well as segmentation of white matter, gray matter and cerebrospinal fluid. STAGE uses vendors' product gradient echo sequences. It can be applied from 0.35 T to 7 T across all manufacturers producing similar results in contrast and quantification of the data. In this paper, we discuss the strengths and weaknesses of STAGE, demonstrate its contrast-to-noise (CNR) behavior relative to a large clinical data set and introduce a few new image contrasts derived from STAGE, including DIR images and a new concept referred to as true susceptibility weighted imaging (tSWI) linked to fluid attenuated inversion recovery (FLAIR) or tSWI-FLAIR for the evaluation of multiple sclerosis lesions. The robustness of STAGE T1 mapping was tested using the NIST/NIH phantom, while the reproducibility was tested by scanning a given individual ten times in one session and the same subject scanned once a week over a 12-week period. Assessment of the CNR for the enhanced T1W image (T1WE) showed a significantly better contrast between gray matter and white matter than conventional T1W images in both patients with Parkinson's disease and healthy controls. We also present some clinical cases using STAGE imaging in patients with stroke, metastasis, multiple sclerosis and a fetus with ventriculomegaly. Overall, STAGE is a comprehensive protocol that provides the clinician with numerous qualitative and quantitative images.
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Affiliation(s)
- E Mark Haacke
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA; The MRI Institute for Biomedical Research, Bingham Farms, MI, USA; Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA.
| | - Yongsheng Chen
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA; Department of Neurology, Wayne State University School of Medicine, Detroit, MI, USA
| | - David Utriainen
- The MRI Institute for Biomedical Research, Bingham Farms, MI, USA; Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA
| | - Bo Wu
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA
| | - Yu Wang
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China; Neusoft Medical Systems Co., Ltd., Shanghai, China
| | - Shuang Xia
- Department of Radiology, Tianjin First Central Hospital, Tianjin, China
| | - Naying He
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunyan Zhang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiao Wang
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | | | - Yu Luo
- Department of Radiology, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Ali Fatemi
- Departments of Radiology and Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA
| | - Saifeng Liu
- The MRI Institute for Biomedical Research, Bingham Farms, MI, USA
| | - Sara Gharabaghi
- Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA
| | - Dongmei Wu
- Shanghai Key Laboratory of Magnetic Resonance, School of Physics and Electronic Science, East China Normal University, Shanghai, China
| | - Sean K Sethi
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA; The MRI Institute for Biomedical Research, Bingham Farms, MI, USA; Magnetic Resonance Innovations, Inc., Bingham Farms, MI, USA
| | - Feng Huang
- Neusoft Medical Systems Co., Ltd., Shanghai, China
| | - Taotao Sun
- Department of Radiology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feifei Qu
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Brijesh K Yadav
- Department of Radiology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Xiaoyue Ma
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Yan Bai
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Meiyun Wang
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, China; Department of Radiology, Zhengzhou University People's Hospital, Zhengzhou, China.
| | - Jingliang Cheng
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fuhua Yan
- Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Obmann VC, Marx C, Berzigotti A, Mertineit N, Hrycyk J, Gräni C, Ebner L, Ith M, Heverhagen JT, Christe A, Huber AT. Liver MRI susceptibility-weighted imaging (SWI) compared to T2* mapping in the presence of steatosis and fibrosis. Eur J Radiol 2019; 118:66-74. [PMID: 31439261 DOI: 10.1016/j.ejrad.2019.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/22/2019] [Accepted: 07/01/2019] [Indexed: 12/20/2022]
Abstract
PURPOSE To show that both susceptibility-weighted imaging (SWI) and T2*-mapping are dependent on liver steatosis, which should be taken into account when using these parameters to grade liver fibrosis and cirrhosis. METHODS In this prospective study, a total of 174 patients without focal liver disease underwent multiparametric MRI at 3 T including SWI, T1- and T2* mapping, proton density fat fraction (PDFF) quantification and MR elastography. SWI, T2* and T1 were measured in the liver (4 locations), as well as in paraspinal muscles, to calculate the liver-to-muscle ratio (LMR). Liver and LMR values were compared among patients with different steatosis grades (PDFF < 5%, 5-10%, 10-20% and >20%), patients with normal, slightly increased and increased liver stiffness (<2.8 kPa, 2.8-3.5 kPa and >3.5 kPa, respectively). ANOVA with Bonferroni-corrected post hoc tests as well as a multivariate analysis were used to compare values among groups and parameters. RESULTS SWI and T2* both differed significantly among groups with different steatosis grades (p < 0.001). However, SWI allowed a better differentiation among liver fibrosis grades (p < 0.001) than did T2* (p = 0.05). SWI LMR (p < 0.001) and T2* LMR (p = 0.036) showed a similar performance in differentiating among liver fibrosis grades. CONCLUSION SWI and T2*-mapping are strongly dependent on the liver steatosis grades. Nevertheless, both parameters are useful predictors for liver fibrosis when using a multiparametric approach.
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Jethwa K, Aphiwatthanasumet K, Mougin O, Bowtell R, Auer D, Gowland P. Phase enhanced PSIR T1 weighted imaging improves contrast resolution of the nucleus basalis of Meynert at 7 T: a preliminary study. Magn Reson Imaging 2019; 61:296-299. [PMID: 31202788 DOI: 10.1016/j.mri.2019.06.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/29/2019] [Accepted: 06/02/2019] [Indexed: 01/29/2023]
Abstract
BACKGROUND The nucleus basalis of Meynert (NBM) provides the majority of cortical cholinergic innervation which is required for memory formation, maintaining attention and promoting learning. Neuronal loss within this area is implicated in a number of neurodegenerative disorders. Imaging the NBM is however limited by its small size and suboptimal contrast resolution at the base of the brain. PURPOSE To develop a novel method of processing T1 weighted MRI data for improving contrast resolution and delineation of the NBM. STUDY TYPE Technical development, case series. SUBJECTS Five healthy volunteers. FIELD STRENGTH, SEQUENCE, ANALYSIS Volunteers were scanned on a Philips 7 T Achieva imaging system. T1-weighted images were constructed from a double inversion phase sensitive inversion recovery (PSIR) sequence. Inversion recovery data were combined with the filtered phase data from the long inversion time image to produce a novel susceptibility weighted-PSIR (SW-PSIR) map. This process is similar to that used to combine T2* weighted image and phase maps to create susceptibility weighted images (SWI), but with the processing parameters optimized in terms of contrast-to-noise ratio to the NBM in the final SW-PSIR maps. Average NBM thickness was reported as mean ± standard deviation (SD). Intra-observer and inter-observer reliability were tested using intra-class correlation coefficient (ICC). RESULTS 0.7mm3 isotropic resolution images were acquired in a 5 min and 50 s scan. The mean thickness ± SD of the left (right) NBM was 3.5 ± 0.4 mm and 3.8 ± 0.5 mm (3.6 ± 0.5 mm and 3.7 ± 0.5 mm) by the first and second observers respectively with excellent intra-observer and inter-observer agreement (>0.90). CONCLUSION In this pilot study the SW-PSIR imaging approach improves delineation of the NBM between the ventral pallidum and chiasmatic cistern allowing accurate thickness measurement. The role of this sequence, in enabling robust morphometry of the NBM in health and disease, can be tested further in larger studies.
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Affiliation(s)
- Ketan Jethwa
- National Institute of Health Research Nottingham Biomedical Research Centre, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, United Kingdom; Sir Peter Mansfield Imaging Centre, University Park, University of Nottingham, NG7 2RD, United Kingdom.
| | - Kingkarn Aphiwatthanasumet
- National Institute of Health Research Nottingham Biomedical Research Centre, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, United Kingdom
| | - Olivier Mougin
- National Institute of Health Research Nottingham Biomedical Research Centre, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, United Kingdom
| | - Richard Bowtell
- National Institute of Health Research Nottingham Biomedical Research Centre, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, United Kingdom
| | - Dorothee Auer
- National Institute of Health Research Nottingham Biomedical Research Centre, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, United Kingdom; Sir Peter Mansfield Imaging Centre, University Park, University of Nottingham, NG7 2RD, United Kingdom
| | - Penny Gowland
- National Institute of Health Research Nottingham Biomedical Research Centre, Queens Medical Centre, Derby Road, Nottingham NG7 2UH, United Kingdom
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Lai PH, Chung HW, Chang HC, Fu JH, Wang PC, Hsu SH, Hsu SS, Lin HS, Chuang TC. Susceptibility-weighted imaging provides complementary value to diffusion-weighted imaging in the differentiation between pyogenic brain abscesses, necrotic glioblastomas, and necrotic metastatic brain tumors. Eur J Radiol 2019; 117:56-61. [PMID: 31307653 DOI: 10.1016/j.ejrad.2019.05.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this retrospective study was to investigate the differentiation of abscess and necrotic tumors, using susceptibility-weighted imaging (SWI) and apparent diffusion coefficients (ADC) either separated or combined. METHODS Imaging was performed on 26 patients with pyogenic brain abscesses, 31 patients with rim-enhancing glioblastomas, and 21 patients with rim-enhancing metastases. The degree of intralesional susceptibility signal (ILSS) was independently assessed by three observers. Average ADC in the lesion core was calculated. After receiver operating characteristic (ROC) analysis, the area under the ROC curve was compared using three different analytical models (ILSS, ADC, and ILSS-ADC combined) to differentiate abscess from the two rim-enhancing necrotic tumors. RESULTS The ILSS-ADC combined model had greater area under the ROC curves than ILSS or ADC used alone. In this study, the ILSS-ADC combined model showed 100% diagnostic accuracy differentiating abscesses from glioblastoma. The ADC model and the ILSS-ADC combined model performed equally well in distinguishing abscesses from metastases. CONCLUSION It is concluded that SWI and ADC are complementary, and the combination of SWI and ADC may improve results compared with the use of only one model. Validation by an independent cohort is the next necessary step to broaden its applicability in routine clinical settings.
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Affiliation(s)
- Ping-Hong Lai
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Hsiao-Wen Chung
- Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan
| | - Hing-Chiu Chang
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong
| | - Jui-Hsun Fu
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Po-Chin Wang
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Shuo-Hsiu Hsu
- Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Shu-Shong Hsu
- Department of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Huey-Shyan Lin
- Department of Health-Business Administration, School of Nursing, Fooyin University, Kaohsiung, Taiwan
| | - Tzu-Chao Chuang
- Department of Electrical Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan.
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Zhang S, Chiang GCY, Knapp JM, Zecca CM, He D, Ramakrishna R, Magge RS, Pisapia DJ, Fine HA, Tsiouris AJ, Zhao Y, Heier LA, Wang Y, Kovanlikaya I. Grading meningiomas utilizing multiparametric MRI with inclusion of susceptibility weighted imaging and quantitative susceptibility mapping. J Neuroradiol 2019; 47:272-277. [PMID: 31136748 DOI: 10.1016/j.neurad.2019.05.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/14/2019] [Accepted: 05/14/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE The ability to predict high-grade meningioma preoperatively is important for clinical surgical planning. The purpose of this study is to evaluate the performance of comprehensive multiparametric MRI, including susceptibility weighted imaging (SWI) and quantitative susceptibility mapping (QSM) in predicting high-grade meningioma both qualitatively and quantitatively. METHODS Ninety-two low-grade and 37 higher grade meningiomas in 129 patients were included in this study. Morphological characteristics, quantitative histogram analysis of QSM and ADC images, and tumor size were evaluated to predict high-grade meningioma using univariate and multivariate analyses. Receiver operating characteristic (ROC) analyses were performed on the morphological characteristics. Associations between Ki-67 proliferative index (PI) and quantitative parameters were calculated using Pearson correlation analyses. RESULTS For predicting high-grade meningiomas, the best predictive model in multivariate logistic regression analyses included calcification (β=0.874, P=0.110), peritumoral edema (β=0.554, P=0.042), tumor border (β=0.862, P=0.024), tumor location (β=0.545, P=0.039) for morphological characteristics, and tumor size (β=4×10-5, P=0.004), QSM kurtosis (β=-5×10-3, P=0.058), QSM entropy (β=-0.067, P=0.054), maximum ADC (β=-1.6×10-3, P=0.003), ADC kurtosis (β=-0.013, P=0.014) for quantitative characteristics. ROC analyses on morphological characteristics resulted in an area under the curve (AUC) of 0.71 (0.61-0.81) for a combination of them. There were significant correlations between Ki-67 PI and mean ADC (r=-0.277, P=0.031), 25th percentile of ADC (r=-0.275, P=0.032), and 50th percentile of ADC (r=-0.268, P=0.037). CONCLUSIONS Although SWI and QSM did not improve differentiation between low and high-grade meningiomas, combining morphological characteristics and quantitative metrics can help predict high-grade meningioma.
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Affiliation(s)
- Shun Zhang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Department of Radiology, Weill Cornell Medicine, 407, E61st, Suite 117, 10065 New York, NY, USA
| | - Gloria Chia-Yi Chiang
- Department of Radiology, Weill Cornell Medicine, 407, E61st, Suite 117, 10065 New York, NY, USA
| | | | - Christina M Zecca
- Department of Radiology, Weill Cornell Medicine, 407, E61st, Suite 117, 10065 New York, NY, USA
| | - Diana He
- Department of Radiology, Weill Cornell Medicine, 407, E61st, Suite 117, 10065 New York, NY, USA
| | - Rohan Ramakrishna
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Rajiv S Magge
- Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - David J Pisapia
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY, USA
| | - Howard Alan Fine
- Department of Neurology, Weill Cornell Medicine, New York, NY, USA
| | - Apostolos John Tsiouris
- Department of Radiology, Weill Cornell Medicine, 407, E61st, Suite 117, 10065 New York, NY, USA
| | - Yize Zhao
- Department of Healthcare Policy and Research, Weill Cornell Medicine, New York, NY, USA
| | - Linda A Heier
- Department of Radiology, Weill Cornell Medicine, 407, E61st, Suite 117, 10065 New York, NY, USA
| | - Yi Wang
- Department of Radiology, Weill Cornell Medicine, 407, E61st, Suite 117, 10065 New York, NY, USA; Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA
| | - Ilhami Kovanlikaya
- Department of Radiology, Weill Cornell Medicine, 407, E61st, Suite 117, 10065 New York, NY, USA.
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Vander Linden C, Verhelst H, Genbrugge E, Deschepper E, Caeyenberghs K, Vingerhoets G, Deblaere K. Is diffuse axonal injury on susceptibility weighted imaging a biomarker for executive functioning in adolescents with traumatic brain injury? Eur J Paediatr Neurol 2019; 23:525-536. [PMID: 31023628 DOI: 10.1016/j.ejpn.2019.04.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 03/23/2019] [Accepted: 04/09/2019] [Indexed: 01/07/2023]
Abstract
Traumatic brain injury (TBI) is a heterogeneous disorder in which diffuse axonal injury (DAI) is an important component contributing to executive dysfunction. During adolescence, developing brain networks are especially vulnerable to acceleration-deceleration forces. We aimed to examine the correlation between DAI (number and localization) and executive functioning in adolescents with TBI. We recruited 18 adolescents with a mean age of 15y8m (SD = 1y7m), averaging 2.5 years after sustaining a moderate-to-severe TBI with documented DAI. Susceptibility Weighted Imaging sequence was administered to localize the DAI lesions. The adolescents performed a neurocognitive test-battery, addressing different aspects of executive functioning (working memory, attention, processing speed, planning ability) and their parents completed the Behavior Rating Inventory of Executive Function (BRIEF) - questionnaire. Executive performance of the TBI-group was compared with an age and gender matched control group of typically developing peers. Based on these results we focused on the Stockings of Cambridge test and the BRIEF to correlate with the total number and location of DAI. Results revealed that the anatomical distribution of DAI, especially in the corpus callosum and the deep brain nuclei, may have more implications for executive functioning than the total amount of DAI in adolescents. Results of this study may help guide targeted rehabilitation to redirect the disturbed development of executive function in adolescents with TBI.
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Affiliation(s)
- Catharine Vander Linden
- Ghent University Hospital, Child Rehabilitation Center K7, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Helena Verhelst
- Ghent University, Department of Experimental Psychology, Faculty of Psychology and Educational Sciences, Henri Dunantlaan 2, 9000, Ghent, Belgium.
| | - Eva Genbrugge
- Ghent University Hospital, Department of Neuroradiology, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Ellen Deschepper
- Ghent University, Biostatistics Unit, Department of Public Health, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
| | - Karen Caeyenberghs
- Australian Catholic University, Mary McKillop Institute for Health Research, Level 5, 215 Spring Street, Melbourne, VIC, 3000, Australia.
| | - Guy Vingerhoets
- Ghent University, Department of Experimental Psychology, Faculty of Psychology and Educational Sciences, Henri Dunantlaan 2, 9000, Ghent, Belgium.
| | - Karel Deblaere
- Ghent University Hospital, Department of Neuroradiology, Corneel Heymanslaan 10, 9000, Ghent, Belgium.
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Croal PL, Leung J, Phillips CL, Serafin MG, Kassner A. Quantification of pathophysiological alterations in venous oxygen saturation: A comparison of global MR susceptometry techniques. Magn Reson Imaging 2019; 58:18-23. [PMID: 30639755 DOI: 10.1016/j.mri.2019.01.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Revised: 01/09/2019] [Accepted: 01/10/2019] [Indexed: 01/21/2023]
Abstract
The purpose of this study was to compare the Infinite Cylinder and Forward Field methods of quantifying global venous oxygen saturation (Yv) in the superior sagittal sinus (SSS) from MRI phase data, and assess their applicability in systemic cerebrovascular disease.15 children with sickle cell disease (SCD) and 10 healthy age-matched controls were imaged on a 3.0 T MRI system. Anatomical and phase data around the superior sagittal sinus were acquired from a clinically available susceptibility weighted imaging sequence and converted to Yv using the Infinite Cylinder and Forward Field methods. Yv was significantly higher when calculated using the Infinite Cylinder method compared to the Forward Field method in both patients (p = 0.003) and controls (p < 0.001). A significant difference in Yv was observed between patients and controls for the Forward Field method only (p = 0.006). While various implementations of Yv quantification can be used in practice, the results can differ significantly. Simplistic models such as the Infinite Cylinder method may be easier to implement, but their dependence on broad assumptions can lead to an overestimation of Yv, and may reduce the sensitivity to pathophysiological changes in Yv.
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Affiliation(s)
- Paula L Croal
- Department of Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Biomedical Engineering, The University of Oxford, Oxford, United Kingdom
| | - Jackie Leung
- Department of Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Charly L Phillips
- Department of Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Systems Design Engineering, University of Waterloo, Waterloo, Ontario, Canada
| | - Malambing G Serafin
- Department of Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrea Kassner
- Department of Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
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Ronsin S, Hannoun S, Thobois S, Petiot P, Vighetto A, Cotton F, Tilikete C. A new MRI marker of ataxia with oculomotor apraxia. Eur J Radiol 2019; 110:187-92. [PMID: 30599859 DOI: 10.1016/j.ejrad.2018.11.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/23/2018] [Accepted: 11/28/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE Evaluate the specificity and sensitivity of disappearance of susceptibility weighted imaging (SWI) dentate nuclei (DN) hypointensity in oculomotor apraxia patients (AOA). METHOD In this prospective study, 27 patients with autosomal genetic ataxia (AOA (n = 11), Friedreich ataxia and ataxia with vitamin E deficit (n = 4), and dominant genetic ataxia (n = 12)) were included along with fifteen healthy controls. MRIs were qualitatively classified for the presence or absence of DN hypointensity on FLAIR and SWI sequences. The MRIs were then quantitatively studied, with measurement of a ratio of DN over brainstem white matter signal intensity through manual delineation. The institutional review board approved this study, and written informed consent was obtained. In the cross-sectional analysis, the Mann-Whitney test was applied. RESULTS Qualitatively, the eleven AOA patients presented absence of both DN SWI and FLAIR hyposignals; three dominant genetic ataxia patients had moderate SWI DN hyposignal and absent FLAIR hyposignal; the thirteen remaining subjects presented normal SWI and FLAIR DN hyposignal. Absence of DN SWI hypointensity was 100% sensitive and specific to AOA. Quantitative signal intensity ratio (mean ± standard deviation) of the AOA group (98·96 ± 5·37%) was significantly higher than in control subjects group (76.40 ± 8.34%; p < 0.001), dominant genetic ataxia group (81·15 ± 9·94%; p < 0·001), and Friedreich ataxia and ataxia with vitamin E deficit group (87·56 ± 2·78%; p < 0·02). CONCLUSION This small study shows that loss of the normal hypointensity in the dentate nucleus on both SWI and FLAIR imaging at 3 T is a highly sensitive and specific biomarker for AOA.
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Yeoh H, Lee JY, Lee YJ, Park DW, Kim TY, Ahn GY, Bae SC, Kim YS, Kim HY, Kim CK, Kim JY, Kim H, Han JW. Relationship between cerebral microbleeds and white matter MR hyperintensities in systemic lupus erythematosus: a retrospective observational study. Neuroradiology 2018; 61:265-274. [PMID: 30415319 DOI: 10.1007/s00234-018-2130-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 11/01/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE White matter hyperintensities (WMH) and cerebral microbleeds (CMBs) are known to be associated with small vessel diseases (SVD) and neuroinflammation. The purpose was to investigate the relationship between CMBs and WMH in patients with systemic lupus erythematosus (SLE). METHODS Thirty-one SLE patients with WMH and 27 SLE patients with normal brain MRI were compared. The presence, location, and grading of CMBs were assessed using susceptibility-weighted images. WMH volume was quantitatively measured. Clinical characteristics and serologic markers were compared. We also performed two separate subgroup analyses after (1) dividing WMH into inflammatory lesion vs. SVD subgroups and (2) dividing WMH into those with vs. without CMB subgroups. RESULTS The WMH group showed more frequent CMBs than the normal MR group (p < 0.001). The WMH group showed higher SLE disease activity index, longer disease duration, and a higher incidence of antiphospholipid syndrome than the normal MR group (p = 0.02, 0.04, and 0.04, respectively). There was a moderate correlation between WMH volume and CMB grading (r = 0.49, p = 0.006). Within the WMH group, the inflammatory lesion subgroup showed more frequent CMBs and larger WMH volume than the SVD subgroup (p < 0.001 and 0.02, respectively). The WMH with CMB subgroup had larger WMH volume than the WMH without CMB subgroup (p = 0.004). CONCLUSION In patients with SLE, CMBs could be related to large-volume WMH and inflammatory lesions. CMBs along with severe WMH could be used as an imaging biomarker of vasculitis in patients with SLE.
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Affiliation(s)
- Hyunjung Yeoh
- Department of Radiology, Hanyang University Hospital, Hanyang University College of Medicine, 17 Haengdang-dong, Seongdong-gu, Seoul, 133-792, South Korea
| | - Ji Young Lee
- Department of Radiology, Hanyang University Hospital, Hanyang University College of Medicine, 17 Haengdang-dong, Seongdong-gu, Seoul, 133-792, South Korea.
| | - Young-Jun Lee
- Department of Radiology, Hanyang University Hospital, Hanyang University College of Medicine, 17 Haengdang-dong, Seongdong-gu, Seoul, 133-792, South Korea
| | - Dong Woo Park
- Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
| | - Tae Yoon Kim
- Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
| | - Ga Young Ahn
- Department of Rheumatology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, South Korea
| | - Sang-Cheol Bae
- Department of Rheumatology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, South Korea
| | - Young Seo Kim
- Department of Neurology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, South Korea
| | - Hyun Young Kim
- Department of Neurology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, South Korea
| | - Chun K Kim
- Department of Nuclear Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, South Korea
| | - Ji Young Kim
- Department of Nuclear Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, South Korea
| | - Haejin Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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El Mekabaty A, Pearl MS, Mershon B, Berkowitz I, Gailloud P, Huisman TAGM. Susceptibility weighted imaging in infants with staged embolization of vein of Galen aneurysmal malformations. J Neuroradiol 2018; 46:214-221. [PMID: 30423378 DOI: 10.1016/j.neurad.2018.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 05/07/2018] [Accepted: 09/24/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND AND PURPOSE The vein of Galen aneurysmal malformation (VGAM) is a rare congenital vascular malformation with a higher morbidity and mortality, especially in neonates. Ultrasound, CT and MR are usually used in diagnosis and treatment monitoring of these disorders. In this current study, we aim to examine utility of SWI in evaluation of treatment response in infants with VGAM. MATERIALS AND METHODS We performed a retrospective chart analysis of children with VGAM in our institution between January 2008 and December 2016. Inclusion criteria included; confirmed VGAM on DSA; available SWI sequence at baseline and at follow up after at least a single embolization session; age at initial MR of 18 years or younger. Signal intensity and Angioarchitecture of VGAM and cerebral veins on SWI, as well as hydrocephalus and clinical outcome were evaluated. RESULTS Of 11 patients identified with VGAM in our institution, 5 children (3 males and 2 females) satisfied the inclusion criteria. The average age at initial MR was 29 days (range 1-120). Fourteen MRI were available for review. All children had VGAM of mural type. Intramedullary veins were dilated and SWI-hypointense in all children, while subependymal and sulcal veins were dilated and SWI-hypointense in 4 patients on initial MRI. On the first available follow up MRI, cerebral veins have mostly normalized in 4 children and remained mostly dilated and SWI-hypointense in 1 child; even after complete treatment of the VGAM. CONCLUSION Our preliminary findings show that SWI seems to offer a beneficial non-invasive tool in evaluating passive venous congestion patterns in pediatric patients with VGAM. It remains to be determined in larger studies, the clinical significance of these SWI changes.
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Affiliation(s)
- Amgad El Mekabaty
- Division of Interventional Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns-Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Monica S Pearl
- Division of Interventional Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns-Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bommy Mershon
- Department of Anesthesiology and Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ivor Berkowitz
- Department of Anesthesiology and Critical Care, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Philippe Gailloud
- Division of Interventional Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns-Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Thierry A G M Huisman
- Division of Pediatric Radiology and Pediatric Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns-Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Buch S, Chen Y, Mark Haacke E. Susceptibility mapping of the dural sinuses and other superficial veins in the brain. Magn Reson Imaging 2019; 57:19-27. [PMID: 30355528 DOI: 10.1016/j.mri.2018.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 09/26/2018] [Accepted: 10/18/2018] [Indexed: 12/17/2022]
Abstract
Quantitative susceptibility mapping (QSM) is a means to obtain direct measurements of local tissue susceptibility distribution. Usually the focus is on imaging tissues in the brain, and the region of the brain studied is dictated by an eroded skull stripped mask. Producing the pristine local phase behavior for regions at the edge of the brain has been difficult in the past. For structures such as the superior sagittal sinus (SSS) that run alongside the surface of the brain and under the skull bones, a considerable part of the external phase from the dipole effect is lost due to the short T2* of the bones. In this paper, we propose a method that seeks to reconstruct the susceptibility distribution inside the dural sinuses by ensuring that the entire geometry of the dural sinuses is preserved with the help of an MR angiogram and venogram (MRAV). Having a geometrical model of the vessels makes it possible to estimate the missing phase outside the brain as well, by using the forward phase model and, hence, allowing a complete phase map to be reconstructed. Fifteen healthy volunteers were scanned using a susceptibility weighted imaging (SWI) sequence with interleaved rephased-dephased echoes. QSM results were compared between the conventional techniques and the proposed method of phase preservation outside the brain and inside the dural sinuses. This method demonstrates the reconstruction of the SSS, whereas conventional methods are either unable to preserve this structure or unable to provide complete phase information. The mean and standard deviation inside the SSS for all volunteers was 435 ± 5 ppb (this is the inter-subject error). To validate the proposed approach, the mean susceptibility inside the straight sinus showed good agreement between conventional approach and the proposed method. The results presented in this study indicate the potential of generating the susceptibility map for the whole brain, including the SSS (as well as potentially all the cortical veins).
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Abstract
Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder, caused by expansion of the CAG repeat in the huntingtin gene. HD is characterized clinically by progressive motor, cognitive and neuropsychiatric symptoms. There are currently no disease modifying treatments available for HD, and there is a great need for biomarkers to monitor disease progression and identify new targets for therapeutic intervention. Neuroimaging techniques provide a powerful tool for assessing disease pathology and progression in premanifest stages, before the onset of overt motor symptoms. Structural magnetic resonance imaging (MRI) is non-invasive imaging techniques which have been employed to study structural and microstructural changes in premanifest and manifest HD gene carriers. This chapter described structural imaging techniques and analysis methods employed across HD MRI studies. Current evidence for structural MRI abnormalities in HD, and associations between atrophy, structural white matter changes, iron deposition and clinical performance are discussed; together with the use of structural MRI measures as a diagnostic tool, to assess longitudinal changes, and as potential biomarkers and endpoints for clinical trials.
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Morrison MA, Payabvash S, Chen Y, Avadiappan S, Shah M, Zou X, Hess CP, Lupo JM. A user-guided tool for semi-automated cerebral microbleed detection and volume segmentation: Evaluating vascular injury and data labelling for machine learning. Neuroimage Clin 2018; 20:498-505. [PMID: 30140608 DOI: 10.1016/j.nicl.2018.08.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 06/18/2018] [Accepted: 08/03/2018] [Indexed: 11/22/2022]
Abstract
Background and purpose With extensive research efforts in place to address the clinical relevance of cerebral microbleeds (CMBs), there remains a need for fast and accurate methods to detect and quantify CMB burden. Although some computer-aided detection algorithms have been proposed in the literature with high sensitivity, their specificity remains consistently poor. More sophisticated machine learning methods appear to be promising in their ability to minimize false positives (FP) through high-level feature extraction and the discrimination of hard-mimics. To achieve superior performance, these methods require sizable amounts of precisely labelled training data. Here we present a user-guided tool for semi-automated CMB detection and volume segmentation, offering high specificity for routine use and FP labelling capabilities to ease and expedite the process of generating labelled training data. Materials and methods Existing computer-aided detection methods reported by our group were extended to include fully-automated segmentation and user-guided CMB classification with FP labelling. The algorithm's performance was evaluated on a test set of ten patients exhibiting radiotherapy-induced CMBs on MR images. Results The initial algorithm's base sensitivity was maintained at 86.7%. FP's were reduced to inter-rater variations and segmentation results were in 98% agreement with ground truth labelling. There was an approximate 5-fold reduction in the time users spent evaluating CMB burden with the algorithm versus without computer aid. The Intra-class Correlation Coefficient for inter-rater agreement was 0.97 CI[0.92,0.99]. Conclusions This development serves as a valuable tool for routine evaluation of CMB burden and data labelling to improve CMB classification with machine learning. The algorithm is available to the public on GitHub (https://github.com/LupoLab-UCSF/CMB_labeler).
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Xie H, Cheng YCN, Liu S, Kokeny P. Removing unwanted background phase with a reference phantom for applications in susceptibility quantification. Magn Reson Imaging 2018; 54:32-45. [PMID: 30055292 DOI: 10.1016/j.mri.2018.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 07/20/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE A method of removing the background phase with a reference phantom but without overcorrecting the induced phase from objects of interest is proposed. Several factors during the imaging procedure and post-processing are investigated for their accuracies. METHODS A method using a reference phantom to remove eddy currents as well as using the least squares fit to quantify susceptibility and to remove the background phase is proposed. Phase induced from simulated spheroids was fitted and compared to their true magnetic moments, an important concept for the proposed method. A cylindrical phantom and its simulation, a phantom with straws filled with Gd-DTPA, and a simulated head model were used to study systematic errors due to some confounding factors. The feasibility for in vivo applications was demonstrated from an actual human head. Susceptibility and remaining phase after removing the background phase were measured in all cases. RESULTS Simulations show that magnetic moments of various spheroids and phantoms can be accurately quantified from images, regardless of the partial volume effect. All measured susceptibility values are within ±0.16 ppm of -9.4 ppm for agarose and 0.05 ppm of 1 ppm for Gd-DTPA. Most residual phase is within ±0.1 rad from the phantom center. Susceptibilities close to -9.4 ppm are also obtained for the simulated and actual head. Correspondingly, the remaining phase has a mean value less than two standard deviations. CONCLUSION The proposed method from phantom studies can reliably remove the background phase without overcorrections. The in vivo example demonstrates the feasibility of the method.
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Affiliation(s)
- He Xie
- Department of Physics and Astronomy, Wayne State University, Detroit, MI, USA
| | | | | | - Paul Kokeny
- Department of Biomedical Engineering, Wayne State University, Detroit, MI, USA
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Halefoglu AM, Yousem DM. Susceptibility weighted imaging: Clinical applications and future directions. World J Radiol 2018; 10:30-45. [PMID: 29849962 PMCID: PMC5971274 DOI: 10.4329/wjr.v10.i4.30] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 04/08/2018] [Accepted: 04/20/2018] [Indexed: 02/06/2023] Open
Abstract
Susceptibility weighted imaging (SWI) is a recently developed magnetic resonance imaging (MRI) technique that is increasingly being used to narrow the differential diagnosis of many neurologic disorders. It exploits the magnetic susceptibility differences of various compounds including deoxygenated blood, blood products, iron and calcium, thus enabling a new source of contrast in MR. In this review, we illustrate its basic clinical applications in neuroimaging. SWI is based on a fully velocity-compensated, high-resolution, three dimensional gradient-echo sequence using magnitude and phase images either separately or in combination with each other, in order to characterize brain tissue. SWI is particularly useful in the setting of trauma and acute neurologic presentations suggestive of stroke, but can also characterize occult low-flow vascular malformations, cerebral microbleeds, intracranial calcifications, neurodegenerative diseases and brain tumors. Furthermore, advanced MRI post-processing technique with quantitative susceptibility mapping, enables detailed anatomical differentiation based on quantification of brain iron from SWI raw data.
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Affiliation(s)
- Ahmet Mesrur Halefoglu
- Department of Radiology, Sisli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul 34371, Turkey
| | - David Mark Yousem
- Division of Neuroradiology, Department of Radiology, Johns Hopkins Medical Institution, Baltimore, MI 21287, United States
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Chai C, Liu S, Fan L, Liu L, Li J, Zuo C, Qian T, Haacke EM, Shen W, Xia S. Reduced deep regional cerebral venous oxygen saturation in hemodialysis patients using quantitative susceptibility mapping. Metab Brain Dis 2018; 33:313-323. [PMID: 29249064 DOI: 10.1007/s11011-017-0164-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 11/29/2017] [Indexed: 01/07/2023]
Abstract
Cerebral venous oxygen saturation (SvO2) is an important indicator of brain function. There was debate about lower cerebral oxygen metabolism in hemodialysis patients and there were no reports about the changes of deep regional cerebral SvO2 in hemodialysis patients. In this study, we aim to explore the deep regional cerebral SvO2 from straight sinus using quantitative susceptibility mapping (QSM) and the correlation with clinical risk factors and neuropsychiatric testing. 52 hemodialysis patients and 54 age-and gender-matched healthy controls were enrolled. QSM reconstructed from original phase data of 3.0 T susceptibility-weighted imaging was used to measure the susceptibility of straight sinus. The susceptibility was used to calculate the deep regional cerebral SvO2 and compare with healthy individuals. Correlation analysis was performed to investigate the correlation between deep regional cerebral SvO2, clinical risk factors and neuropsychiatric testing. The deep regional cerebral SvO2 of hemodialysis patients (72.5 ± 3.7%) was significantly lower than healthy controls (76.0 ± 2.1%) (P < 0.001). There was no significant difference in the measured volume of interests of straight sinus between hemodialysis patients (250.92 ± 46.65) and healthy controls (249.68 ± 49.68) (P = 0.859). There were no significant correlations between the measured susceptibility and volume of interests in hemodialysis patients (P = 0.204) and healthy controls (P = 0.562), respectively. Hematocrit (r = 0.480, P < 0.001, FDR corrected), hemoglobin (r = 0.440, P < 0.001, FDR corrected), red blood cell (r = 0.446, P = 0.003, FDR corrected), dialysis duration (r = 0.505, P = 0.002, FDR corrected) and parathyroid hormone (r = -0.451, P = 0.007, FDR corrected) were risk factors for decreased deep regional cerebral SvO2 in patients. The Mini-Mental State Examination (MMSE) scores of hemodialysis patients were significantly lower than healthy controls (P < 0.001). However, the deep regional cerebral SvO2 did not correlate with MMSE scores (P = 0.630). In summary, the decreased deep regional cerebral SvO2 occurred in hemodialysis patients and dialysis duration, parathyroid hormone, hematocrit, hemoglobin and red blood cell may be clinical risk factors.
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Affiliation(s)
- Chao Chai
- Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Saifeng Liu
- The MRI Institute for Biomedical Research, N9A6T2, Waterloo, ON, Canada
| | - Linlin Fan
- Department of Prophylactic Inoculation and Statistics, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Lei Liu
- School of Graduates, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Jinping Li
- Department of Hemodialysis, Tianjin First Central Hospital, Tianjin, 300192, China
| | - Chao Zuo
- School of Graduates, Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China
| | - Tianyi Qian
- MR Collaboration, Siemens Healthcare, Northeast Asia, Beijing, 100102, China
| | - E Mark Haacke
- Department of Radiology, Wayne State University, Detroit, MI, 48202, USA
| | - Wen Shen
- Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China.
| | - Shuang Xia
- Department of Radiology, Tianjin First Central Hospital, Tianjin, 300192, China.
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Bus S, van den Munckhof P, Bot M, Pal G, Ouyang B, Sani S, Verhagen Metman L. Borders of STN determined by MRI versus the electrophysiological STN. A comparison using intraoperative CT. Acta Neurochir (Wien) 2018; 160:373-383. [PMID: 29275518 PMCID: PMC5766705 DOI: 10.1007/s00701-017-3432-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 12/06/2017] [Indexed: 12/25/2022]
Abstract
Background It is unclear which magnetic resonance imaging (MRI) sequence most accurately corresponds with the electrophysiological subthalamic nucleus (STN) obtained during microelectrode recording (MER, MER-STN). CT/MRI fusion allows for comparison between MER-STN and the STN visualized on preoperative MRI (MRI-STN). Objective To compare dorsal and ventral STN borders as seen on 3-Tesla T2-weighted (T2) and susceptibility weighted images (SWI) with electrophysiological STN borders in deep brain stimulation (DBS) for Parkinson’s disease (PD). Methods Intraoperative CT (iCT) was performed after each MER track. iCT images were merged with preoperative images using planning software. Dorsal and ventral borders of each track were determined and compared to MRI-STN borders. Differences between borders were calculated. Results A total of 125 tracks were evaluated in 45 patients. MER-STN started and ended more dorsally than respective dorsal and ventral MRI-STN borders. For dorsal borders, differences were 1.9 ± 1.4 mm (T2) and 2.5 ± 1.8 mm (SWI). For ventral borders, differences were 1.9 ± 1.6 mm (T2) and 2.1 ± 1.8 mm (SWI). Conclusions Discrepancies were found comparing borders on T2 and SWI to the electrophysiological STN. The largest border differences were found using SWI. Border differences were considerably larger than errors associated with iCT and fusion techniques. A cautious approach should be taken when relying solely on MR imaging for delineation of both clinically relevant STN borders.
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Zhang JG, Xing ZY, Zha TT, Tian XJ, Xing SJ, Pan X, Xu L, Pan L, Xing W, Chen J. [Feasibility of susceptibility weighted imaging in the evaluation of renal fibrosis induced by unilateral ureteral obstruction in white rabbits]. Zhonghua Yi Xue Za Zhi 2017; 97:3573-3578. [PMID: 29275598 DOI: 10.3760/cma.j.issn.0376-2491.2017.45.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the feasibility of susceptibility weighted imaging (SWI) to reflect the progression of renal fibrosis (RF) induced by unilateral ureteral obstruction (UUO) in rabbits. Methods: Total of 32 New Zealand white rabbits (aged 4-5 months) were used to establish the UUO model (RF group) and were divided into 4 subgroups (including RF-2W group, RF-4W group , RF-6W group and RF-8W group) according to the duration of obstruction(2, 4, 6 and 8 weeks). Another 8 rabbits, underwent sham operation, were used as the control group (Sham group). T2 weighted imaging (T(2)WI) and SWI sequences were performed on the rabbits at 2, 4, 6 and 8 weeks after UUO, respectively. Rabbits were sacrificed and specimens were obtained after MR examination, then hematoxylin&eosin staining and Masson staining were performed to explore the renal tubular injury and interstitial fibrosis. The relationship between the relative signal-to-noise ratio(rSNR)measured on the SWI fusion maps and the degree of renal fibrosis was analyzed. Analysis of variance was used to compare the difference of rSNRs among 5 groups. Results: The rSNRs of the inner medulla gradually decreased over time, the rSNRs of Sham group, RF-2W group, RF-4W group, RF-6W group and RF-8W group was 2.29±0.18, 1.73±0.30, 1.67±0.08, 1.42±0.28, 1.12±0.15, respectively (F=25.876, P<0.01). In RF-2W group, the rSNRs of the outer medulla and cortex increased when compared with those in the Sham group, then they decreased gradually over time in the other groups (F=5.230, 7.621, both P<0.05). The pathological results demonstrated that the morphology of renal tubules in Sham group was normal and no apoptosis or necrosis was seen in the tubular epithelial cells. In the RF-2W group, the main pathological manifestations included renal tubules dilatation, tubular epithelial cell degeneration or necrosis and the infiltration of inflammatory cell. In Masson staining, lots of blue areas were present in the interstitial. As the obstruction time prolonged, the renal tubular collapse, inflammatory cells and fibroblasts increased significantly. Meanwhile blue area also increased significantly in Masson staining. Conclusion: SWI can be used as a noninvasive method to evaluate the pathological progression of fibrosis in the rabbit UUO model.
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Affiliation(s)
- J G Zhang
- Department of Radiology, the Third Affiliated Hospital of Suzhou University, Changzhou 213003, China
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Daugherty AM, Raz N. Incident risk and progression of cerebral microbleeds in healthy adults: a multi-occasion longitudinal study. Neurobiol Aging 2017; 59:22-29. [PMID: 28800410 PMCID: PMC5612885 DOI: 10.1016/j.neurobiolaging.2017.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 06/24/2017] [Accepted: 07/10/2017] [Indexed: 12/21/2022]
Abstract
Decline in cerebrovascular health complicates brain aging, and development of cerebral microbleeds (CMBs) is one of its prominent indicators. In a large sample of healthy adults (N = 251, age 18-78 years at baseline, 70% women), the contributions of chronological age and vascular health indicators to the risk of developing a CMB, as well as the change in CMB size and iron content, were examined in a prospective 8-year longitudinal study using susceptibility weighted imaging. Twenty-six persons (10.4%), most of whom were 40 years of age or older, had at least 1 CMB during the study. Older age was associated with greater risk for developing a CMB (odds ratio 1.03). Elevation of combined metabolic syndrome indicators (b = 0.15, p = 0.001) conferred additional risk (odds ratio 1.02). High body mass index exacerbated the risk associated with poor vascular health (b = 0.75, p < 0.001) and frequent exercise mitigated it (b = -0.46, p = 0.03). CMBs persisted over time, yet their volume decreased (mean change = -0.32, p < 0.05), whereas their relative iron content remained stable (mean change = -0.14, p = 0.05). We conclude that although developing a CMB is unlikely during normal aging, risk increases with declining vascular health, which is modifiable via behavioral and pharmaceutical intervention.
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Affiliation(s)
- Ana M Daugherty
- Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Urbana, IL, USA.
| | - Naftali Raz
- Department of Psychology and Institute of Gerontology, Wayne State University, Detroit, MI, USA; Max Planck Institute for Human Development, Berlin, Germany
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Stabile A, Di Lazzaro V, Colosimo C, Piazza F, Ferrarese C, DiFrancesco JC. Idiopathic infratentorial superficial siderosis of the central nervous system: case report and review of literature. Neurol Neurochir Pol 2017; 52:102-106. [PMID: 29122310 DOI: 10.1016/j.pjnns.2017.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 10/18/2017] [Indexed: 10/18/2022]
Abstract
The superficial siderosis (SS) of the central nervous system (CNS) is a rare condition characterized by a wide range of neurological manifestations directly linked to an acquired iron-mediated neurodegeneration. First described more than 100 years ago, only recently SS has been divided into two distinct entities, according to the distribution of iron deposition in the CNS: cortical superficial siderosis (cSS) and infratentorial superficial siderosis (iSS). Here we describe an adult case of iSS, with detailed clinical and radiological features. Moreover, we extensively review the literature of SS, particularly focusing on the pathogenesis, clinical-radiological classification, diagnostic algorithm and treatment options of this rare condition.
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Affiliation(s)
- Andrea Stabile
- Department of Neurology, ASST San Gerardo Hospital, Monza, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, Rome, Italy
| | - Cesare Colosimo
- Radiology and Neuroradiology Unit, Diagnostic Imaging Area, Fondazione Policlinico Universitario A. Gemelli, Institute of Radiology, School of Medicine, Catholic University, Rome, Italy
| | - Fabrizio Piazza
- Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Carlo Ferrarese
- Department of Neurology, ASST San Gerardo Hospital, Monza, Italy; Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Jacopo C DiFrancesco
- Department of Neurology, ASST San Gerardo Hospital, Monza, Italy; Milan Center for Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
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Lawrence TP, Pretorius PM, Ezra M, Cadoux-Hudson T, Voets NL. Early detection of cerebral microbleeds following traumatic brain injury using MRI in the hyper-acute phase. Neurosci Lett 2017; 655:143-50. [PMID: 28663054 DOI: 10.1016/j.neulet.2017.06.046] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2017] [Revised: 06/13/2017] [Accepted: 06/24/2017] [Indexed: 12/12/2022]
Abstract
Traumatic cerebral microbleeds (TCMBS) can be identified using susceptibility weighted imaging in the first few hours after injury. TCMBs are a useful indicator of severity in this time frame. The presence of TCMBs is an early indicator of injury severity following trauma. There is a relationship between decreasing size of TCMBs and recovery.
Background Traumatic brain injury (TBI) is a leading cause of death and disability in people under 45. Advanced imaging techniques to identify injury and classify severity in the first few hours and days following trauma could improve patient stratification and aid clinical decision making. Traumatic cerebral microbleeds (TCMBs), detectable on magnetic resonance susceptibility weighted imaging (SWI), can be used as markers of long-term clinical outcome. However, the relationship between TCMBs and injury severity in the first few hours after injury, and their natural evolution, is unknown. Methods We obtained SWI scans in 10 healthy controls, and 13 patients scanned 3–24 h following TBI and again at 7–15 days. TCMBs were identified and total volume quantified for every lesion in each scan. Results TCMBs were present in 6 patients, all with more severe injury classified by GCS. No lesions were identified in patients with an initial GCS of 15. Improvement in GCS in the first 15 days following injury was significantly associated with a reduction in microbleed volume over the same time-period. Conclusion MRI is feasible in severely injured patients in the first 24 h after trauma. Detection of TCMBs using SWI provides an objective early marker of injury severity following trauma. TCMBs revealed in this time frame, offer the potential to help determine the degree of injury, improving stratification, in order to identify patients who require admission to hospital, transfer to a specialist center, or an extended period of intubation on intensive care.
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Chai C, Guo R, Zuo C, Fan L, Liu S, Qian T, Mark Haacke E, Xia S, Shen W. Decreased susceptibility of major veins in mild traumatic brain injury is correlated with post-concussive symptoms: A quantitative susceptibility mapping study. Neuroimage Clin 2017; 15:625-32. [PMID: 28664033 DOI: 10.1016/j.nicl.2017.06.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 06/04/2017] [Accepted: 06/07/2017] [Indexed: 01/28/2023]
Abstract
Cerebral venous oxygen saturation (SvO2) is an important biomarker of brain function. In this study, we aimed to explore the relative changes of regional cerebral SvO2 among axonal injury (AI) patients, non-AI patients and healthy controls (HCs) using quantitative susceptibility mapping (QSM). 48 patients and 32 HCs were enrolled. The patients were divided into two groups depending on the imaging based evidence of AI. QSM was used to measure the susceptibility of major cerebral veins. Nonparametric testing was performed for susceptibility differences among the non-AI patient group, AI patient group and healthy control group. Correlation was performed between the susceptibility of major cerebral veins, elapsed time post trauma (ETPT) and post-concussive symptom scores. The ROC analysis was performed for the diagnostic efficiency of susceptibility to discriminate mTBI patients from HCs. The susceptibility of the straight sinus in non-AI and AI patients was significantly lower than that in HCs (P < 0.001, P = 0.004, respectively, Bonferroni corrected), which may indicate an increased regional cerebral SvO2 in patients. The susceptibility of the straight sinus in non-AI patients positively correlated with ETPT (r = 0.573, P = 0.003, FDR corrected) while that in AI patients negatively correlated with the Rivermead Post Concussion Symptoms Questionnaire scores (r = − 0.582, P = 0.018, FDR corrected). The sensitivity, specificity and AUC values of susceptibility for the discrimination between mTBI patients and HCs were 88%, 69% and 0.84. In conclusion, the susceptibility of the straight sinus can be used as a biomarker to monitor the progress of mild TBI and to differentiate mTBI patients from healthy controls. Mild traumatic brain injury caused decreased venous susceptibility. The venous susceptibility can discriminate mTBI patients from healthy controls. Decreased susceptibility may indicate increased venous oxygen saturation (SvO2). Increased SvO2 of patients without axonal injury decreased with time post-injury. Increased SvO2 of axonal injury patients indicated severe post-concussive symptoms.
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Liu J, Chen Y, Bao XM, Ling XL, Ding JP, Zhang ZK. [Study of susceptibility weighted imaging on MR and pathologic findings to distinguish benign or malignant soft tissue tumor]. Zhonghua Zhong Liu Za Zhi 2017; 39:350-354. [PMID: 28535651 DOI: 10.3760/cma.j.issn.0253-3766.2017.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the diagnostic performance of susceptibility weighted imaging (SWI)in distinguishing benign or malignant soft tissue tumor, and to study pathological observation. Methods: Sixty-eight patients with soft tissue tumor, who received no previous treatment or invasive examination, received routine preoperative MRI examination and SWI scanning. The graduation and distribution of intratumoral susceptibility signal intensity(ITSS) and proportion of tumor volume were observed.The pathological results were also included for comparative analysis. Results: Fourty of 68 patients were benign and 28 were malignant. 72.5% (29/40) patients with benign soft tissue tumors were ITSS grade 1 and ITSS grade 3 (hemangioma). 89.3%(25/28) patients with malignant soft tissue tumors were ITSS grade 2 and ITSS grade 3. The difference was statistically significant (P<0.01). The distribution of ITSS in patients with benign soft tissue tumors was dominated by peripheral distribution and diffuse distribution (hemangioma), accounting for 90.0% (36/40). The distribution of ITSS in patients with malignant soft tissue tumors mainly distributed in the central region, accounting for 78.6% (22 /28). The difference was statistically significant (P<0.01). The proportion of tumor volume occupied by ITSS in benign soft tissue tumors was <1/3 and> 2/3 (hemangioma), accounting for 90.0% (36/40). The volume of malignant soft tissue tumors were predominantly <1/3 , accounting for 82.1% (23/28). The difference was statistically significant (P<0.01). Conclusion: SWI is sensitive in displaying the vein and blood metabolites in soft tissue lesions, which is helpful for the differential diagnosis of benign and malignant tumors in soft tissue.
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Affiliation(s)
- J Liu
- Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China
| | - Y Chen
- Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China
| | - X M Bao
- Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China
| | - X L Ling
- Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China
| | - J P Ding
- Department of Radiology, the Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, China
| | - Z K Zhang
- Department of Radiology, the Third Hospital of hebei Medical University, Shijiazhuang 050051, China
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