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1.
Sci Rep ; 4: 6130, 2014 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-25167363

RESUMO

Most people choose to listen to music that they prefer or 'like' such as classical, country or rock. Previous research has focused on how different characteristics of music (i.e., classical versus country) affect the brain. Yet, when listening to preferred music--regardless of the type--people report they often experience personal thoughts and memories. To date, understanding how this occurs in the brain has remained elusive. Using network science methods, we evaluated differences in functional brain connectivity when individuals listened to complete songs. We show that a circuit important for internally-focused thoughts, known as the default mode network, was most connected when listening to preferred music. We also show that listening to a favorite song alters the connectivity between auditory brain areas and the hippocampus, a region responsible for memory and social emotion consolidation. Given that musical preferences are uniquely individualized phenomena and that music can vary in acoustic complexity and the presence or absence of lyrics, the consistency of our results was unexpected. These findings may explain why comparable emotional and mental states can be experienced by people listening to music that differs as widely as Beethoven and Eminem. The neurobiological and neurorehabilitation implications of these results are discussed.


Assuntos
Córtex Auditivo/fisiologia , Música , Estimulação Acústica , Adulto , Atitude , Conectoma , Feminino , Hipocampo/fisiologia , Humanos , Masculino , Adulto Jovem
2.
AJNR Am J Neuroradiol ; 33(3): 556-62, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22116105

RESUMO

BACKGROUND AND PURPOSE: MR perfusion imaging can be used to help predict glial tumor grade and disease progression. Our purpose was to evaluate whether perfusion imaging has a diagnostic or therapeutic impact on clinical management planning in patients with glioma. MATERIALS AND METHODS: Standard MR imaging protocols were interpreted by a group of 3 NRs in consensus, with each case being interpreted twice: first, including routine sequences; and second, with the addition of perfusion imaging. A multidisciplinary team of treating physicians assessed tumor status and created hypothetical management plans, on the basis of clinical presentation and routine MR imaging and then routine MR imaging plus perfusion MR imaging. Physicians' confidence in the tumor status assessment and management plan was measured by using Likert-type items. RESULTS: Fifty-nine consecutive subjects with glial tumors were evaluated; 50 had known pathologic diagnoses. NRs and the treatment team agreed on tumor status in 45/50 cases (κ = 0.81). With the addition of perfusion, confidence in status assessment increased in 20 (40%) for NRs and in 28 (56%) for the treatment team. Of the 59 patient-care episodes, the addition of perfusion was associated with a change in management plan in 5 (8.5%) and an increase in the treatment team's confidence in their management plan in 34 (57.6%). NRs and the treatment team found perfusion useful in most episodes of care and wanted perfusion included in future MR images for >80% of these subjects. CONCLUSIONS: Perfusion imaging appears to have a significant impact on clinical decision-making and subspecialist physicians' confidence in management plans for patients with brain tumor.


Assuntos
Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/terapia , Glioma/patologia , Glioma/terapia , Angiografia por Ressonância Magnética/métodos , Padrões de Prática Médica , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Prognóstico , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Resultado do Tratamento , Adulto Jovem
3.
Clin Neurophysiol ; 123(7): 1383-90, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22153667

RESUMO

OBJECTIVE: To investigate motor cortical map patterns in children with diplegic and hemiplegic cerebral palsy (CP), and the relationships between motor cortical geometry and motor function in CP. METHODS: Transcranial magnetic stimulation (TMS) was used to map motor cortical representations of the first dorsal interosseus (FDI) and tibialis anterior (TA) muscles in 13 children with CP (age 9-16 years, 6 males.) The Gross Motor Function Measure (GMFM) and Melbourne upper extremity function were used to quantify motor ability. RESULTS: In the hemiplegic participants (N = 7), the affected (right) FDI cortical representation was mapped on the ipsilateral (N = 4), contralateral (N = 2), or bilateral (N = 1) cortex. Participants with diplegia (N = 6) showed either bilateral (N = 2) or contralateral (N = 4) cortical hand maps. The FDI and TA motor map center-of-gravity mediolateral location ranged from 2-8 cm and 3-6 cm from the midline, respectively. Among diplegics, more lateral FDI representation locations were associated with lower Melbourne scores, i.e. worse hand motor function (Spearman's rho = -0.841, p = 0.036). CONCLUSIONS: Abnormalities in TMS-derived motor maps cut across the clinical classifications of hemiplegic and diplegic CP. The lateralization of the upper and lower extremity motor representation demonstrates reorganization after insults to the affected hemispheres of both diplegic and hemiplegic children. SIGNIFICANCE: The current study is a step towards defining the relationship between changes in motor maps and functional impairments in CP. These results suggest the need for further work to develop improved classification schemes that integrate clinical, radiologic, and neurophysiologic measures in CP.


Assuntos
Mapeamento Encefálico/métodos , Paralisia Cerebral/fisiopatologia , Avaliação da Deficiência , Vias Eferentes/fisiopatologia , Córtex Motor/fisiopatologia , Estimulação Magnética Transcraniana/métodos , Adolescente , Tornozelo/fisiopatologia , Criança , Potencial Evocado Motor/fisiologia , Feminino , Lateralidade Funcional/fisiologia , Mãos/fisiopatologia , Hemiplegia/fisiopatologia , Humanos , Masculino
4.
AJNR Am J Neuroradiol ; 30(4): 815-20, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19147711

RESUMO

BACKGROUND AND PURPOSE: Tuberous sclerosis presents with characteristic cortical hamartomas and subependymal nodules associated with seizures. The purpose of this study was to use pulsed arterial spin-labeling (PASL) to quantify the perfusion of the cortical hamartomas and correlate the perfusion values with seizure frequency. MATERIALS AND METHODS: A retrospective search yielded 16 MR imaging examinations including conventional MR imaging and PASL perfusion performed in 13 patients (age range, 7 months to 23 years) with a history of tuberous sclerosis. The mean perfusion of each cortical hamartoma greater than 5 mm in size localized with conventional MR imaging sequences was obtained with use of manually drawn regions of interest. Cortical hamartomas were classified as normal, hyperperfused, or hypoperfused on the basis of the mean and SD of the unaffected cortex. Correlation was made between perfusion imaging, conventional imaging, and clinical history. RESULTS: Of the 245 cortical hamartomas, 227 (92.7%) were hypoperfused, 10 (4.1%) were hyperperfused, and 8 (3.3%) were unchanged relative to the mean gray matter. One patient had a subependymal giant cell astrocytoma with a mean perfusion of 93.5 mL/100 g tissue/min. There was a statistically significant positive correlation between seizure frequency and the number of hyperperfused cortical tubers (r = 0.51; n = 16; P = .04), with higher seizure frequency associated with a greater number of hyperperfused cortical tubers. There was no significant correlation, however, between seizure frequency and the overall number of cortical tubers (r = 0.20; n = 16; P = .47). CONCLUSIONS: The PASL technique can assess and quantify the perfusion characteristics of a cortical hamartoma. Most lesions are hypoperfused; however, both normally perfused and hyperperfused lesions occur. The presence of hyperperfused cortical tubers was associated with increased seizure frequency.


Assuntos
Epilepsia/patologia , Imageamento por Ressonância Magnética/métodos , Marcadores de Spin , Esclerose Tuberosa/patologia , Adolescente , Astrocitoma/etiologia , Astrocitoma/patologia , Encefalopatias/complicações , Encefalopatias/patologia , Neoplasias Encefálicas/etiologia , Neoplasias Encefálicas/patologia , Criança , Pré-Escolar , Progressão da Doença , Epilepsia/etiologia , Hamartoma/complicações , Hamartoma/patologia , Humanos , Lactente , Estudos Retrospectivos , Esclerose Tuberosa/complicações , Adulto Jovem
5.
AJNR Am J Neuroradiol ; 30(2): 378-85, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18854443

RESUMO

BACKGROUND AND PURPOSE: The incidence of cerebral hyperperfusion and hypoperfusion, respectively, resulting from hypercapnia and hypocapnia in hospitalized patients is unknown but is likely underrecognized by radiologists and clinicians without routine performance of quantitative perfusion imaging. Our purpose was to report the clinical and perfusion imaging findings in a series of patients confirmed to have hypercapnic cerebral hyperperfusion and hypocapnic hypoperfusion. MATERIALS AND METHODS: Conventional cerebral MR imaging examination was supplemented with arterial spin-labeled (ASL) MR perfusion imaging in 45 patients during a 16-month period at a single institution. Patients presented with an indication of altered mental status, metastasis, or suspected stroke. Images were reviewed and correlated with arterial blood gas (ABG) analysis and clinical history. RESULTS: Patients ranged in age from 1.5 to 85 years. No significant acute findings were identified on conventional MR imaging. Patients with hypercapnia showed global hyperperfusion on ASL cerebral blood flow (CBF) maps, respiratory acidosis on ABG, and diffuse air-space abnormalities on same-day chest radiographs. Regression analysis revealed a significant positive linear relationship between cerebral perfusion and the partial pressure of carbon dioxide (pCO(2); beta, 4.02; t, 11.03; P < .0005), such that rates of cerebral perfusion changed by 4.0 mL/100 g/min for each 1-mm Hg change in pCO(2). CONCLUSIONS: With the inception of ASL as a routine perfusion imaging technique, hypercapnic-associated cerebral hyperperfusion will be recognized more frequently and may provide an alternative cause of unexplained neuropsychiatric symptoms in hospitalized patients. In a similar fashion, hypocapnia may account for a subset of patients with normal MR imaging examinations with poor ASL perfusion signal.


Assuntos
Circulação Cerebrovascular , Hipercapnia/complicações , Hipercapnia/diagnóstico , Hiperemia/diagnóstico , Hiperemia/etiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Encéfalo/irrigação sanguínea , Dióxido de Carbono/sangue , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Modelos Lineares , Imageamento por Ressonância Magnética/métodos , Masculino , Transtornos Mentais/diagnóstico , Transtornos Mentais/etiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Marcadores de Spin , Adulto Jovem
6.
AJNR Am J Neuroradiol ; 29(7): 1302-7, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18451089

RESUMO

BACKGROUND AND PURPOSE: Anoxic brain injury is a devastating result of prolonged hypoxia. The goal of this study was to use arterial spin-labeling (ASL) to characterize the perfusion patterns encountered after anoxic injury to the brain. MATERIALS AND METHODS: Sixteen patients with a history of anoxic or hypoxic-ischemic injury ranging in age from 1.5 to 78.0 years (mean, 50.3 years) were analyzed with conventional MR imaging and pulsed ASL 1.0-13.0 days (mean, 4.6 days) after anoxic insult. The cerebral perfusion in each case was quantified by using pulsed ASL as part of the standard stroke protocol. Correlation was made among perfusion imaging, conventional imaging, clinical history, laboratory values, and outcome. RESULTS: Fifteen of the 16 patients showed marked global hyperperfusion, and 1 patient showed unilateral marked hyperperfusion. Mean gray matter (GM) cerebral blood flow (CBF) in these patients was 142.6 mL/100 g of tissue per minute (ranging from 79.9 to 204.4 mL/100 g of tissue per minute). Global GM CBF was significantly higher in anoxic injury subjects, compared with age-matched control groups with and without infarction (F(2,39) = 63.11; P < .001). Three patients had global hyperperfusion sparing areas of acute infarction. Conventional imaging showed characteristic restricted diffusion in the basal ganglia (n = 10) and cortex (n = 13). Most patients examined died (n = 12), with only 4 patients surviving at the 4-month follow-up. CONCLUSION: Pulsed ASL can dramatically demonstrate and quantify the severity of the cerebral hyperperfusion after a global anoxic injury. The global hyperperfusion probably results from loss of autoregulation of cerebral vascular resistance.


Assuntos
Encéfalo/irrigação sanguínea , Hiperemia/diagnóstico , Hipóxia Encefálica/diagnóstico , Aumento da Imagem/métodos , Processamento de Imagem Assistida por Computador/métodos , Angiografia por Ressonância Magnética/métodos , Adolescente , Adulto , Idoso , Velocidade do Fluxo Sanguíneo/fisiologia , Criança , Pré-Escolar , Dominância Cerebral/fisiologia , Feminino , Parada Cardíaca/complicações , Parada Cardíaca/fisiopatologia , Homeostase/fisiologia , Humanos , Hiperemia/fisiopatologia , Hipóxia Encefálica/etiologia , Hipóxia Encefálica/fisiopatologia , Lactente , Infarto da Artéria Cerebral Média/diagnóstico , Infarto da Artéria Cerebral Média/fisiopatologia , Masculino , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional/fisiologia , Estudos Retrospectivos , Resistência Vascular/fisiologia
7.
AJNR Am J Neuroradiol ; 29(8): 1494-7, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18499796

RESUMO

We present a case series demonstrating abnormal regional cerebral hyperperfusion associated with migraine headache using arterial spin-labeling (ASL). In 3 of 11 patients, regional cortical hyperperfusion was demonstrated during a headache episode that corresponded to previous aura symptoms.


Assuntos
Artérias Cerebrais/patologia , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/diagnóstico , Imageamento por Ressonância Magnética/métodos , Transtornos de Enxaqueca/complicações , Transtornos de Enxaqueca/diagnóstico , Idoso de 80 Anos ou mais , Feminino , Humanos , Pessoa de Meia-Idade , Marcadores de Spin
8.
AJNR Am J Neuroradiol ; 29(8): 1428-35, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18356466

RESUMO

Arterial spin-labeled (ASL) perfusion imaging can be implemented successfully into a routine clinical neuroimaging protocol and can accurately demonstrate alterations in brain perfusion. We have observed patterns of focal, regional, and global hyperperfusion in a wide variety of disease processes. The causes of hyperperfusion at clinical ASL have not been previously characterized. Focal lesions such as brain tumors and vascular malformations with increased perfusion can be well depicted by ASL. More global causes of hyperperfusion, including postanoxia vasodilation and hypercapnia, may go undetected on conventional MR images, whereas the regional hyperperfusion, which may occur in reversible encephalopathies and luxury perfusion, has been consistently illustrated on ASL cerebral blood flow maps at our institution.


Assuntos
Encéfalo/irrigação sanguínea , Encéfalo/patologia , Artérias Cerebrais/patologia , Transtornos Cerebrovasculares/patologia , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Marcadores de Spin
9.
AJNR Am J Neuroradiol ; 29(7): 1235-41, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18356467

RESUMO

Arterial spin-labeling (ASL) is a powerful perfusion imaging technique capable of quickly demonstrating both hypo- and hyperperfusion on a global or localized scale in a wide range of disease states. Knowledge of pathophysiologic changes in blood flow and common artifacts inherent to the sequence allows accurate interpretation of ASL when performed as part of a routine clinical imaging protocol. Patterns of hypoperfusion encountered during routine application of ASL perfusion imaging in a large clinical population have not been described. The objective of this review article is to illustrate our experience with a heterogeneous collection of ASL perfusion cases and describe patterns of hypoperfusion. During a period of 1 year, more than 3000 pulsed ASL procedures were performed as a component of routine clinical brain MR imaging evaluation at both 1.5 and 3T. These images were reviewed with respect to image quality and patterns of hypoperfusion in various normal and disease states.


Assuntos
Isquemia Encefálica/diagnóstico , Encéfalo/irrigação sanguínea , Imagem de Difusão por Ressonância Magnética/métodos , Aumento da Imagem/métodos , Processamento de Imagem Assistida por Computador/métodos , Angiografia por Ressonância Magnética/métodos , Artefatos , Velocidade do Fluxo Sanguíneo/fisiologia , Encefalopatias/diagnóstico , Encefalopatias/etiologia , Encefalopatias/fisiopatologia , Isquemia Encefálica/etiologia , Isquemia Encefálica/fisiopatologia , Diagnóstico Diferencial , Dominância Cerebral/fisiologia , Humanos , Valores de Referência , Fluxo Sanguíneo Regional/fisiologia , Sensibilidade e Especificidade
10.
AJNR Am J Neuroradiol ; 29(7): 1228-34, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18372417

RESUMO

The routine use of arterial spin-labeling (ASL) in a clinical population has led to the depiction of diverse brain pathologic features. Unique challenges in the acquisition, postprocessing, and analysis of cerebral blood flow (CBF) maps are encountered in such a population, and high-quality ASL CBF maps can be generated consistently with attention to quality control and with the use of a dedicated postprocessing pipeline. Familiarity with commonly encountered artifacts can help avoid pitfalls in the interpretation of CBF maps. The purpose of this review was to describe our experience with a heterogeneous collection of ASL perfusion cases with an emphasis on methodology and common artifacts encountered with the technique. In a period of 1 year, more than 3000 pulsed ASL cases were performed as a component of routine clinical brain MR evaluation at both 1.5 and 3T. These ASL studies were analyzed with respect to overall image quality and patterns of perfusion on final gray-scale DICOM images and color Joint Photographic Experts Group (JPEG) CBF maps, and common artifacts and their impact on final image quality were categorized.


Assuntos
Encéfalo/irrigação sanguínea , Aumento da Imagem/métodos , Processamento de Imagem Assistida por Computador/métodos , Angiografia por Ressonância Magnética/métodos , Adolescente , Adulto , Fatores Etários , Artefatos , Velocidade do Fluxo Sanguíneo/fisiologia , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Valores de Referência , Fluxo Sanguíneo Regional/fisiologia , Sensibilidade e Especificidade , Design de Software
11.
J Comput Assist Tomogr ; 25(4): 515-9, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11473179

RESUMO

PURPOSE: As MR scanner hardware has improved, allowing for increased gradient strengths, we are able to generate higher b values for diffusion-weighted (DW) imaging. Our purpose was to evaluate the appearance of the normal brain on DW MR images as the diffusion gradient strength ("b value") is increased from 1,000 to 3,000 s/mm2. METHOD: Three sets of echo planar images were acquired at 1.5 T in 25 normal subjects (mean age 61 years) using progressively increasing strengths of a diffusion-sensitizing gradient (corresponding to b values of 0, 1,000, and 3,000 s/mm2). All other imaging parameters remained constant. Qualitative assessments of trace images were performed by two neuroradiologists, supplemented by quantitative measures of MR signal and noise in eight different anatomic regions. RESULTS: As gradient strength increased from b = 1,000 to 3,000, both gray and white matter structures diminished in signal as expected based on their relative diffusion coefficients [calculated average apparent diffusion coefficient (ADC) values: gray matter = 8.5 x 10(-4) mm2/s, white matter = 7.5 x 10(-4) mm2/s]. The signal-to-noise ratios for the b = 1,000 images were approximately 2.2 times higher than for the b = 3,000 images (p < 0.0001). As the strength of the diffusion-sensitizing gradient increased, white matter became progressively hyperintense to gray matter. Relative to the thalamus, for example, the average MR signal intensity of white matter structures increased by an average of 27.5%, with the densely packed white matter tracts (e.g., middle cerebellar peduncle, tegmentum, and internal capsule) increasing the most. CONCLUSION: Brain DW images obtained at b = 3,000 appear significantly different from those obtained at b = 1,000, reflecting expected loss of signal from all areas of brain in proportion to their ADC values. Consequently, when all other imaging parameters are held constant, b = 3,000 DW images appear significantly noisier than b = 1,000 images, and white matter tracts are significantly more hyperintense than gray matter structures.


Assuntos
Encéfalo/fisiologia , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Encéfalo/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valores de Referência , Sensibilidade e Especificidade
12.
AJNR Am J Neuroradiol ; 21(8): 1388-96, 2000 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-11003269

RESUMO

BACKGROUND AND PURPOSE: Movements of the participant during blood oxygen level-dependent (BOLD) functional MR imaging cerebral activation studies are known to produce occasionally regions of false activation, especially when these movements are relatively large (>3 mm) and highly correlated with the stimulus. We investigated whether minimal (<1 mm), weakly correlated movements in a controlled functional MR imaging model could produce false activation artifacts that could potentially mimic regions of true activation in size, location, and statistical significance. METHODS: A life-size brain phantom was constructed by embedding vials of a dilute carboxylic acid solution within a gadolinium-doped gelatin mold. Imaging was performed at 1.5 T using a 2D spiral sequence (3,000/5 [TR/TE]; flip angle, 88 degrees; matrix, 64 x 64; field of view, 24 cm; section thickness, 5 mm). Controlled, in-plane, submillimeter movements of the phantom were generated using a pneumatic system and were made to correlate with a hypothetical "boxcar" stimulus over the range 0.31 < r < 0.96. Regions of false activation were sought using standard statistical methods (SPM96) that excluded phantom edges and accounted for spatial extent (regions tested at P < .05, corrected for multiple comparisons). A similar experiment was performed on a resting volunteer. RESULTS: The pneumatic system provided motion control with average in-plane displacements and rotations of 0.74 mm and 0.47 degrees, respectively, in the 18 data sets analyzed. No areas of false activation in the phantom were identified for poorly correlated motions (r < 0.52). Above this level, false activations occurred with increasing frequency, scaling in size and number with the degree of motion correlation. For motions with r > 0.67, areas of false activation were seen in every experiment. For a statistical threshold of P = .001, the median number of falsely activated regions was 3.5, with a mean size of 71.7 voxels (approximately 5 cc). Areas of possibly false activation of average size 72.5 voxels resulting from passive motion of the resting human participant were observed in two of four experiments. CONCLUSION: Participant movements of 1 mm or less that are only modestly correlated with a blocked stimulus paradigm can produce appreciable false activation artifacts on BOLD functional MR imaging studies, even when strict image realignment methods are used to prevent them.


Assuntos
Encéfalo/fisiologia , Imageamento por Ressonância Magnética , Oxigênio/sangue , Artefatos , Reações Falso-Positivas , Movimento (Física) , Imagens de Fantasmas
13.
Pediatr Radiol ; 30(1): 33-4, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10663506

RESUMO

BACKGROUND: Enterobacter sakazakii is a rare but important cause of life-threatening neonatal sepsis and meningitis complicated by the development of brain abscess. OBJECTIVE: Given the neurotropic qualities of this organism, early diagnosis and treatment are crucial as a poor prognosis follows brain abscess formation. MATERIALS AND METHODS: Cross-sectional imaging (CT and MRI) play an important role in the diagnostic work-up. CONCLUSION: A biopsy-proven case of E. sakazakii brain abscess, which was diagnosed on MR images, is presented, and the importance of prompt radiologic imaging of the central nervous system in the work-up of patients with this life-threatening disease is discussed.


Assuntos
Abscesso Encefálico/diagnóstico , Enterobacter , Infecções por Enterobacteriaceae/diagnóstico , Biópsia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Feminino , Humanos , Recém-Nascido , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X
14.
AJNR Am J Neuroradiol ; 20(8): 1535-42, 1999 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-10512242

RESUMO

BACKGROUND AND PURPOSE: Echo-planar diffusion-weighted and fluid-attenuated inversion-recovery (FLAIR) imaging have both proved valuable for detecting acute ischemic infarcts, but little is known about the value of diffusion-weighted imaging beyond the acute infarct period. Furthermore, no direct comparison of the techniques has been published. We compared the diagnostic utility of diffusion-weighted, FLAIR, and T2-weighted fast spin-echo (FSE) imaging for detecting cerebral infarctions up to 10 days old. METHODS: FSE, FLAIR, and diffusion-weighted MR sequences were obtained prospectively over a 6-month period in 212 patients with suspected cerebral infarctions. Seventy patients with nonhemorrhagic ischemic infarcts less than 10 days old whose symptoms lasted longer than 48 hours were identified. The three sequences were compared for detectability and conspicuity of abnormalities that correlated with the neurologic deficit. RESULTS: Seventy-two symptomatic infarcts were found in the 70 patients. Diffusion-weighted imaging detected 70 (97%), FLAIR, 69 (96%), and FSE, 64 (89%) of the 72 lesions. Only the difference between diffusion-weighted and FSE imaging approached statistical significance. There was no difference in the number of lesions detected in the patients imaged 48 hours or more after infarction. Lesion conspicuity on diffusion-weighted images was judged superior to that on FSE and FLAIR images in 55 (77%) and 47 (67%) of the cases, respectively. FLAIR images were judged superior to FSE in 34 (48%) of the cases. CONCLUSION: Diffusion-weighted images showed more infarcts than FLAIR and FSE images, and FLAIR images showed more than FSE images, but the differences were not statistically significant. Lesion conspicuity, however, was consistently better on diffusion-weighted images than on either FLAIR or FSE images throughout the 10-day period. Acquisition of diffusion-weighted images in the late acute and subacute periods after ischemic cerebral infarction appears to be beneficial.


Assuntos
Infarto Cerebral/diagnóstico , Imagem Ecoplanar , Aumento da Imagem , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade
15.
Radiology ; 212(2): 333-9, 1999 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10429687

RESUMO

PURPOSE: To quantify the relative contributions of spin density and T2 effects ("shine through") on diffusion-weighted (DW) magnetic resonance (MR) images of acute and subacute cerebral infarction. MATERIALS AND METHODS: In 30 patients, 1.5-T imaging was performed within the first 7 days after onset of cerebral infarction. Estimates of T2, spin density, and apparent diffusion coefficient (ADC) in the region of stroke and contralateral normal brain were computed by means of standard regression techniques after quadruple-echo conventional MR imaging and single-shot echo-planar DW imaging with a maximum b value of 1,000 sec/mm2. Expected signal intensity (S) enhancement ratios resulting from independent changes in T2, spin density, and ADC were then calculated for the DW sequence. RESULTS: The overall SI of cerebral infarction on DW images was significantly higher than that of normal brain throughout the 1st week after stroke (mean relative SI enhancement ratio, 2.29; P < .001). During the first 2 days after stroke, decreased ADC within the stroke region made the dominant contribution to increased SI on DW images. By day 3, increased T2 values in the stroke region became equally important, and, from days 3-7, the contribution to SI from T2 effects became dominant. A slight increase of spin density in the stroke region made a relatively small and constant contribution to DW SI over the 1st week. CONCLUSION: The increased SI of subacute cerebral infarction on DW images reflects not only a shortening of ADC but a prolongation of T2 and spin-density values.


Assuntos
Encéfalo/patologia , Infarto Cerebral/diagnóstico , Imageamento por Ressonância Magnética/métodos , Doença Aguda , Encéfalo/irrigação sanguínea , Imagem Ecoplanar , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
16.
J Comput Assist Tomogr ; 22(5): 792-4, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9754118

RESUMO

We evaluated the relative accuracy of calculating apparent diffusion coefficients (ADCs) of intracranial tissues using a two-point versus a six-point regression technique. Echo planar diffusion-weighted MRI was performed at 1.5 T in three standard locations and in pathologic regions in 10 subjects using gradient strengths corresponding to b values of 1, 100, 200, 500, 800, and 1,000 s/mm2. Estimation of ADCs was made using two methods: a nonlinear regression model using measurements from the full set of b values (six-point technique) and linear estimation using b values of 1 and 1,000 only (two-point technique). A high correlation between the two methods was noted (R2 = 0.999), and the mean percentage difference was 0.84%. These results suggest there is little error in estimating brain ADCs using a two-point technique.


Assuntos
Encéfalo/patologia , Imageamento por Ressonância Magnética/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Neoplasias Encefálicas/diagnóstico , Hemorragia Cerebral/diagnóstico , Infarto Cerebral/diagnóstico , Difusão , Feminino , Hematoma/diagnóstico , Humanos , Imageamento por Ressonância Magnética/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
17.
AJR Am J Roentgenol ; 171(3): 791-5, 1998 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9725318

RESUMO

OBJECTIVE: The objective of this study was to determine the time course of signal intensity changes on diffusion-weighted MR images after cerebral infarction. MATERIALS AND METHODS: Echoplanar diffusion-weighted MR images were obtained at 1.5 T in 212 patients referred for suspected cerebral infarction over a 6-month period. Of those patients, 85 met strict criteria for inclusion in this study: final clinical diagnosis of stroke, reliable timing of clinical ictus by history, and neurologic symptoms persisting longer than 48 hr after onset. Using adjacent or contralateral normal brain for comparison, diffusion-weighted images were visually analyzed retrospectively to evaluate for abnormalities in signal intensity. Because three patients were scanned on two occasions and five patients had two anatomically separable infarctions, 93 reliably dated brain lesions were analyzed. RESULTS: Diffusion-weighted images showed abnormal findings in 13 (100%) of 13 lesions less than 1 day old, 46 (96%) of 48 lesions 1-4 days old, 16 (94%) of 17 lesions 5-9 days old, three (60%) of five lesions 10-14 days old, and zero (0%) of 10 lesions more than 14 days old. CONCLUSION: Abnormal signal intensity was present on all diffusion-weighted MR studies obtained in patients within 24 hr of acute cerebral infarction and in up to 94% of patients scanned during the first 2 weeks after ictus. The percentage of abnormal diffusion studies declined with time, and no signal intensity abnormality was seen in stroke patients scanned more than 2 weeks after symptom onset.


Assuntos
Encéfalo/patologia , Infarto Cerebral/diagnóstico , Imagem Ecoplanar , Idoso , Meios de Contraste , Feminino , Gadolínio DTPA , Humanos , Masculino , Fatores de Tempo
18.
Radiology ; 198(3): 837-43, 1996 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-8628880

RESUMO

PURPOSE: To compare the diagnostic usefulness of three-dimensional (3D) stereotaxic surface projection (SSP) with that of standard transaxial display in brain positron emission tomography (PET) in Alzheimer disease (AD). MATERIALS AND METHODS: Standard transaxial section display and 3D-SSP PET image sets obtained after administration of 2-deoxy-2-[fluorine-18]fluoro-D-glucose in 39 patients with probable AD (aged 53-82 years; 15 men, 24 women) and 40 subjects without AD (aged 21-78 years; 14 men, 26 women) were randomly interpreted. Receiver operating characteristic (ROC) analysis was performed. RESULTS: Diagnostic performance was superior with 3D SSP (Az[section]=0.94,Az[3D SSP]=0.99[Az=area under the ROC curve];P=.043). With 3D SSP, diagnosis of AD was equally good in beginners and experts. The sensitivity and specificity in questionable or mild dementia were 94% and 99% with 3D SSP and 79% and 88% with standard transaxial display. CONCLUSION: Accuracy of detecting AD was improved in PET with 3D SSP.


Assuntos
Doença de Alzheimer/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Processamento de Imagem Assistida por Computador , Técnicas Estereotáxicas , Tomografia Computadorizada de Emissão , Idoso , Idoso de 80 Anos ou mais , Reações Falso-Positivas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Sensibilidade e Especificidade
19.
Poult Sci ; 64(6): 1188-91, 1985 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-4011557

RESUMO

Two distinctly different basal diets were used to test the influence of supplementary ascorbic acid on the occurrence of tibial dyschondroplasia. Addition of either .1 or .25% ascorbic acid to these diets did not alter the occurrence of tibial dyschondroplasia in 25-day-old broiler chickens. However, supplementary ascorbic acid did increase the amounts of ascorbic acid present in blood plasma. Also, individual differences in circulating ascorbic acid were not associated with this disease. Furthermore, two strains of chickens selected for high or low incidence of tibial dyschondroplasia had similar amounts of this vitamin in blood plasma. In contrast to the results reported for the Willow Ptarmigan, ascorbic acid does not appear to be involved in the development of tibial dyschondroplasia in the young broiler chicken.


Assuntos
Ácido Ascórbico/farmacologia , Galinhas , Osteocondrodisplasias/veterinária , Doenças das Aves Domésticas/epidemiologia , Animais , Ácido Ascórbico/administração & dosagem , Ácido Ascórbico/sangue , Peso Corporal , Galinhas/metabolismo , Alimentos Fortificados , Osteocondrodisplasias/epidemiologia , Tíbia
20.
J Anim Sci ; 52(1): 69-74, 1981 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-7016822

RESUMO

Plasma concentrations of glucose, free fatty acids (FFA), insulin and growth hormone (GH) were determined immediately after food removal and then hourly for 24 hours. Blood was sampled from six lean and six obese pigs at 10 weeks of age via indwelling catheters. Plasma glucose decreased but was similar in both pig strains shortly after feed removal; at the end of the 24-hr fast, plasma glucose was higher (P less than .01) in lean pigs. Plasma FFA concentrations were similar in lean and obese pigs and increased five-fold within 24 hr of fasting. Plasma insulin was higher (P less than .05) in obese pigs than in lean pigs immediately after food removal only (21.4 +/- 3.0 vs 9.8 +/- 2.4 microU/ml). Pattern of GH secretion over 24 hr was episodic; average plasma GH was lower in obese pigs than in lean pigs (2.8 +/- .7 vs 9.4 +/- 1.9 ng/ml). In summary, FFA mobilization was similar in lean and obese pigs, GH concentrations were lower in plasma of obese pigs and relative differences in plasma glucose and insulin between pig strains were influenced by time after feed removal.


Assuntos
Jejum , Insulina/sangue , Somatomedinas/sangue , Suínos/metabolismo , Animais , Glicemia/análise , Ácidos Graxos não Esterificados/sangue , Feminino , Obesidade , Suínos/sangue , Suínos/crescimento & desenvolvimento
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