Journal of Neuroimaging最新文献_第10页

Intraarterial Thrombolysis as an Adjunct to Thrombectomy in Acute Ischemic Stroke: Current Status and Future Prospects 动脉内溶栓作为急性缺血性卒中取栓的辅助手段：现状和未来展望

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-03-17 DOI: 10.1111/jon.70030

Adnan I. Qureshi, Mohammed M. Al-Salihi, Ibrahim A. Bhatti, Maryam S. Al-Jebur, Ahmed Abd Elazim, Sameer A. Ansari, Daniel E. Ford, Daniel F. Hanley, Ameer E. Hassan, Pashmeen Lakhani, David R. Mehr, Thanh N. Nguyen, Alejandro M. Spiotta, William J. Powers, Syed F. Zaidi

Background and Purpose

Intraarterial thrombolysis (IAT) has been sporadically used as an adjunct to mechanical thrombectomy (MT) in acute ischemic stroke patients for nearly two decades to improve distal arterial and microvascular perfusion even in patients with near complete or complete recanalization.

Methods

We provide an overall narrative review that includes a systematic review and meta-analysis of two randomized controlled trials (RCTs), Chemical Optimization of Cerebral Embolectomy and Endovascular Recanalization in Patients with Acute Posterior Circulation Arterial Occlusion, to identify current and future implications. Risk ratios (RRs) were calculated from RCTs using a fixed-effects model. We identified 10 ongoing or planned RCTs after a search on clinicaltrials.gov and other sources, of which eight are in China, one in Europe, and one in Australia.

Results

A previous meta-analysis of 16 (predominantly observational) studies involving 7572 MT-treated patients had identified 14% higher odds of functional independence (modified Rankin scale [mRS] 0–2) at 90 days in patients treated with IAT. In the current analysis of 321 patients who underwent MT in RCTs, 165 were randomized to IAT and 156 were in the control group. The RR of achieving an mRS score of 0–1 at 90 days postrandomization was higher in patients treated with IAT compared with the control group (absolute increase of 12.87%, RR = 1.39, 95% confidence interval [CI] 1.04–1.86). The rate of symptomatic intracerebral hemorrhage (sICH) within 24 h was slightly higher (absolute increase of 1.64%, RR = 0.95, 95% CI 0.07–13.30) in patients treated with IAT. The ongoing RCTs have sample sizes ranging from 80 to 498 that can identify very large minimal clinically important differences (MCIDs) (13%–20% increase) in primary outcomes, but smaller MCIDs (<10%) that can still result in practice changes with interventions associated with low cost and complexity and are easy to implement, such as IAT, will not be identified.

Conclusions

Observational studies and recent RCTs suggest a potential benefit of IAT in improving functional outcomes among patients post-MT, although the potentially increased risk of sICH, inadequate sample sizes, and lack of data from the United States need to be considered. A large, definitive, and generalizable RCT is required to establish the therapeutic value and safety profile of IAT prior to widespread incorporation into routine practice.

近二十年来，动脉内溶栓（IAT）作为机械取栓（MT）的辅助手段在急性缺血性脑卒中患者中被零星地使用，以改善远端动脉和微血管灌注，即使是在几乎完全或完全再通的患者中也是如此。方法：我们对两项随机对照试验（RCTs）进行系统回顾和荟萃分析，即急性后循环动脉闭塞患者脑栓塞切除术和血管内再通的化学优化，以确定当前和未来的影响。使用固定效应模型从随机对照试验中计算风险比（rr）。通过检索clinicaltrials.gov和其他来源，我们确定了10项正在进行或计划进行的随机对照试验，其中8项在中国，1项在欧洲，1项在澳大利亚。先前的荟萃分析包括16项（主要是观察性）研究，涉及7572名mt治疗患者，发现IAT治疗患者90天功能独立性（修正Rankin量表[mRS] 0-2）的几率高出14%。在目前的分析中，321例接受MT的随机对照试验中，165例被随机分配到IAT组，156例被分配到对照组。与对照组相比，接受IAT治疗的患者在随机化后90天mRS评分为0-1的RR更高（绝对增加12.87%,RR = 1.39, 95%可信区间[CI] 1.04-1.86）。IAT组24 h内症状性脑出血（siich）发生率略高（绝对升高1.64%,RR = 0.95, 95% CI 0.07 ~ 13.30）。正在进行的随机对照试验的样本量从80到498不等，可以确定主要结局的非常大的最小临床重要差异（MCIDs）（增加13%-20%），但较小的MCIDs（10%）仍然可以导致实践变化，与低成本和复杂性相关的干预措施，如IAT，易于实施，将无法确定。结论：观察性研究和最近的随机对照试验表明，IAT在改善mt后患者的功能结局方面有潜在的益处，尽管需要考虑到潜在的sICH风险增加、样本量不足以及缺乏来自美国的数据。在广泛纳入常规实践之前，需要进行大规模、明确和可推广的随机对照试验来确定IAT的治疗价值和安全性。

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引用次数: 0

Systematic Review of Radiomics and Artificial Intelligence in Intracranial Aneurysm Management 放射组学和人工智能在颅内动脉瘤治疗中的系统评价

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-03-17 DOI: 10.1111/jon.70037

Monica-Rae Owens, Samuel A. Tenhoeve, Clayton Rawson, Mohammed Azab, Michael Karsy

Intracranial aneurysms, with an annual incidence of 2%–3%, reflect a rare disease associated with significant mortality and morbidity risks when ruptured. Early detection, risk stratification of high-risk subgroups, and prediction of patient outcomes are important to treatment. Radiomics is an emerging field using the quantification of medical imaging to identify parameters beyond traditional radiology interpretation that may offer diagnostic or prognostic significance. The general radiomic workflow involves image normalization and segmentation, feature extraction, feature selection or dimensional reduction, training of a predictive model, and validation of the said model. Artificial intelligence (AI) techniques have shown increasing interest in applications toward vascular pathologies, with some commercially successful software including AiDoc, RapidAI, and Viz.AI, as well as the more recent Viz Aneurysm. We performed a systematic review of 684 articles and identified 84 articles exploring the applications of radiomics and AI in aneurysm treatment. Most studies were published between 2018 and 2024, with over half of articles in 2022 and 2023. Studies included categories such as aneurysm diagnosis (25.0%), rupture risk prediction (50.0%), growth rate prediction (4.8%), hemodynamic assessment (2.4%), clinical outcome prediction (11.9%), and occlusion or stenosis assessment (6.0%). Studies utilized molecular data (2.4%), radiologic data alone (51.2%), clinical data alone (28.6%), and combined radiologic and clinical data (17.9%). These results demonstrate the current status of this emerging and exciting field. An increased pace of innovation in this space is likely with the expansion of clinical applications of radiomics and AI in multiple vascular pathologies.

颅内动脉瘤的年发病率为2%-3%，是一种罕见的疾病，破裂后具有显著的死亡率和发病率风险。早期发现、高危亚组风险分层和预测患者预后对治疗非常重要。放射组学是一个新兴的领域，它使用医学成像的量化来识别可能提供诊断或预后意义的传统放射学解释之外的参数。一般放射学工作流程包括图像归一化和分割、特征提取、特征选择或降维、预测模型的训练以及所述模型的验证。人工智能（AI）技术对血管病理学的应用越来越感兴趣，一些商业上成功的软件包括AiDoc、RapidAI和Viz.AI，以及最近的Viz动脉瘤。我们对684篇文章进行了系统回顾，并确定了84篇探讨放射组学和人工智能在动脉瘤治疗中的应用的文章。大多数研究发表在2018年至2024年之间，超过一半的文章发表在2022年和2023年。研究包括动脉瘤诊断（25.0%）、破裂风险预测（50.0%）、生长速度预测（4.8%）、血流动力学评估（2.4%）、临床结果预测（11.9%）和闭塞或狭窄评估（6.0%）等类别。研究使用了分子数据（2.4%）、单独的放射学数据（51.2%）、单独的临床数据（28.6%）以及放射学和临床联合数据（17.9%）。这些结果表明了这一新兴而激动人心的领域的现状。随着放射组学和人工智能在多种血管病变中的临床应用的扩大，这一领域的创新步伐可能会加快。

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引用次数: 0

Arterial Spin Labeling MRI in Alzheimer's Disease: A Systematic Review of Cerebral Perfusion Biomarkers 阿尔茨海默病的动脉自旋标记MRI：脑灌注生物标志物的系统回顾

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-03-15 DOI: 10.1111/jon.70035

Caterina Bernetti, Valerio D'Andrea, Andrea Buoso, Ilenia Barbalace, Federico Greco, Fabio Pilato, Rosalinda Calandrelli, Vincenzo Di Lazzaro, Bruno Beomonte Zobel, Carlo A. Mallio

Background

Alzheimer's disease (AD) is a leading cause of dementia. Arterial spin labeling (ASL) MRI, particularly at 3 Tesla (3T), offers a noninvasive method to assess cerebral blood flow alterations, which are believed to be early indicators of AD.

Purpose

The purpose of this study is to evaluate the utility of 3T ASL MRI in identifying cerebral perfusion biomarkers for the diagnosis and management of AD, assess its prognostic value, and compare it to other imaging modalities, such as PET.

Data Sources

A systematic literature search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines across PubMed, Cochrane Library, and Scopus using keywords related to “ASL,” “3T MRI,” and “AD.”

Study Selection

Studies were included if they used 3T ASL MRI to investigate CBF in AD. Reviews, preclinical studies, case reports, studies lacking 3T ASL MRI, or those focusing on other dementias or mild cognitive impairment without an AD comparison were excluded. Data extracted included study design, sample characteristics, imaging techniques, parameters measured, and outcomes. A qualitative synthesis of findings highlights CBF patterns and biomarkers associated with AD.

Results

Findings demonstrated hypoperfusion in the hippocampus, precuneus, and posterior cingulate cortex, distinguishing AD from normal aging and other forms of dementia. CBF patterns are often correlated with the severity and progression of cognitive impairment. ASL MRI at 3T demonstrated diagnostic accuracy comparable to that of PET while being noninvasive and radiation free.

Conclusion

ASL MRI at 3T could be a valuable tool for the early diagnosis and monitoring of AD. Its noninvasive nature makes it ideal for repeated measures and longitudinal studies. Further research should focus on standardizing protocols and validating their use in larger populations.

阿尔茨海默病（AD）是痴呆症的主要原因。动脉自旋标记（ASL） MRI，特别是3tesla (3T)，提供了一种无创的方法来评估脑血流改变，这被认为是AD的早期指标。本研究的目的是评估3T ASL MRI在识别AD诊断和管理的脑灌注生物标志物方面的应用，评估其预后价值，并将其与其他成像方式（如PET）进行比较。根据PubMed、Cochrane图书馆和Scopus的系统评价和荟萃分析指南的首选报告项目，使用与“ASL”、“3T MRI”和“AD”相关的关键词进行了系统的文献检索。研究选择纳入使用3T ASL MRI检查AD患者脑血流的研究。综述、临床前研究、病例报告、缺乏3T ASL MRI的研究，或关注其他痴呆或轻度认知障碍而没有AD比较的研究被排除在外。提取的资料包括研究设计、样本特征、成像技术、测量参数和结果。研究结果的定性综合强调了与AD相关的CBF模式和生物标志物。结果发现海马、楔前叶和后扣带皮层灌注不足，将AD与正常衰老和其他形式的痴呆区分开来。脑血流模式通常与认知障碍的严重程度和进展相关。ASL MRI在3T时显示出与PET相当的诊断准确性，同时无创和无辐射。结论ASL MRI可作为AD早期诊断和监测的重要工具。它的非侵入性使其成为重复测量和纵向研究的理想选择。进一步的研究应侧重于使协议标准化，并在更大的人群中验证它们的使用。

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引用次数: 0

Annual Meeting of the American Society of Neuroimaging 美国神经成像学会年会

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-03-09 DOI: 10.1111/jon.70033

引用次数: 0

Safety of Indocyanine Green Microdosing for Clinical Imaging of CSF Ventricular Dynamics and Extracranial Outflow 吲哚菁绿微剂量对脑脊液心室动力学和颅外流出临床成像的安全性

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-03-03 DOI: 10.1111/jon.70028

Miriam Zamorano, Banghe Zhu, Ahmed T. Massoud, Jonathan Hendricks, H. Alex Choi, Pedram Peesh, Brandon A. Miller, Xinhai Robert Zhang, Manish N. Shah, Eva M. Sevick-Muraca

Background and Purpose

Intravenous administration of indocyanine green (ICG) has been approved in brain surgeries for decades, yet concerns about neurotoxicity prevent its direct administration into the cerebrospinal fluid (CSF). Armed with prior animal studies demonstrating the feasibility of using ICG microdosing into the CSF, we sought to evaluate its nonclinical safety profile and obtain surrogate measures in adults prior to its use in human neonates.

Methods

Evaluation of ICG toxicity was conducted in mixed primary CNS cell cultures and in an extended safety study of juvenile rat pups deploying intraventricular injections of saline (as control) or ICG. Analysis of animal behavior included Novel Object Place Recognition Test and rotarod behavioral tests. Immunohistochemical analysis of tumor necrosis factor-alpha (TNF-α), oxidative deoxyribonucleic acid damage, microglial activation, and neuronal density was performed on collected brains. We measured ICG levels (before and after intravenous administration) in collected CSF from external ventricular drain catheters of 10 brain-injured adults.

Results

TNF-α and lactate dehydrogenase assay for cytotoxicity showed transient elevations after 1 h of incubation with 1291 µM ICG, but none at or below 322 µM ICG, even after 24 h of incubation. Behavioral tests and immunohistochemical analyses showed no differences between ICG-administered animals and controls. Intraventricular concentrations of ICG in collected human CSF ranged between 0.17 and 7.93 µM, with no adverse events associated with intravenous administration.

Conclusions

With intraventricular microdosing of 100 µg ICG, maximal ICG concentrations in neonatal CSF range from 1.3 to 6 5 µM. CNS cell culture, rat safety studies, and surrogate measures in adults evidence the safety of microdosing ICG directly into the CSF.

背景与目的静脉注射吲哚菁绿（ICG）已被批准用于脑外科手术数十年，但对神经毒性的担忧阻碍了其直接进入脑脊液（CSF）。有了先前的动物研究证明在脑脊液中使用ICG微剂量的可行性，我们试图评估其非临床安全性，并在将其用于人类新生儿之前获得成人的替代测量。方法在混合初级中枢神经系统细胞培养中进行ICG毒性评估，并在幼鼠幼鼠脑室内注射生理盐水（作为对照）或ICG的扩展安全性研究中进行。动物行为分析包括新物体位置识别测试和旋转杆行为测试。对采集的脑组织进行肿瘤坏死因子-α (TNF-α)、氧化脱氧核糖核酸损伤、小胶质细胞活化和神经元密度的免疫组化分析。我们测量了10名脑损伤成人脑室外引流管收集的脑脊液（静脉给药前后）的ICG水平。结果TNF-α和乳酸脱氢酶细胞毒性试验显示，1291µM ICG孵育1 h后出现短暂升高，但在322µM ICG孵育24 h后无升高。行为测试和免疫组织化学分析显示，注射icg的动物和对照组之间没有差异。收集的人脑脊液中ICG的脑室内浓度在0.17至7.93µM之间，没有与静脉给药相关的不良事件。结论脑室内微给药100µg ICG，新生儿脑脊液最大ICG浓度为1.3 ~ 6.5µM。中枢神经系统细胞培养、大鼠安全性研究和成人替代测量证明了将微剂量ICG直接注入脑脊液的安全性。

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引用次数: 0

Resting-State fMRI to Map Language Function for Surgical Planning in Patients With Brain Tumors: A Feasibility Study 静息状态功能磁共振成像绘制脑肿瘤患者手术计划的语言功能：可行性研究

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-02-25 DOI: 10.1111/jon.70027

Annalisa Bozzano, Laura Barletta, Stefano Caneva, Monica Truffelli, Elisa Bennicelli, Giacomo Rebella, Gianluigi Zona, Lucio Castellan

Background and Purpose

In neurosurgery, functional MRI is crucial for preoperative planning to obtain the cortical cortex map of language areas. This preliminary work involved analyzing the functional MRIs of 20 oncological patients. Our question is if resting-state functional MRI (rs-fMRI) can replace standard task-based functional MRI (tb-fMRI) in routine clinical applications. The aim of this challenge is to determine if rs-fMRI is as effective as tb-fMRI and to develop a systematic approach for the extraction of a cortical language map.

Methods

We started by analyzing our rs-fMRI images and validated the correct mapping of language regions using an independent components analysis approach; then, we used the analysis of connectivity networks to compare the two techniques.

Results

The regions identified in rs-fMRI align with established medical knowledge; a comparison of rs-fMRI and tb-fMRI reveals that the four language regions—Broca's and Wernicke's areas in both hemispheres—exhibit activation in both techniques; furthermore, we highlighted that rs-fMRI reveals more comprehensive details about functional connectivity in contrast to tb-fMRI.

Conclusions

rs-MRI and tb-MRI provide similar levels of efficacy in revealing the functional areas of the brain for preoperative mapping when a lesion lies in areas related to language; thus, both techniques can be utilized for this goal. Based on this, we developed an rs-fMRI processing pipeline for clinical usage and applied it to a patient outside the study.

背景与目的在神经外科手术中，功能MRI对术前规划获取语言区皮层图至关重要。这项初步工作包括分析20名肿瘤患者的功能性核磁共振成像。我们的问题是静息状态功能MRI （rs-fMRI）能否在常规临床应用中取代标准的基于任务的功能MRI （tb-fMRI）。这项挑战的目的是确定rs-fMRI是否与tb-fMRI一样有效，并开发一种系统的方法来提取皮层语言地图。方法首先对rs-fMRI图像进行分析，利用独立分量分析方法验证语言区域的正确映射；然后，我们使用连通性网络分析来比较两种技术。结果磁共振成像识别的脑区与已有的医学知识一致；通过对rs-fMRI和tb-fMRI的比较，我们发现大脑的四个语言区域——两个半球的broca’s和Wernicke’s区域——在这两种技术中都被激活了；此外，我们强调，与tb-fMRI相比，rs-fMRI揭示了更全面的功能连接细节。结论：rs-MRI和tb-MRI在揭示与语言相关的脑损伤区域的术前定位功能区域方面提供了相似的效果；因此，这两种技术都可以用于实现这一目标。在此基础上，我们开发了一种临床使用的rs-fMRI处理管道，并将其应用于研究外的患者。

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引用次数: 0

Blood Flow Velocities as Determined by Real-Time Phase-Contrast MRI in Patients With Carotid Artery Stenosis 颈动脉狭窄患者的实时相衬MRI血流速度测定

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-02-24 DOI: 10.1111/jon.70016

Deborah Bochert, Sabine Hofer, Peter Dechent, Jens Frahm, Mathias Bähr, Jan Liman, Ilko Maier

Background and Purpose

Real-time phase-contrast (RT-PC) flow MRI can be used to determine quantitative flow parameters throughout the vessel lumen of extracranial, brain-supplying arteries. Its potential value in the diagnostic workup of patients with carotid artery stenosis has not been evaluated.

Methods

RT-PC flow MRI was performed in 10 patients with carotid stenosis in comparison to conventional neurovascular ultrasound (nvUS). Peak systolic velocity, end-diastolic velocity, mean flow velocity, and flow volumes have been evaluated by RT-PC flow MRI. Measurements have been performed at standardized sites along the common, internal, and external carotid arteries on both sides and at the maximum of the carotid stenosis.

Results

Blood flow velocities were significantly lower with RT-PC flow MRI compared to nvUS and not consistently correlated between both methods. Within the maximum of the carotid stenosis, RT-PC flow MRI showed implausible flow velocity reductions compared to nvUS. In contrast, the flow volumes determined by RT-PC flow MRI—with exception of the stenosis maximum—were comparable with nvUS and significantly correlated in the prestenotic common carotid artery.

Conclusion

RT-PC flow MRI does not appear to be suitable for quantifying blood flow velocities and volumes in the patients with carotid stenosis compared to nvUS. Apart from the lower temporal resolution of RT-PC MRI, the lack of correlation of blood flow velocities might be ascribed to the prevalence of nonlaminar flow within and behind the stenosis, which violates a general prerequisite for valid flow velocity measurements by PC MRI.

背景与目的实时相衬（RT-PC）血流MRI可用于测定颅内外供脑动脉血管腔内的定量血流参数。其在颈动脉狭窄患者诊断中的潜在价值尚未得到评价。方法对10例颈动脉狭窄患者行RT-PC血流MRI检查，并与常规神经血管超声（nvUS）进行比较。采用RT-PC血流MRI评估收缩期峰值速度、舒张末期速度、平均血流速度和血流体积。在沿颈总动脉、颈内动脉和颈外动脉两侧以及颈动脉狭窄最严重处的标准化位置进行测量。结果与nvUS相比，RT-PC血流MRI的血流速度明显降低，两种方法之间的相关性不一致。在颈动脉狭窄的最大范围内，与nvUS相比，RT-PC血流MRI显示难以置信的血流速度降低。相比之下，RT-PC血流mri（除最大狭窄外）测定的血流容量与nvUS相当，并且在狭窄的颈总动脉中显著相关。结论与nvUS相比，RT-PC血流MRI似乎不适合量化颈动脉狭窄患者的血流速度和血流体积。除了RT-PC MRI的时间分辨率较低外，血流速度缺乏相关性可能归因于狭窄内和狭窄后普遍存在非层流，这违反了PC MRI有效测量血流速度的一般先决条件。

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引用次数: 0

Myelin Quantification Using Ultrashort Echo Time Magnetization Transfer Ratio in a Mouse Model of Traumatic Brain Injury 利用超短回波时间磁化传递比定量测定外伤性脑损伤小鼠模型中的髓磷脂

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-02-24 DOI: 10.1111/jon.70029

Jiyo S. Athertya, Xin Cheng, Qingbo Tang, Dina Moazamian, Eric Y. Chang, Catherine E. Johnson, Jiankun Cui, Zezong Gu, Yajun Ma, Jiang Du

Background and Purpose

This study aims to assess the potential of ultrashort echo time imaging-based magnetization transfer ratio (UTE-MTR) in detecting demyelination in mice with mild traumatic brain injury (mTBI) caused by an open-field low-intensity blast (LIB) injury model.

Methods

This study included 30 male C57BL/6 mice, approximately 8 weeks old, sourced from Jackson Laboratories in Bar Harbor, ME, and conducted under institutional guidelines. The mice were divided into the mTBI group (n = 15) and the sham control group (n = 15). All animal experiments followed the approved protocols for the Care and Use of Laboratory Animals and Animal Research. The mTBI group underwent the open-field LIB injury. Behavioral tests were conducted to assess motor activity and anxiety-like responses. UTE-MT imaging was performed using a 3 Tesla Bruker system to measure UTE-MTR from two UTE-MT datasets with saturation powers of 1500° and 500°, and two frequency offsets of 2 and 50 kHz, respectively. Luxol fast blue (LFB) staining was performed to evaluate myelin content. The mean UTE-MTR values for regions of interest centered at the medial section of the corpus callosum were computed. The behavioral tests, LFB myelin staining, and UTE-MTR values were compared between the two groups using the independent t-test. p values <0.05 were considered significant.

Results

The mTBI mice demonstrated decreased motor activity and increased anxiety-like response over sham controls. The mTBI mice also showed significantly lower UTE-MTR values (0.399±0.007 vs. 0.393±0.005; p<0.05) and reduced LFB myelin staining (0.848±0.324 vs. 1.145±0.260; p = 0.048) over sham controls.

Conclusion

The significantly lower UTE-MTR values in the corpus callosum of mTBI mice are consistent with reduced LFB myelin staining, indicating that UTE-MTR can detect myelin loss and associated alterations in motor and anxiety domains post-LIB exposure.

背景与目的本研究旨在探讨基于超短回波时间成像的磁化传递比（UTE-MTR）检测开放性低强度爆炸（LIB）损伤小鼠轻度创伤性脑损伤（mTBI）模型脱髓鞘的潜力。方法本研究采用30只雄性C57BL/6小鼠，约8周龄，来自Jackson实验室Bar Harbor， ME，并在机构指南下进行。将小鼠分为mTBI组（n = 15）和假对照组（n = 15）。所有动物实验均遵循经批准的实验动物和动物研究的护理和使用规程。mTBI组行开放性LIB损伤。进行行为测试以评估运动活动和焦虑样反应。使用3 Tesla Bruker系统对两个饱和功率为1500°和500°、频率偏移分别为2和50 kHz的UTE-MT数据集进行UTE-MT成像，测量UTE-MTR。Luxol快速蓝（LFB）染色测定髓磷脂含量。计算以胼胝体内侧为中心的感兴趣区域的平均UTE-MTR值。行为学测试、LFB髓磷脂染色、UTE-MTR值采用独立t检验比较两组间差异。P值<；0.05认为显著。结果与假对照相比，mTBI小鼠表现出运动活动减少和焦虑样反应增加。mTBI小鼠的UTE-MTR值也显著降低(0.399±0.007 vs 0.393±0.005；plt;0.05)， LFB髓磷脂染色降低(0.848±0.324∶1.145±0.260；P = 0.048)。结论mTBI小鼠胼胝体中显著降低的UTE-MTR值与LFB髓磷脂染色降低一致，表明UTE-MTR可以检测lib暴露后髓磷脂丢失及其相关的运动和焦虑区改变。

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引用次数: 0

Hippocampal Subfield Abnormalities in Patients With Primary Trigeminal Neuralgia 原发性三叉神经痛患者海马亚区异常

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-02-18 DOI: 10.1111/jon.70026

Elena Filimonova, Anton Pashkov, Galina Moysak, Azniv Martirosyan, Jamil Rzaev

Background and Purpose

Primary trigeminal neuralgia (PTN) is a prevalent chronic pain disorder whose pathogenesis is not solely confined to the trigeminal system. Although substantial progress has been made in understanding the underlying mechanisms, comprehensive and consistent data concerning the involvement of the hippocampal formation in this process are lacking. The aim of this study was to evaluate structural changes in hippocampal subfields in patients with PTN.

Methods

Fifty-nine individuals who were diagnosed with PTN and 28 healthy controls matched for age and sex underwent high-resolution 3 Tesla MRI. HippUnfold software was used for the segmentation of hippocampal subfields and the extraction of features. Covariance analyses were performed to analyze changes in the volume, thickness, and gyrification index of different subfields in patients with PTN compared to controls. Furthermore, the relationships between MR morphometry data and the severity of nerve root compression, as well as the intensity and duration of pain, were examined in patients with PTN.

Results

Our analysis demonstrated a decrease in the volume of the right cornu ammonis subfield 1 (CA1)–CA3 and left CA2 hippocampal subfields in patients with PTN compared to healthy controls (adjusted p < 0.05 for all comparisons). No statistically significant associations were found between hippocampal MR morphometry data and clinical metrics.

Conclusions

Our results suggest the existence of bilateral structural abnormalities in the hippocampal subfields in individuals with PTN, which could contribute to the development and progression of this condition.

背景与目的原发性三叉神经痛（PTN）是一种常见的慢性疼痛疾病，其发病机制并不局限于三叉神经系统。尽管在了解其潜在机制方面取得了实质性进展，但关于海马体形成参与这一过程的全面和一致的数据缺乏。本研究的目的是评估PTN患者海马亚区的结构变化。方法对59例PTN患者和28例年龄、性别匹配的健康对照进行高分辨率3特斯拉MRI检查。使用hip展开软件对海马子区进行分割和特征提取。采用协方差分析分析PTN患者与对照组相比不同亚野的体积、厚度和旋转指数的变化。此外，在PTN患者中，MR形态测量数据与神经根压迫的严重程度以及疼痛的强度和持续时间之间的关系进行了检查。结果我们的分析表明，与健康对照相比，PTN患者右角氨亚区1 (CA1) -CA3和左CA2海马亚区体积减少(调整p <；0.05为所有比较)。海马MR形态测量数据与临床指标之间无统计学意义的关联。结论PTN患者海马亚区存在双侧结构异常，可能与PTN的发生发展有关。

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引用次数: 0

High-Field Diffusion Tensor Imaging of Median, Tibial, and Sural Nerves in Type 2 Diabetes With Morphometric Analysis 2型糖尿病正中神经、胫骨神经和腓肠神经的高场弥散张量成像与形态计量学分析

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2025-02-17 DOI: 10.1111/jon.70025

Luka Pušnik, Aljoša Gabor, Barbora Radochová, Jiří Janáček, František Saudek, Armin Alibegović, Igor Serša, Erika Cvetko, Nejc Umek, Žiga Snoj

Background and Purpose

The primary objective was to compare diffusion tensor imaging (DTI) scalar parameters of peripheral nerves between subjects with type 2 diabetes mellitus (T2DM) and those without diabetes. Secondarily, we aimed to correlate DTI scalar parameters with nerve morphometric properties.

Methods

Median, tibial, and sural nerves were harvested from 34 male cadavers (17 T2DM, 17 nondiabetic). Each nerve was divided into three segments. The initial segment was scanned using 9.4 Tesla MRI system (three-dimensional pulsed-gradient spin-echo sequence). DTI scalars were calculated from region-average diffusion-weighted signals. Second segment was optically cleared, acquired with optical projection tomography (OPT), and analyzed for morphometrical properties. Toluidine-stained sections were prepared from last segment, and axon- and myelin-related properties were evaluated.

Results

DTI scalar parameters of median and tibial nerves were comparable between the groups, while sural nerves of T2DM exhibited on average 41% higher mean diffusivity (MD) (p = 0.03), 38% higher radial diffusivity (RD) (p = 0.03), and 27% lower fractional anisotropy (FA) (p = 0.005). Significant differences in toluidine-evaluated parameters of sural nerves were observed between the groups, with a positive correlation between FA with fiber density (p = 0.0001) and with myelin proportion (p < 0.0001) and an inverse correlation between RD and myelin proportion (p = 0.003). OPT-measured morphometric properties did not correlate with DTI scalar parameters.

Conclusions

High-field DTI shows promise as an imaging technique for detecting axonal and myelin-related changes in small sural nerves ex vivo. The reduced fiber density and decreased myelin content, which can be observed in T2DM, likely contribute to observed FA reduction and increased MD/RD.

背景与目的比较2型糖尿病（T2DM）患者与非糖尿病患者周围神经弥散张量成像（DTI）标量参数。其次，我们的目标是将DTI标量参数与神经形态特征相关联。方法采集34具男性尸体（T2DM 17例，非糖尿病17例）正中神经、胫神经和腓肠神经。每条神经被分成三段。使用9.4特斯拉MRI系统（三维脉冲梯度自旋回波序列）扫描初始段。从区域平均扩散加权信号中计算DTI标量。第二段进行光学清除，用光学投影断层扫描（OPT）获得，并分析形态计量学性质。最后一段制备甲苯胺染色切片，评估轴突和髓鞘相关性质。结果两组间正中神经和胫神经的DTI指标具有可比性，T2DM腓骨神经的平均弥漫性（MD）高41% (p = 0.03)，径向弥漫性（RD）高38% (p = 0.03)，分数各向异性（FA）低27% （p = 0.005）。各组间腓肠神经甲苯胺评价参数差异有统计学意义，FA与纤维密度呈正相关（p = 0.0001），与髓磷脂比例呈正相关(p <；0.0001)， RD与髓磷脂比例呈负相关（p = 0.003）。opt测量的形态特征与DTI标量参数无关。结论高视场DTI在体外检测小腓肠神经轴突和髓鞘相关变化方面具有良好的应用前景。在T2DM中可以观察到纤维密度降低和髓磷脂含量降低，这可能导致观察到的FA减少和MD/RD增加。

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引用次数: 0