Interscanner reproducibility of volumetric quantitative susceptibility mapping about cerebral subcortical gray nuclei at different MR vendors with the same magnetic strength.

BACKGROUND AND PURPOSE: Quantitative susceptibility mapping (QSM) technique was a new quantitative magnetic resonance imaging technique to evaluate the cerebral iron deposition in clinical practice. The current study was aimed to investigate the reproducibility of the volumetric susceptibility value of the subcortical gray nuclei at two different MR vendor with the same magnetic strength. METHODS: Cerebral magnitude and phase images of 21 normal subjects were acquired from a 3D multiecho enhanced gradient recalled echo sequence at two different 3.0T MR scanner, and then the magnetic susceptibility images were generated by STI software. The brain structural images were coregistered with magnitude images and generated the normalized parameters, and then generated the normalized susceptibility images. The subcortical gray nuclei template was applied to extract the volumetric susceptibility value of the target nuclei. RESULTS: ICC value (95% CI) of the caudate, putamen and GP were 0.847 (0.660-0.935), 0.848 (0.663-0.935) and 0.838 (0.643-0.931), respectively. The ICC value of the thalamus was 0.474 (0.064-0.747). Ninety-five point two percent (20/21) of the difference points of the susceptibility located between the 95% LA for the caudate at the two different 3.0T MR scanner, while the less than 95% of the difference points of the susceptibility value located between the 95% LA for the putamen, globus pallidus and thalamus. CONCLUSION: The current study identified that the caudate had the stable reproducibility of the magnetic susceptibility value, and the other basal ganglion nuclei should be cautious for the quantitative evaluation of the magnetic susceptibility value at different 3.0T MR scanner.

[CT-Like MRI and Calcium-Suppressed Spectral CT Imaging of Multifocal Bone Infarcts in Both Lower Extremities:Report of One Case].

Bone infarction has a low incidence in clinical practice and mostly occurs in the metaphysis and diaphysis.Few studies report the advanced imaging technique for bone infarction.Here we reported the fast field echo resembling a CT using restricted echo-spacing and calcium-suppressed spectral CT imaging for a case of multifocal bone infarcts in both lower extremities,aiming to provide diagnostic experience for clinical practice.

Decreased Cerebral Perfusion in Chronic Migraine: A Voxel-based Cerebral Blood Flow Analysis Using 3D Pseudo-continuous Arterial Spin Labeling.

BACKGROUND: A contrast agent-free approach would be preferable to the frequently used invasive approaches for evaluating cerebral perfusion in chronic migraineurs (CM). In this work, non-invasive quantitative volumetric perfusion imaging was used to evaluate alterations in cerebral perfusion in CM. METHODS: We used conventional brain structural imaging sequences and 3D pseudo-continuous arterial spin labeling (3D PCASL) to examine thirteen CM patients and fifteen normal controls (NCs). The entire brain gray matter underwent voxel-based analysis, and the cerebral blood flow (CBF) values of the altered positive areas were retrieved to look into the clinical variables' significant correlation. RESULTS: Brain regions with the decreased perfusion were located in the left postcentral gyrus, bilateral middle frontal gyrus, left middle occipital gyrus, left superior parietal lobule, left medial segment of superior frontal gyrus, and right orbital part of the inferior frontal gyrus. White matter fibers with decreased perfusion were located in bilateral superior longitudinal tracts, superior corona radiata, external capsules, anterior and posterior limbs of the internal capsule, anterior corona radiata, inferior longitudinal fasciculus, and right corticospinal tract. However, the correlation analysis showed no significant correlation between the CBF value of the above positive brain regions with clinical variables (p > 0.05). CONCLUSION: The current study provided more useful information to comprehend the pathophysiology of CM and revealed a new insight into the neural mechanism of CM from the pattern of cerebral hypoperfusion.

Hypoperfusion of Amygdala in Chronic Migraine: An Exploratory Quantitative Perfusion Imaging Using 3D Pseudo-Continuous Arterial Spin Labeling.

BACKGROUND: Although the amygdala has structural and functional abnormalities in Chronic Migraine (CM), less is known about the altered perfusion of the amygdala in CM. OBJECTIVE: The current study aimed to assess amygdala perfusion in CM using a contrast agent-free and quantitative approach. METHODS: 15 Normal Controls (NC) and 13 patients with CM during the migraine interval were assessed for brain structure and subjected to 3D Pseudo- Continuous Arterial Spin Labeling (3D-PCASL) MR imaging. The Cerebral Blood Flow (CBF) value of the amygdala was automatically extracted based on the individual amygdala mask for all participants. The independent sample t-test, Receiver Operating Characteristic (ROC) curve, and correlation analysis were used to evaluate the perfusion changes in CM. RESULTS: Bilateral amygdala cerebral perfusion was lower in CM (left amygdala, 42.21±4.49 ml/100mg/min; right amygdala, 42.38±4.41 ml/100mg/min) than in NC (left amygdala, 48.31±6.92 ml/100mg/min; right amygdala, 47.88±6.53 ml/100mg/min) (left, p = 0.01; right, p = 0.02). There was no significant correlation between the perfusion of bilateral amygdalas and the clinical variables. Also, there was no significant difference in the volume of bilateral amygdalas between the two groups. The Area Under the Curve (AUC) of the CBF values of the left and right amygdala was 0.78 (95%CI: 0.58-0.91) and 0.75 (95%CI: 0.55-0.89), respectively. The cut-off value was 44.24 ml/100mg/min (left amygdala, with sensitivity 76.90% and specificity 78.70%) and 46.75 ml/100mg/min (right amygdala, with sensitivity 92.3% and specificity 58.80%), respectively. CONCLUSION: CM presented bilateral hypoperfusion in the amygdala, offering potential diagnostic value in distinguishing CM from NC. The 3D-PCASL could be regarded as a simple and efficient neuroimaging tool to assess the perfusion status in CM patients.

Transgelin Promotes Glioblastoma Stem Cell Hypoxic Responses and Maintenance Through p53 Acetylation.

Glioblastoma (GBM) is a lethal cancer characterized by hypervascularity and necrosis associated with hypoxia. Here, it is found that hypoxia preferentially induces the actin-binding protein, Transgelin (TAGLN), in GBM stem cells (GSCs). Mechanistically, TAGLN regulates HIF1α transcription and stabilizes HDAC2 to deacetylate p53 and maintain GSC self-renewal. To translate these findings into preclinical therapeutic paradigm, it is found that sodium valproate (VPA) is a specific inhibitor of TAGLN/HDAC2 function, with augmented efficacy when combined with natural borneol (NB) in vivo. Thus, TAGLN promotes cancer stem cell survival in hypoxia and informs a novel therapeutic paradigm.

Increased Brain Iron Deposition in Episodic Migraine: A Pilot Voxel-based Quantitative Susceptibility Mapping

INTRODUCTION: Although iron deposition has been identified as a significant migraine trigger, the key structures in episodic migraine (EM) remain unknown. OBJECTIVE: The aim of this study is to investigate cerebral iron deposition in EM using an advanced voxel-based quantitative susceptibility mapping (QSM). METHODS: A multi-echo gradient echo sequence MR was performed in 15 episodic migraine patients (EMs) and 27 normal control subjects (NCs). The reconstructed quantitative susceptibility mapping images and voxel-based analysis were performed over the entire brain. The susceptibility value of all brain regions with altered iron deposition was extracted, and the correlations between susceptibility value and clinical variables (including HAMA, HAMD, MoCA, VAS, MIDAS score, diseased duration, and headache frequency) were calculated. RESULTS: EM patients presented increased susceptibility value in the left putamen and bilateral substantia nigra (SN) compared with NC. There was no correlation between susceptibility value and the clinical variables. CONCLUSION: Increased brain iron deposition in the extrapyramidal system may be a biomarker for migraine, and abnormal iron metabolism may be involved in the extrapyramidal mechanism. The QSM technique would be an optimal and simple tool for clinical practice and research in iron measurement.

[Brain iron deposition increases in the bilateral substantia nigra of patients with medication-overuse headache: a quantitative susceptibility mapping analysis].

OBJECTIVE: To investigate iron accumulation level over the whole brain and explore the possible neuromechanism of medication-overuse headache (MOH) using quantitative susceptibility mapping (QSM). METHODS: Thirty-seven MOH patients and 27 normal control subjects were enrolled in the study for examinations with both a multiecho gradient echo magnetic resonance (MR) sequence and brain high resolution structural imaging. A voxel-based analysis was performed to detect the brain regions with altered iron deposition, and the quantitative susceptibility mapping values of the positive brain regions were extracted. Correlation analysis was performed between the susceptibility values and the clinical variables of the patients. RESULTS: In patients with MOH, increased susceptibility values were found mainly in the bilateral substantia nigra (SN) (MNI coordinate: 8, -18, -14; -6, -16, -14) as compared with the normal control subjects (P < 0.001), but these alterations in iron deposition were not significantly correlated with the clinical variables of the patients (P > 0.05). The susceptibility value in the left SN had an area under curve (AUC) of 0.734, and at the cut-off value of 0.077, its diagnostic sensitivity was 72.97% and its specificity was 70.37% for distinguishing MOH from normal controls; The susceptibility value in the right SN had an AUC of 0.699 with a diagnostic sensitivity of 72.97% and a specificity of 62.96% at the cut-off value of 0.084. CONCLUSION: Increased iron deposition occurs in the bilateral SN of MOH patients, which provides a new insight into the mechanism of mesocorticolimbic dopamine system dysfunction in MOH. QSM technique can be used as a non-invasive means for quantitative analysis of brain iron deposition in migraine neuroimaging.

Corrigendum: Altered cerebral neurovascular coupling in medication-overuse headache: a study combining multi-modal resting-state fMRI with 3D PCASL.

[This corrects the article DOI: 10.3389/fnins.2023.1139086.].

[Optimal Parameters for Virtual Mono-Energetic Imaging of Liver Solid Lesions].

Objective To explore the optimal parameters for virtual mono-energetic imaging of liver solid lesions. Methods A retrospective analysis was performed on 60 patients undergoing contrast-enhanced spectral CT of the abdomen.The iodine concentration values of hepatic arterial phase images and the CT values of different mono-energetic images were measured.The correlation coefficient and coefficient of variation were calculated. Results The average correlation coefficients between iodine concentrations and CT values of hepatic solid lesion images at 40,45,50,55,60,65,and 70 keV were 0.996,0.995,0.993,0.989,0.978,0.970,and 0.961,respectively.The correlation coefficients at 40(P=0.007),45(P=0.022),50 keV (P=0.035)were higher than that at 55 keV,and the correlation coefficients at 40 keV(P=0.134) and 45 keV(P=0.368) had no significant differences from that at 50 keV.The coefficients of variation of the CT values at 40,45,and 50 keV were 0.146,0.154,and 0.163,respectively. Conclusion The energy of 40 keV is optimal for virtual mono-energetic imaging of liver solid lesions in the late arterial phase,which is helpful for the diagnosis of liver diseases.

Altered cerebral neurovascular coupling in medication-overuse headache: A study combining multi-modal resting-state fMRI with 3D PCASL.

Aim: Structural and functional changes in the brain have been identified in individuals with medication-overuse headache (MOH) using MRI. However, it has not been clearly established whether neurovascular dysfunction occurs in MOH, which could be elucidated by examining neurovascular coupling (NVC) from the viewpoints of neuronal activity and cerebral blood flow. The aim of this study was to investigate potential alterations in NVC function of the brain in individuals with MOH using resting-state functional MRI (rs-fMRI) and 3D pseudo-continuous arterial spin labeling (3D PCASL) imaging techniques. Methods: A total of 40 patients with MOH and 32 normal controls (NCs) were recruited, and rs-fMRI and 3D PCASL data were obtained using a 3.0 T MR scanner. Standard preprocessing of the rs-fMRI data was performed to generate images representing regional homogeneity (ReHo), fractional amplitude of low-frequency fluctuation (fALFF), and degree centrality (DC); cerebral blood flow (CBF) images were generated using 3D PCASL sequence data. These functional maps were all normalized into Montreal Neurological Institute (MNI) space, and NVC was subsequently determined on the basis of Pearson correlation coefficients between the rs-fMRI maps (ReHo, fALFF, and DC) and CBF maps. The statistical significance of differences between the MOH and NC groups in terms of NVC in different brain regions was established via Z-test. Further analysis was performed to examine correlations between NVC in the brain regions with NVC dysfunction and clinical variables among patients with MOH. Results: NVC mainly presented a negative correlation in patients with MOH and NCs. No significant difference between the two groups was detected in terms of average NVC over the entire gray matter area. However, several brain regions with significantly decreased NVC in patients with MOH compared to NCs were identified: the left orbital region of the superior frontal gyrus, the bilateral gyrus rectus, and the olfactory cortex (P < 0.05). A correlation analysis revealed that the DC of the brain regions with NVC dysfunction was significantly positively correlated with disease duration (r = 0.323, P = 0.042), and DC-CBF connectivity was negatively correlated with VAS score (r = -0.424, P = 0.035). Conclusion: The current study demonstrated that cerebral NVC dysfunction occurs in patients with MOH, and the NVC technique could function as a new imaging biomarker in headache research.

[MRI Findings of the Uterine Tumors Resembling Ovarian Sex Cord Tumors:Report of Two Cases].

Uterine tumors resembling ovarian sex cord tumors are rarely reported with limited imaging findings.The current study reported two case of uterine tumors resembling ovarian sex cord tumors and described the detailed MRI findings,which would provide valuable imaging evidence for the diagnosis of such tumors.

Cofilin Acts as a Booster for Progression of Malignant Tumors Represented by Glioma.

Cofilin, as a depolymerization factor of actin filaments, has been widely studied. Evidences show that cofilin has a role in actin structural reorganization and dynamic regulation. In recent years, several studies have demonstrated a regulatory role for cofilin in the migration and invasion mediated by cell dynamics and epithelial to mesenchymal transition (EMT)/EMT-like process, apoptosis, radiotherapy resistance, immune escape, and transcriptional dysregulation of malignant tumor cells, particularly glioma cells. On this basis, it is practical to evaluate cofilin as a biomarker for predicting tumor metastasis and prognosis. Targeting cofilin regulating kinases, Lin11, Isl-1 and Mec-3 kinases (LIM kinases/LIMKs) and their major upstream molecules inhibits tumor cell migration and invasion and targeting cofilin-mediated mitochondrial pathway induces apoptosis of tumor cells represent effective options for the development of novel anti-malignant tumor drug, especially anti-glioma drugs. This review explores the structure, general biological function, and regulation of cofilin, with an emphasis on the critical functions and prospects for clinical therapeutic applications of cofilin in malignant tumors represented by glioma.

Regional brain atrophy in patients with chronic ankle instability: A voxel-based morphometry study.

The objective of this study was to investigate whether brain volume changes occur in patients with chronic ankle instability (CAI) using voxel-based morphometry and assessing correlations with clinical tests. Structural magnetic resonance imaging data were prospectively acquired in 24 patients with CAI and 34 healthy controls. CAI symptoms and pain intensity were assessed using the Foot and Ankle Ability Measure (FAAM), Cumberland Ankle Instability Tool (CAIT), American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and visual analog scale (VAS). The gray matter volume (GMV) of each voxel was compared between the two groups while controlling for age, sex, weight, and education level. Correlation analysis was performed to identify associations between abnormal GMV regions and the FAAM score, AOFAS score, VAS score, disease duration, and body mass index. Patients with CAI exhibited reduced GMV in the right precentral and postcentral areas, right parahippocampal area, left thalamus, left parahippocampal area, and left postcentral area compared to that of healthy controls. Furthermore, the right parahippocampal (r = 0.642, p = 0.001), left parahippocampal (r = 0.486, p = 0.016), and left postcentral areas (r = 0.521, p = 0.009) were positively correlated with disease duration. The left thalamus was positively correlated with the CAIT score and FAAM activities of daily living score (r = 0.463, p = 0.023 and r = 0.561, p = 0.004, respectively). A significant positive correlation was found between the local GMV of the right and left parahippocampal areas (r = 0.487, p = 0.016 and r = 0.763, p < 0.001, respectively) and the AOFAS score. Neural plasticity may occur in the precentral and postcentral areas, parahippocampal area, and thalamus in patients with CAI. The patterns of structural reorganization in patients with CAI may provide useful information on the neuropathological mechanisms of CAI.

[Atypical Cystic Meningioma:Report of One Case].

The diagnosis of atypical cystic meningioma is difficult because of the atypical MRI findings.This paper reported a case of atypical cystic meningioma and described the detailed MRI findings,which would provide valuable imaging evidence for the localization and classification of cystic meningioma.

Hypoperfusion in nucleus accumbens in chronic migraine using 3D pseudo-continuous arterial spin labeling imaging MRI.

BACKGROUND: Nucleus accumbens (NAcc) played an important role in pain mediation, and presents changes of neuronal plasticity and functional connectivity. However, less is known about altered perfusion of NAcc in chronic migraine (CM). The aim of this study is to investigate the altered perfusion of the NAcc in CM using a MR three-dimensional pseudo-continuous arterial spin labeling (3D PCASL) imaging. METHODS: Thirteen CM patients and 15 normal controls (NC) were enrolled and underwent 3D PCASL and brain structural imaging. The cerebral blood flow (CBF) images were co-registered with the brain structural images, and the volume and CBF value of NAcc were extracted from the raw brain structural images and co-registered CBF images using an individual NAcc mask, which was obtained from the AAL3 template under transformation by the inverse deformation field generated from the segmentation of the brain structural images. The independent sample t test and receiver operating characteristic (ROC) curve was used to investigate the altered volume and perfusion of the NAcc in CM patients. RESULTS: There was no significant difference for the volume of bilateral NAccs between CM and NC (p > 0.05). CM presented a lower CBF value (49.34 ± 6.09 ml/100 mg/min) compared with that of NC (55.83 ± 6.55 ml/100 mg/min) in left NAcc (p = 0.01), while right NAcc showed no significant difference between CM and NC (p = 0.11). ROC analysis identified that the area under the curve was 0.73 (95CI% 0.53-0.88) with cut-off value 48.63 ml/100 mg/min with sensitivity 50.00% and specificity 93.33%. The correlation analysis found a negative correlation between the CBF value of the left NAcc and VAS score (r = -0.61, p = 0.04). CONCLUSION: Hypoperfusion of the left NAcc was observed in CM, which could be considered as a potential diagnostic imaging biomarker in CM.

Voxel-Based Intraclass Correlation Coefficient to Evaluate the Inter- Scanner Reproducibility of Quantitative Susceptibility Mapping Over the Deep Gray Matter Structure at 3.0T MR.

BACKGROUND: The quantitative susceptibility mapping (QSM) technique can be used to quantitatively evaluate the cerebral iron deposition of the deep gray matter structure (DGM) in clinical practice. However, it could be significantly important to assess the reproducibility of the susceptibility values at different magnetic resonance (MR) scanners before the QSM technique can be widely used in clinical applications. OBJECTIVE: This study aimed to assess the reproducibility of susceptibility value of the deep gray matter structure (DGM) at two different MR systems with the same magnetic strength. METHODS: Raw data of 21 normal subjects (M/F = 7/14, median age 29 (21, 63) years) were acquired from a 3D multi-echo enhanced gradient recalled echo sequence at two different 3.0T MR systems, and STI software was used to reconstruct the magnetic susceptibility images. Brain structural images were used to be coregistered with magnitude images to generate normalized parameters and normalized susceptibility images. Voxel-based intraclass correlation coefficient (VB-ICC) was used to evaluate the reproducibility of susceptibility value of DGM at different 3.0T MR systems. RESULTS: DGM with ICC > 0.75 is located in the bilateral posterior putamen and globus pallidus, bilateral red nuclei, and left dental nucleus. DGM with 0.6 < ICC < 0.75 is mainly located in the bilateral anterior putamen and globus pallidus, the margin of the bilateral red nuclei, right dental nucleus, and the margin of the left dental nucleus. DGM with 0.4 < ICC < 0.6 is located in anterior parts of the bilateral putamen, bilateral globus pallidus and substantia nigra, the margin of the bilateral dental nuclei, and the inferior part of the right dental nucleus. CONCLUSION: DGM presented regional dependent reproducibility of susceptibility value at two different 3.0T MR systems based on VB-ICC analysis.

The increased iron deposition of the gray matter over the whole brain in chronic migraine: An exploratory quantitative susceptibility mapping study.

BACKGROUND: Prior studies identified iron deposition in deep brain nuclei and the periaqueductal gray matter region in chronic migraine, and less is known about the cerebral iron deposition over the whole cerebral gray matter in CM. The aim of this case-control study is to investigate the cerebral iron deposition of gray matter in CM using an advanced quantitative susceptibility mapping. METHODS: A multi-echo gradient echo MR sequence was used to obtain raw quantitative susceptibility mapping data from 12 CM patients and 18 normal controls and the quantitative susceptibility mapping were reconstructed. Three dimensional T1 images were segmented and the gray matter mask was generated to extract the susceptibility value of gray matter over the whole brain. The independent t test and receiver operating characteristic curve Receiver operating characteristics was used to investigate the iron deposition changes in CM patients. RESULTS: CM presented a higher susceptibility value (1.44 × 10-3 ppm) compared with NC group (0.47 × 10-3 ppm) (p < 0.0001) over the whole cerebral gray matter. There was no correlation between susceptibility value and the clinical variables including disease duration, Visual Analog Scale (VAS), Migraine Disability Assessment Scale (MIDAS), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Montreal Cognitive Assessment (MoCA) scores (p > 0.05). ROC analysis demonstrated the susceptibility had a high diagnostic efficacy (AUC 0.949, sensitivity 77.78% and specificity 100%) in distinguishing CM from NC. CONCLUSION: CM patients had increased iron deposition in total cerebral gray matter which could be considered as a potential diagnostic and evaluated imaging biomarker in CM.

The Evaluation of the Maculopathy Using Dynamic Contrast-enhanced MRI in Patients with Proliferative Diabetic Retinopathy.

BACKGROUND: Dynamic Contrast-enhanced Magnetic Resonance Imaging (DCE-MRI) technique could not only quantify blood-retinal barrier (BRB) breakdown leading to macular edema associated with diabetes, but also provide a two-dimensional imaging method that is not interfered by refracting media. OBJECTIVE: The current study was aimed to evaluate the macular change in the patients with diabetic retinopathy using DCE-MRI technique. METHODS: Twenty patients with Diabetic Retinopathy (DR) and 20 Normal Controls (NC) were included. The fast spoiled gradient echo sequence was used to perform dynamic contrast T1WI enhancement on 3.0T MR system. The macular region, optic papila and nasal retina were performed with quantitative DCE-MRI evaluation using Omni-Kinetics software. RESULTS: The maximal concentration, the area under the concentration-time curve (AUCconcentration-time) and maximal slope of macular region were significantly higher in DR [0.270(0.03,1.20)mmol/ 100ml, 2.71(0.04,9.91) mmol*min and 0.38(0.06,3.18) mmol/min, respectively] than that [0.169(0.03,0.72) mmol/1.25(0.13,10.41) mmol*min and 0.245(0.06,1.34) mmol/min] in NC (U value = 515.00 and P value = 0.080, U value = 433.00 and P value = 0.000, and U value = 563.00 and P value = 0.023, respectively). The receiver operating characteristic curve (ROC) analysis demonstrated that the area under AUCconcentration-time was 0.729±0.058 with the cut-off value 1.479 mmol*min (sensitivity 80.00% and specificity 62.50%) for macular region. CONCLUSION: The quantitative DCE-MRI technique could be used to evaluate the maculopathy associated with diabetic retinopathy.

[Papillary Tumor of the Pineal Region:Report of One Case].

We report a case of papillary tumor in the pineal region.The imaging findings mainly included:(1)slight high density on CT images;(2)short T1 signal,cystic changes,and evident enhancement on magnetic resonance imaging.