Journal of Neuroimaging最新文献_第4页

Contrast enhancement patterns associated with acute stroke in moyamoya disease using MR vessel wall imaging 利用磁共振血管壁成像观察与 moyamoya 病急性中风相关的对比增强模式。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2024-07-31 DOI: 10.1111/jon.13226

Jae-Chan Ryu, Chul-Rae Jang, Sang-Hun Lee

Background and Purpose

High-resolution magnetic resonance imaging (HR-MRI) can provide valuable insights into the histopathological characteristics of moyamoya disease (MMD). However, the patterns of vessel wall contrast enhancement have not been well established. We aimed to identify the contrast enhancement patterns of the vessel walls associated with acute cerebral infarction using HR-MRI in MMD.

Methods

In this retrospective study, we conducted genetic tests for Ring Finger Protein 213 (RNF 213) and performed HR-MRI on patients suspected of having MMD. We analyzed wall enhancement patterns including concentric, eccentric, or mixed enhancement types, and the occurrence of acute cerebral infarction in patients who simultaneously tested positive for RNF 213 and exhibited definite features of MMD on HR-MRI.

Results

Among 306 patients who underwent RNF 213 tests for the evaluation of MMD, 56 showed positive RNF 213, and HR-MRI was performed on 32 of them. Among the patients with acute cerebral infarction, the incidence rate was significantly higher in the group with concentric wall enhancement compared to patients without acute cerebral infarction (73.3% vs. 17.0%, p < .002). Furthermore, the incidence was notably elevated, even in patients with pure concentric wall enhancement (40.0% vs. 5.9%, p = .033). The area under the curve (AUC) for the group with any concentric wall enhancement showed a significant result of .78 (95% confidence interval [CI]: .61-.95, p = .007), whereas the predictive ability for pure concentric wall enhancement did not reach significance (AUC = .67, 95% CI: .48-.86, p = .100).

Conclusions

Concentric wall enhancement was a significant predictor of acute cerebral infarction in patients with MMD.

背景和目的：高分辨率磁共振成像（HR-MRI）可为了解莫亚莫亚病（MMD）的组织病理学特征提供有价值的信息。然而，血管壁对比度增强的模式尚未得到很好的确定。我们的目的是利用 HR-MRI 鉴别与 MMD 急性脑梗死相关的血管壁对比度增强模式：在这项回顾性研究中，我们对环指蛋白 213（RNF 213）进行了基因检测，并对疑似 MMD 患者进行了 HR-MRI。我们分析了同时检测出 RNF 213 阳性并在 HR-MRI 上表现出明确 MMD 特征的患者的室壁增强模式，包括同心、偏心或混合增强类型，以及急性脑梗死的发生情况：在接受 RNF 213 检测以评估 MMD 的 306 名患者中，56 人的 RNF 213 检测呈阳性，其中 32 人接受了 HR-MRI 检查。在急性脑梗死患者中，同心壁强化组的发病率明显高于非急性脑梗死患者（73.3% 对 17.0%，P 结论：同心壁强化是急性脑梗死的先兆：同心壁强化是MMD患者发生急性脑梗死的重要预测因素。

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引用次数: 0

Artificial intelligence/machine learning for neuroimaging to predict hemorrhagic transformation: Systematic review/meta-analysis 人工智能/机器学习用于神经影像学预测出血转化：系统综述/元分析。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2024-07-21 DOI: 10.1111/jon.13223

Richard Dagher, Burak Berksu Ozkara, Mert Karabacak, Samir A. Dagher, Elijah Isaac Rumbaut, Licia P. Luna, Vivek S. Yedavalli, Max Wintermark

Background and Purpose

Early and reliable prediction of hemorrhagic transformation (HT) in patients with acute ischemic stroke (AIS) is crucial for treatment decisions and early intervention. The purpose of this study was to conduct a systematic review and meta-analysis on the performance of artificial intelligence (AI) and machine learning (ML) models that utilize neuroimaging to predict HT.

Methods

A systematic search of PubMed, EMBASE, and Web of Science was conducted until February 19, 2024. Inclusion criteria were as follows: patients with AIS who received reperfusion therapy; AI/ML algorithm using imaging to predict HT; or presence of sufficient data on the predictive performance. Exclusion criteria were as follows: articles with less than 20 patients; articles lacking algorithms that operate solely on images; or articles not detailing the algorithm used. The quality of eligible studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 and Checklist for Artificial Intelligence in Medical Imaging. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated using a random-effects model, and a summary receiver operating characteristic curve was constructed using the Reitsma method.

Results

We identified six eligible studies, which included 1640 patients. Aside from an unclear risk of bias regarding flow and timing identified in two of the studies, all studies showed low risk of bias and applicability concerns in all categories. Pooled sensitivity, specificity, and DOR were .849, .878, and 45.598, respectively.

Conclusion

AI/ML models can reliably predict the occurrence of HT in AIS patients. More prospective studies are needed for subgroup analyses and higher clinical certainty and usefulness.

背景和目的：早期可靠地预测急性缺血性卒中（AIS）患者的出血转化（HT）对于治疗决策和早期干预至关重要。本研究旨在对利用神经影像学预测出血性转变的人工智能（AI）和机器学习（ML）模型的性能进行系统回顾和荟萃分析：方法：对PubMed、EMBASE和Web of Science进行了系统检索，直至2024年2月19日。纳入标准如下：接受再灌注治疗的 AIS 患者；利用影像学预测 HT 的 AI/ML 算法；或有关于预测性能的充足数据。排除标准如下：患者人数少于 20 人的文章；缺乏完全基于图像的算法的文章；或未详细说明所用算法的文章。符合条件的研究采用诊断准确性研究质量评估-2 和医学影像人工智能检查表进行质量评估。使用随机效应模型计算汇总的灵敏度、特异性和诊断几率比（DOR），并使用Reitsma方法构建接收者操作特征曲线：我们确定了六项符合条件的研究，共纳入了 1640 名患者。除了其中两项研究在流程和时间方面存在不明确的偏倚风险外，所有研究在所有类别中均显示出较低的偏倚风险和适用性问题。汇总的敏感性、特异性和DOR分别为0.849、0.878和45.598：结论：AI/ML 模型可以可靠地预测 AIS 患者 HT 的发生。结论：AI/ML 模型可以可靠地预测 AIS 患者高血压的发生，但还需要更多的前瞻性研究来进行亚组分析，以提高临床确定性和实用性。

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引用次数: 0

Which compartments of the optic nerve and its sheath are associated with intracranial pressure? An exploratory study 视神经及其鞘的哪些区段与颅内压有关？一项探索性研究。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2024-07-21 DOI: 10.1111/jon.13224

Jakob Pansell, Matteo Bottai, Max Bell, Peter C. Rudberg, Ola Friman, Charith Cooray

Background and Purpose

The optic nerve sheath diameter (ONSD) is a commonly used estimate of intracranial pressure (ICP). The rationale behind this is that pressure changes in the cerebrospinal fluid affect the optic nerve subarachnoid space (ONSAS) thickness. Still, possible effects on other compartments of the optic nerve sheath (ONS) have not been studied. This is the first study ever to analyze all measurable compartments of the ONS for associations with elevated ICP.

Methods

We measured changes in ICP and changes in ONS compartments in 75 patients treated with invasive ICP monitoring at the Karolinska University Hospital. Associations between changes in ICP and changes in ONS compartments were estimated with generalized estimating equations. The potential to identify elevated ICP was assessed with the area under the receiver operating characteristic curve (AUROC) for ONS compartments associated with ICP changes.

Results

Both ONSAS and perioptic dura mater thickness were significantly associated with changes in ICP in multivariable modeling. ONSAS was the only compartment that independently predicted changes in ICP, with an AUROC of 0.69 for predicting ICP increase. Still, both the perioptic dura mater thickness and the optic nerve diameter added value in predicting ICP changes in multivariable modeling.

Conclusions

The results from this study challenge the current understanding of the mechanism behind the association between ICP and ONSD. Contrary to the common opinion that ONSAS is the only affected compartment, this study shows a more complex picture. It suggests that all ONS compartments may add value in predicting changes in ICP.

背景和目的：视神经鞘直径（ONSD）是常用的颅内压（ICP）估算值。其原理是脑脊液中的压力变化会影响视神经蛛网膜下腔（ONSAS）的厚度。但是，对视神经鞘（ONS）其他部分可能产生的影响尚未进行研究。这是第一项分析视神经鞘所有可测量部分与 ICP 升高相关性的研究：我们测量了在卡罗林斯卡大学医院接受有创ICP监测治疗的75名患者的ICP变化和ONS分区的变化。用广义估计方程估计了ICP变化与ONS分区变化之间的关联。用接收者操作特征曲线下面积（AUROC）评估了与ICP变化相关的ONS分区识别ICP升高的潜力：结果：在多变量建模中，ONSAS和硬脑膜周围厚度均与ICP的变化显著相关。ONSAS 是唯一能独立预测 ICP 变化的分区，预测 ICP 升高的 AUROC 为 0.69。不过，在多变量建模中，视神经周围硬脑膜厚度和视神经直径在预测ICP变化方面仍有附加值：本研究的结果挑战了目前对 ICP 与 ONSD 之间关联机制的理解。与认为 ONSAS 是唯一受影响区室的普遍观点相反，本研究显示了更为复杂的情况。它表明，所有 ONS 区段都可能为预测 ICP 的变化增加价值。

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引用次数: 0

Combined MR quantitative susceptibility mapping and multi-shell diffusion in Parkinson's disease 帕金森病中的磁共振定量易感性图谱和多壳扩散相结合。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2024-07-14 DOI: 10.1111/jon.13222

Oscar Andersson Forsman, Henrik Sjöström, Per Svenningsson, Tobias Granberg

Background and Purpose

Quantitative susceptibility mapping (QSM), neurite orientation dispersion and density imaging (NODDI), and the g-ratio have separately shown differences between Parkinson's disease (PD) and healthy controls. The g-ratio has, however, not been studied in PD in the substantia nigra (SN) and the putamen. A combination of these methods could also potentially be a complementary imaging biomarker for PD. This study aimed to assess the diagnostic performance of QSM, NODDI, the g-ratio, and a combined QSM-NODDI imaging marker in the SN and putamen of PD patients.

Methods

In this prospective study, the diagnostic performance of median region of interest values was compared in a cohort of 15 participants with PD and 14 healthy controls after manual segmentation. The diagnostic performance was assessed using the area under curve (AUC) for the receiving operator characteristic.

Results

Median QSM in the contralateral SN identified PD with AUC 0.77, and median isotropic volume fraction identified PD in the ipsilateral SN with AUC 0.68. A combined NODDI-QSM marker improved diagnostic performance (AUC 0.80). No significant differences were found in the g-ratio.

Conclusion

A combination of median QSM and median isotropic volume fraction improves the differentiation of PD from healthy controls and is a potential biomarker in the diagnostics of PD. This confirms previously reported results indicating that combining QSM and NODDI modestly improves differentiation of PD.

背景和目的：定量易感图（QSM）、神经元定向分散和密度成像（NODDI）以及g比率已分别显示出帕金森病（PD）与健康对照组之间的差异。然而，尚未对帕金森病黑质（SN）和普鲁士门的 g 比率进行研究。这些方法的结合也有可能成为帕金森病的补充成像生物标志物。本研究旨在评估 QSM、NODDI、g 比值以及 QSM-NODDI 联合成像标记物在帕金森病患者的黑质和视丘中的诊断性能：在这项前瞻性研究中，对 15 名帕金森病患者和 14 名健康对照者进行手动分割后，比较了感兴趣区中值的诊断性能。诊断性能使用接收操作者特征曲线下面积（AUC）进行评估：结果：对侧SN的QSM中位数识别出了PD，AUC为0.77；同侧SN的各向同性体积分数中位数识别出了PD，AUC为0.68。联合 NODDI-QSM 标记提高了诊断性能（AUC 0.80）。结论：结论：QSM中位数和各向同性体积分数中位数的组合提高了PD与健康对照组的区分度，是诊断PD的潜在生物标志物。这证实了之前报道的结果，即结合QSM和NODDI可适度改善PD的分化。

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引用次数: 0

Lesion phenotyping based on magnetic susceptibility in pediatric multiple sclerosis 基于小儿多发性硬化症磁感应强度的病变表型。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2024-07-14 DOI: 10.1111/jon.13221

Vincenzo Daniele Boccia, Giacomo Boffa, Caterina Lapucci, Mauro Costagli, Luca Bosisio, Maria Margherita Mancardi, Matilde Inglese, Maria Cellerino

Background and purpose

Pediatric multiple sclerosis (MS) displays different pathological features compared to adult MS, which can be studied in vivo by assessing tissue magnetic susceptibility with 3T-MRI. We aimed to assess different white matter lesions (WMLs) phenotypes in pediatric MS patients using quantitative susceptibility mapping (QSM) and susceptibility mapping weighted imaging (SMWI) over 12 months.

Methods

Eleven pediatric MS patients [female: 63.6%; mean ± standard deviation (SD) age and disease duration: 16.3 ± 2.2 and 2.4 ± 1.5; median (range) Expanded Disability Status Scale (EDSS) 1 (0-2)] underwent 3 Tesla-MRI exams and EDSS assessments at baseline and after 1 year. QSM and SMWI were obtained using 3-dimensional (3D)-segmented echo-planar-imaging with submillimetric spatial resolution. WMLs were classified according to their QSM appearance and SMWI was used to identify QSM hyperintensities ascribable to veins. Total brain volumes at baseline and follow-up were computed using high-resolution 3D T1-weighted images.

Results

Mean ± SD paramagnetic rim lesions (PRLs) prevalence was 7.0% ± 9.0. Fifty-four percent (6/11) of patients exhibited at least one PRL, with one patient exhibiting ≥ 4 PRLs. All patients showed QSM-iso-/hypo-intense lesions, which represented a mean ± SD of 65.8% ± 22.7 of total WMLs. QSM-hyperintense WMLs showed a positive correlation with total brain volume reduction at follow-up (r = 0.705; p = .02). No lesion was classified as different between baseline and follow-up.

Conclusion

Chronic compartmentalized inflammation seems to occur early in pediatric MS patients with short disease duration. A high prevalence of iso-/hypo-intense lesions was found, which could account for the higher remyelination potential in pediatric MS.

背景和目的：与成人多发性硬化症相比，小儿多发性硬化症（MS）显示出不同的病理特征，这可以通过3T-MRI评估组织磁感应强度进行体内研究。我们旨在使用定量磁感应强度图谱（QSM）和磁感应强度图谱加权成像（SMWI）评估小儿多发性硬化症患者12个月内不同的白质病变（WMLs）表型：11名小儿多发性硬化症患者（女性：63.6%；平均±标准差（SD）年龄和病程：16.3±2.2和16.3±2.216.3±2.2和2.4±1.5；中位数（范围）残疾状况扩展量表（EDSS）1（0-2）]在基线和1年后接受了3特斯拉-MRI检查和EDSS评估。QSM和SMWI是通过具有亚毫米空间分辨率的三维（3D）分割回声平面成像获得的。WML根据其QSM外观进行分类，SMWI用于识别可归因于静脉的QSM高密度。使用高分辨率三维T1加权图像计算基线和随访时的脑总体积：结果：顺磁性边缘病变（PRLs）发生率的平均值（± SD）为 7.0% ± 9.0。54%的患者（6/11）表现出至少一个PRL，其中一名患者表现出≥4个PRL。所有患者都出现了 QSM 异/低密度病变，平均（±SD）占 WML 总数的 65.8% ± 22.7。QSM-hyperintense WMLs与随访时脑总体积缩小呈正相关（r = 0.705; p = .02）。没有任何病变被归类为基线与随访期间的差异：结论：在病程较短的儿童多发性硬化症患者中，慢性分区炎症似乎发生得较早。结论：在病程较短的小儿多发性硬化症患者中，慢性室间隔炎症似乎发生较早，等/低强度病变的发生率较高，这可能是小儿多发性硬化症患者再髓鞘化潜力较高的原因。

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引用次数: 0

Pial collaterals limit stroke progression and metabolic stress in hypoperfused tissue: An MRI perfusion and mq-BOLD study 在低灌注组织中，静脉瓣限制了中风的进展和代谢压力：磁共振成像灌注和 mq-BOLD 研究。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2024-06-26 DOI: 10.1111/jon.13220

Franziska Frank, Stephan Kaczmarz, Christine Preibisch, Ralf Deichmann, Ulrike Nöth, Marlies Wagner, Alexander Seiler

Background and Purpose

In acute ischemic stroke (AIS) due to large-vessel occlusion (LVO), the relationship between cerebral oxygen extraction fraction (OEF) as the hallmark of the ischemic penumbra and leptomeningeal collateral supply is not well established. We aimed to investigate the relationship between pial collateralization and tissue oxygen extraction in patients with LVO using magnetic resonance imaging (MRI).

Methods

Data from 14 patients with anterior circulation LVO who underwent MRI before acute stroke treatment were analyzed. In addition to diffusion-weighted imaging and perfusion-weighted imaging (PWI), the protocol comprised sequences for multiparametric quantitative blood-oxygen-level-dependent imaging for the calculation of relative OEF (rOEF). Pial collateral supply was quantitatively assessed by analyzing the signal variance in T2*-weighted PWI time series. Relationships between collateral supply, infarct volume, rOEF in peri-infarct hypoperfused tissue, and clinical stroke severity were assessed.

Results

The PWI-based parameter quantifying collateral supply was negatively correlated with baseline ischemic core volume and rOEF in the hypoperfused peri-infarct area (p < .01). Both reduced collateral supply and increased rOEF correlated significantly with higher scores on the National Institutes of Health Stroke Scale (p < .05). Increased rOEF within hypoperfused tissue was associated with higher baseline (p = .043) and follow-up infarct volume (p = .009).

Conclusions

Signal variance-based mapping of collaterals with PWI depicts pial collateral supply, which is closely tied to tissue pathophysiology and clinical and imaging outcomes. Magnetic-resonance-derived mapping of cerebral rOEF reveals penumbral characteristics of hypoperfused tissue and might provide a promising imaging biomarker in AIS.

背景和目的：在大血管闭塞（LVO）导致的急性缺血性卒中（AIS）中，作为缺血半影标志的脑氧萃取率（OEF）与脑侧膜侧供之间的关系尚未明确。我们的目的是利用磁共振成像（MRI）研究 LVO 患者的静脉侧支与组织氧萃取之间的关系：方法：分析了 14 名前循环 LVO 患者的数据，这些患者在急性卒中治疗前接受了 MRI 检查。除了弥散加权成像和灌注加权成像（PWI）外，方案还包括用于计算相对 OEF（rOEF）的多参数定量血氧水平依赖性成像序列。通过分析 T2* 加权 PWI 时间序列中的信号方差，对皮质侧支供应进行定量评估。评估了侧支供应、梗死容积、梗死周围低灌注组织的 rOEF 和临床卒中严重程度之间的关系：结果：基于脉搏波成像的侧支供应量化参数与基线缺血核心容积和梗死周围低灌注区的 rOEF 呈负相关（p 结论：基于脉搏波成像的侧支供应量化参数与基线缺血核心容积和梗死周围低灌注区的 rOEF 呈负相关（p 结论）：基于信号方差的脉搏波成像侧支映射描述了与组织病理生理学、临床和成像结果密切相关的侧支供应。磁共振衍生的大脑 rOEF 映射揭示了低灌注组织的半影特征，可能为 AIS 提供一种有前景的成像生物标志物。

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引用次数: 0

Biological variation in cervical spinal cord MRI morphometry in healthy individuals and people with multiple sclerosis 健康人和多发性硬化症患者颈椎脊髓核磁共振成像形态测量的生物变异。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2024-06-10 DOI: 10.1111/jon.13219

Sarah R. Cook, Kritin Vasamreddy, Anna Combes, Simon Vandekar, Mereze Visagie, Delaney Houston, Lily Wald, Ashwin Kumar, Megan McGrath, Colin D. McKnight, Francesca Bagnato, Seth A. Smith, Kristin P. O'Grady

Background and Purpose

Conclusions from prior literature regarding the impact of sex, age, and height on spinal cord (SC) MRI morphometrics are conflicting, while the effect of body weight on SC morphometrics has been found to be nonsignificant. The purpose of this case-control study is to assess the associations between cervical SC MRI morphometric parameters and age, sex, height, and weight to establish their potential role as confounding variables in a clinical study of people with multiple sclerosis (MS) compared to a cohort of healthy volunteers.

Methods

Sixty-nine healthy volunteers and 31 people with MS underwent cervical SC MRI at 3 Tesla field strength. Images were centered at the C3/C4 intervertebral disc and processed using Spinal Cord Toolbox v.4.0.2. Mixed-effects linear regression models were used to evaluate the effects of biological variables and disease status on morphometric parameters.

Results

Sex, age, and height had significant effects on cord and gray matter (GM) cross-sectional area (CSA) as well as the GM:cord CSA ratio. There were no significant effects of body weight on morphometric parameters. The effect of MS disease duration on cord CSA in the C4 level was significant when controlling for all other variables.

Conclusions

Studies of disease-related changes in SC morphometry should control for sex, age, and height to account for physiological variation.

背景和目的：关于性别、年龄和身高对脊髓（SC）MRI 形态测量的影响，以往文献的结论相互矛盾，而体重对脊髓形态测量的影响则不明显。本病例对照研究的目的是评估颈椎 SC MRI 形态测量参数与年龄、性别、身高和体重之间的关系，以确定它们在多发性硬化症（MS）患者的临床研究中与健康志愿者队列相比作为混杂变量的潜在作用：69 名健康志愿者和 31 名多发性硬化症患者在 3 特斯拉场强下接受了颈椎 SC MRI 检查。图像以 C3/C4 椎间盘为中心，使用脊髓工具箱 v.4.0.2 进行处理。混合效应线性回归模型用于评估生物变量和疾病状态对形态测量参数的影响：结果：性别、年龄和身高对脊髓和灰质（GM）横截面积（CSA）以及GM：脊髓CSA比率有显著影响。体重对形态测量参数没有明显影响。在控制所有其他变量的情况下，多发性硬化症病程对C4水平脊髓CSA的影响是显著的：对与疾病相关的SC形态测量变化的研究应控制性别、年龄和身高，以考虑生理变化。

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引用次数: 0

Brain lesion microstructure in neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein disease 神经脊髓炎视网膜谱系障碍和髓鞘少突胶质细胞糖蛋白病的脑损伤微结构。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2024-06-03 DOI: 10.1111/jon.13218

Caterina Lapucci, Vincenzo Daniele Boccia, Thoma Dario Clementi, Simona Schiavi, Luana Benedetti, Antonio Uccelli, Giovanni Novi, Maria Cellerino, Matilde Inglese

Background and purpose

Neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) diagnosis are based on the presence of serological and magnetic resonance imaging (MRI) biomarkers. Diffusion tensor imaging (DTI), neurites orientation dispersion and density imaging (NODDI), and the Spherical Mean Technique (SMT) may be helpful to provide a microstructural characterization of the different types of white matter lesions and give an insight about their different pathological mechanisms. The aim of the study was to characterize microstructural differences between brain typical lesions (TLs) and nontypical lesions (nTLs).

Methods

A total of 17 NMOSD and MOGAD patients [9 Aquaporin4 (AQP4) + NMO, 2 seronegative-NMO, 6 MOGAD] underwent MRI scans on a 3 Tesla MAGNETON PRISMA. Diffusion parameters (fractional anisotropy; mean diffusivity [MD]; intracellular volume fraction [ICVF]; extra-neurite transverse diffusivity; and extra-neurite MD; neurite signal fraction) were obtained using DTI, NODDI, and SMT. Microstructural parameters within lesions were compared through a generalized linear model using age, sex, and total lesion volume as covariates.

Results

In NMOSD/MOGAD whole cohort (total lesions = 477), TLs showed increased MD and decreased ICVF compared to nTLs (p < .05), indicating higher inflammation and axonal loss. Similar results were found also in the AQP4 + NMO subgroup (decreased ICVF, p < .05). Furthermore, in NMOSD/MOGAD whole cohort and in AQP4 + NMO subgroup, TLs showed a trend toward higher EXRATRANS than nTLs, suggesting a more severe degree of demyelination within TLs.

Conclusions

TLs and nTLs in NMOSD/MOGAD showed different diffusion MRI-derived microstructural features, with TLs showing a more severe degree of inflammation and fiber disruption with respect to nTLs.

背景和目的：神经脊髓炎视谱系障碍（NMOSD）和髓鞘少突胶质细胞糖蛋白抗体相关疾病（MOGAD）的诊断基于血清学和磁共振成像（MRI）生物标志物的存在。弥散张量成像（DTI）、神经元取向弥散和密度成像（NODDI）以及球形均值技术（SMT）可能有助于提供不同类型白质病变的微观结构特征，并有助于了解其不同的病理机制。本研究旨在描述脑部典型病变（TLs）和非典型病变（nTLs）之间的微观结构差异：共有 17 名 NMOSD 和 MOGAD 患者（9 名 Aquaporin4 (AQP4) + NMO，2 名血清阴性 NMO，6 名 MOGAD）在 3 特斯拉 MAGNETON PRISMA 上接受了 MRI 扫描。利用 DTI、NODDI 和 SMT 获得了扩散参数（分数各向异性；平均扩散率 [MD]；细胞内体积分数 [ICVF]；神经元外横向扩散率；神经元外 MD；神经元信号分数）。以年龄、性别和病变总体积为协变量，通过广义线性模型对病变内的微结构参数进行比较：在整个 NMOSD/MOGAD 队列（病变总数 = 477）中，与 nTLs 相比，TLs 的 MD 增加，ICVF 减少（p 结论：在 NMOSD/MOGAD 队列中，TLs 和 nTLs 的 MD 增加，ICVF 减少：NMOSD/MOGAD中的TLs和nTLs显示出不同的弥散MRI衍生微结构特征，与nTLs相比，TLs显示出更严重的炎症和纤维破坏。

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引用次数: 0

Validation of bedside manual versus automated measurements of brain arterial diameters from MR angiography 核磁共振血管造影床旁手动与自动脑动脉直径测量的验证。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2024-05-29 DOI: 10.1111/jon.13217

Nicolas D. Garzon-Mancera, Farid Khasiyev, Victor J. Del Brutto, Antonio J. Spagnolo Allende, Clinton B. Wright, Mitchell Elkind, Tatjana Rundek, Oscar H. Del Brutto, Jose Gutierrez

Background and Purpose

Brain arterial luminal diameters are reliably measured with automated imaging software. Nonautomated imaging software alternatives such as a Picture Archiving Communication System are more common bedside tools used for manual measurement. This study is aimed at validating manual measurements against automated methods.

Methods

We randomly selected 600 participants from the Northern Manhattan Study (NOMAS) and 260 participants from the Atahualpa Project studied with 1.5 Tesla MR angiography. Using the Radiant measuring tool, three independent readers (general practitioner, neurology resident, and vascular neurologist) measured manually the diameter of arterial brain vessels. The same vessels were also measured by LKEB Automated Vessel Analysis (LAVA). We calculated the intraclass correlation coefficient (ICC) of each rater's diameters versus those obtained with LAVA.

Results

The ICC between diameters obtained by the general practitioner or the neurology resident compared to LAVA was excellent for both internal carotid arteries (ICA) and Basilar Arteries (BA) (ICC > .80 in all comparisons) in NOMAS. In the Atahualpa Project, ICC between diameters obtained by a vascular neurologist and LAVA was good for both ICA and BA (ICC > .60 in all comparisons). The ICCs for the measurements of the remaining arteries were moderate to poor.

Conclusion

Results suggest that manual measurements of ICA and BA diameters, but not MCA or ACA, are valid and could be used to identify dilated brain arteries at the bedside and for eventual selection of patients with dolichoectasia into clinical trials.

背景和目的：使用自动成像软件可以可靠地测量脑动脉管腔直径。图片存档通信系统等非自动成像软件是更常用的床边手动测量工具。本研究旨在验证手动测量与自动方法之间的差异：我们从曼哈顿北部研究（NOMAS）中随机选取了 600 名参与者，从阿塔瓦尔帕项目中随机选取了 260 名参与者，对他们进行了 1.5 特斯拉磁共振血管造影研究。三名独立读者（全科医生、神经科住院医生和血管神经科医生）使用 Radiant 测量工具手动测量了脑动脉血管的直径。同样的血管也通过 LKEB 自动血管分析仪（LAVA）进行测量。我们计算了每位测量者的直径与 LAVA 所获直径的类内相关系数 (ICC)：结果：在 NOMAS 中，全科医生或神经科住院医师获得的颈内动脉 (ICA) 和基底动脉 (BA) 直径与 LAVA 获得的直径之间的 ICC 非常接近（所有比较中 ICC 均大于 0.80）。在阿塔瓦尔帕项目中，由血管神经科医生和 LAVA 获得的颈内动脉和基底动脉直径的 ICC 均为良好（所有比较中 ICC 均大于 0.60）。其余动脉测量的 ICC 值为中等至较差：结果表明，人工测量 ICA 和 BA 直径（而非 MCA 或 ACA）是有效的，可用于在床旁识别扩张的脑动脉，并最终选择脑动脉硬化症患者进行临床试验。

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引用次数: 0

Sodium signal intensity of CSF using 1H-guided 23Na-MRI as a potential noninvasive biomarker in Alzheimer's disease 利用 1H-guided 23Na-MRI 测量 CSF 的钠信号强度，作为阿尔茨海默病的潜在无创生物标记物。

IF 2.3 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging

Pub Date : 2024-05-28 DOI: 10.1111/jon.13216

Hans-Ulrich Kerl, Hakim Baazaoui, Katrin Herrmann, Anne Adlung, Nadia K. Ludwig, Lucrezia Hausner, Lutz Frölich, Lothar Schad, Christoph Groden, Sherif A. Mohamed

Background and Purpose

Alzheimer's disease (AD) is characterized by cognitive decline and mnestic deficits. The pathophysiology of AD is not fully understood, which renders the development of accurate tools for early diagnosis and effective therapies exceedingly difficult. In this study, we investigated the use of ²³Na-MRI to measure the relative sodium signal intensities (rSSIs) in CSF in patients with AD and healthy controls.

Methods

We prospectively recruited 11 patients with biomarker-diagnosed early-stage AD, as well as 12 cognitively healthy age-matched controls. All participants underwent ²³Na-MRI to measure rSSI. Statistical analyses were performed to compare CSF sodium signal intensities between groups and to evaluate the specificity and sensitivity of the rSSI in the diagnosis of AD.

Results

RSSIs in CSF were significantly higher in AD patients (mean = 68.6% ± 7.7%) compared to healthy controls (mean = 56.9% ± 5.5%) (p < .001). There was also a significant negative correlation between rSSI in CSF and hippocampus and amygdala volumes (r = −.54 and −.49, p < .05) as well as a positive correlation with total CSF volumes (r = .81, p < .05). Receiver operating characteristic analysis showed high diagnostic accuracy for rSSI in discriminating between AD patients and healthy controls (area under the curve = .94).

Conclusion

Our study provides evidence that rSSI in CSF is increased in AD patients in comparison to healthy controls. rSSI may serve as a potential marker for early detection and monitoring of disease progression. Larger, longitudinal studies are needed to confirm our findings and to investigate the association between rSSI in CSF and the severity of cognitive impairment.

背景和目的：阿尔茨海默病（AD）的特征是认知能力下降和运动障碍。由于人们对阿尔茨海默病的病理生理学尚不完全了解，因此很难开发出用于早期诊断和有效治疗的准确工具。在这项研究中，我们探讨了使用 23Na-MRI 测量 AD 患者和健康对照组 CSF 中相对钠信号强度（rSSIs）的方法：我们前瞻性地招募了 11 名经生物标记物确诊的早期 AD 患者和 12 名认知健康的年龄匹配对照者。所有参与者都接受了 23Na-MRI 测量 rSSI。研究人员进行了统计分析，以比较不同组间的脑脊液钠信号强度，并评估rSSI在诊断AD方面的特异性和敏感性：结果：与健康对照组（平均值为 56.9% ± 5.5%）相比，AD 患者脑脊液中的 RSSIs 明显较高（平均值为 68.6% ± 7.7%）（p 结论：我们的研究为 rSSI 在 AD 诊断中的特异性和敏感性提供了证据：我们的研究提供了证据，表明与健康对照组相比，AD 患者 CSF 中的 rSSI 有所增加。需要进行更大规模的纵向研究来证实我们的发现，并调查 CSF 中 rSSI 与认知障碍严重程度之间的关联。

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引用次数: 0