RESUMO
The common marmoset is an essential model for understanding social cognition and neurodegenerative diseases. This study explored the structural and functional brain connectivity in a marmoset under isoflurane anesthesia, aiming to statistically overcome the effects of high inter-individual variability and noise-related confounds such as physiological noise, ensuring robust and reliable data. Similarities and differences in individual subject data, including assessments of functional and structural brain connectivities derived from resting-state functional MRI and diffusion tensor imaging were meticulously captured. The findings highlighted the high consistency of structural neural connections within the species, indicating a stable neural architecture, while functional connectivity under anesthesia displayed considerable variability. Through independent component and dual regression analyses, several distinct brain connectivities were identified, elucidating their characteristics under anesthesia. Insights into the structural and functional features of the marmoset brain from this study affirm its value as a neuroscience research model, promising advancements in the field through fundamental and translational studies.
Assuntos
Anestésicos Inalatórios , Encéfalo , Callithrix , Imagem de Tensor de Difusão , Isoflurano , Imageamento por Ressonância Magnética , Animais , Isoflurano/farmacologia , Anestésicos Inalatórios/farmacologia , Imagem de Tensor de Difusão/métodos , Imageamento por Ressonância Magnética/métodos , Encéfalo/efeitos dos fármacos , Encéfalo/diagnóstico por imagem , Encéfalo/fisiologia , Masculino , Conectoma/métodos , Feminino , Vias Neurais/efeitos dos fármacos , Vias Neurais/fisiologia , Rede Nervosa/efeitos dos fármacos , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/fisiologiaRESUMO
In normal-pressure hydrocephalus, disturbances in cerebrospinal fluid (CSF) circulation occur; therefore, understanding CSF dynamics is crucial. The two-dimensional phase-contrast (2D-PC) method, a common approach for visualizing CSF flow on MRI, often presents challenges owing to prominent vein signals and excessively high contrast, hindering the interpretation of morphological information. Therefore, we devised a new imaging method that utilizes T2-weighted high-signal intensification of the CSF and saturation pulses, without requiring specialized imaging sequences. This sequence utilized a T2-weighted single-shot fast spin-echo combined with multi-phase imaging synchronized with a pulse wave. Optimal imaging conditions (repetition time, presence/absence of fast recovery, and echo time) were determined using self-made contrast and single-plate phantoms to evaluate signal-to-noise ratio, contrast ratio, and spatial resolution. In certain clinical cases of hydrocephalus, confirming CSF flow using 2D-PC was challenging. However, our method enabled the visualization of CSF flow, proving to be useful in understanding the pathophysiology of hydrocephalus.
Assuntos
Líquido Cefalorraquidiano , Imageamento por Ressonância Magnética , Imagens de Fantasmas , Humanos , Líquido Cefalorraquidiano/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Hidrocefalia/diagnóstico por imagem , Hidrocefalia/fisiopatologia , Masculino , Razão Sinal-Ruído , Feminino , Processamento de Imagem Assistida por Computador/métodos , IdosoRESUMO
INTRODUCTION: This study aimed to evaluate the potential of dual-energy computed tomography (CT) to distinguish postoperative ascites, pancreatic fistula, and abscesses. MATERIALS AND METHOD: Patients who underwent biliary and pancreatic surgery performed at our institution between June 2021 and February 2022 were included in the study. Postoperative body fluid samples were collected through a drain or percutaneous drainage. These samples were set in a phantom, and imaging data were obtained using dual-energy CT. Image analysis was performed to obtain CT values at each energy in virtual monoenergetic images (VMIs), effective atomic number, iodine map, and virtual non-contrast (VNC) images. VMIs were calculated from 80 and 140 kVp tube data at 10 kV each from 40-140 kV. Additionally, the effective atomic number, iodine map, and VNC images were reconstructed from the material decomposition process using water and iodine as the base material pair. RESULTS: In this study, 25 patients (eight with abscess and 17 with ascites) were included. No significant association was observed between the presence or absence of abscess and malignancy or surgical procedure. The intervention was performed in six of the eight patients with abscesses. In contrast, five of the 17 patients with postoperative ascites required intervention. A significant relationship was observed between the intervention and the presence of an abscess. Significant differences in C-reactive protein values and the incidence of fever were observed between the groups. Only VNC showed a significant difference between the groups. CONCLUSIONS: VNC using dual-energy CT could differentiate abscesses from postoperative fluid.
RESUMO
PURPOSE: Lower extremity magnetic resonance angiography (MRA) without electrocardiography (ECG) or peripheral pulse unit (PPU) triggering and contrast enhancement is beneficial for diagnosing peripheral arterial disease (PAD) while avoiding synchronization failure and nephrogenic systemic fibrosis. This study aimed to compare the diagnostic performance of turbo spin-echo-based enhanced acceleration-selective arterial spin labeling (eAccASL) (TSE-Acc) of the lower extremities with that of turbo field-echo-based eAccASL (TFE-Acc) and triggered angiography non-contrast enhanced (TRANCE). METHODS: Nine healthy volunteers and a patient with PAD were examined on a 3.0 Tesla magnetic resonance imaging (MRI) system. The artery-to-muscle signal intensity ratio (SIR) and contrast-to-noise ratio (CNR) were calculated. The arterial visibility (1: poor, 4: excellent) and artifact contamination (1: severe, 4: no) were independently assessed by two radiologists. Phase-contrast MRI and digital subtraction angiography were referenced in a patient with PAD. Friedman's test and a post-hoc test according to the Bonferroni-adjusted Wilcoxon signed-rank test were used for the SIR, CNR, and visual assessment. p < 0.05 was considered statistically significant. RESULTS: No significant differences in nearly all the SIRs were observed among the three MRA methods. Higher CNRs were observed with TSE-Acc than those with TFE-Acc (anterior tibial artery, p = 0.014; peroneal artery, p = 0.029; and posterior tibial artery, p = 0.014) in distal arterial segments; however, no significant differences were observed upon comparison with TRANCE (all p > 0.05). The arterial visibility scores exhibited similar trends as the CNRs. The artifact contamination scores with TSE-Acc were significantly lower (but within an acceptable level) compared to those with TFE-Acc. In the patient with PAD, the sluggish peripheral arteries were better visualized using TSE-Acc than those using TFE-Acc, and the collateral and stenosis arteries were better visualized using TSE-Acc than those using TRANCE. CONCLUSION: Peripheral arterial visualization was better with TSE-Acc than that with TFE-Acc in lower extremity MRA without ECG or PPU triggering and contrast enhancement, which was comparable with TRANCE as the reference standard. Furthermore, TSE-Acc may propose satisfactory diagnostic performance for diagnosing PAD in patients with arrhythmia and chronic kidney disease.
Assuntos
Meios de Contraste , Extremidade Inferior , Angiografia por Ressonância Magnética , Doença Arterial Periférica , Marcadores de Spin , Humanos , Angiografia por Ressonância Magnética/métodos , Doença Arterial Periférica/diagnóstico por imagem , Masculino , Feminino , Extremidade Inferior/diagnóstico por imagem , Extremidade Inferior/irrigação sanguínea , Adulto , Pessoa de Meia-Idade , Eletrocardiografia , Idoso , Artefatos , Aumento da Imagem/métodos , Reprodutibilidade dos TestesRESUMO
Using theta burst stimulation (TBS) to induce neural plasticity has played an important role in improving the treatment of neurological disorders. However, the variability of TBS-induced synaptic plasticity in the primary motor cortex prevents its clinical application. Thus, factors associated with this variability should be explored to enable the creation of a predictive model. Statistical approaches, such as regression analysis, have been used to predict the effects of TBS. Machine learning may potentially uncover previously unexplored predictive factors due to its increased capacity for capturing nonlinear changes. In this study, we used our prior dataset (Katagiri et al., 2020) to determine the factors that predict variability in TBS-induced synaptic plasticity in the lower limb motor cortex for both intermittent (iTBS) and continuous (cTBS) TBS using machine learning. Validation of the created model showed an area under the curve (AUC) of 0.85 and 0.69 and positive predictive values of 77.7 and 70.0% for iTBS and cTBS, respectively; the negative predictive value was 75.5% for both patterns. Additionally, the accuracy was 0.76 and 0.72, precision was 0.82 and 0.67, recall was 0.82 and 0.67, and F1 scores were 0.82 and 0.67 for iTBS and cTBS, respectively. The most important predictor of iTBS was the motor evoked potential amplitude, whereas it was the intracortical facilitation for cTBS. Our results provide additional insights into the prediction of the effects of TBS variability according to baseline neurophysiological factors.
RESUMO
Quantitative susceptibility mapping is a magnetic resonance imaging technique that measures brain tissues' magnetic susceptibility, including iron deposition and myelination. This study examines the relationship between subcortical volume and magnetic susceptibility and determines specific differences in these measures among patients with major depressive disorder (MDD), patients with schizophrenia, and healthy controls (HCs). This was a cross-sectional study. Sex- and age- matched patients with MDD (n = 49), patients with schizophrenia (n = 24), and HCs (n = 50) were included. Magnetic resonance imaging was conducted using quantitative susceptibility mapping and T1-weighted imaging to measure subcortical susceptibility and volume. The acquired brain measurements were compared among groups using analyses of variance and post hoc comparisons. Finally, a general linear model examined the susceptibility-volume relationship. Significant group-level differences were found in the magnetic susceptibility of the nucleus accumbens and amygdala (p = 0.045). Post-hoc analyses indicated that the magnetic susceptibility of the nucleus accumbens and amygdala for the MDD group was significantly higher than that for the HC group (p = 0.0054, p = 0.0065, respectively). However, no significant differences in subcortical volume were found between the groups. The general linear model indicated a significant interaction between group and volume for the nucleus accumbens in MDD group but not schizophrenia or HC groups. This study showed susceptibility alterations in the nucleus accumbens and amygdala in MDD patients. A significant relationship was observed between subcortical susceptibility and volume in the MDD group's nucleus accumbens, which indicated abnormalities in myelination and the dopaminergic system related to iron deposition.
Assuntos
Transtorno Depressivo Maior , Esquizofrenia , Humanos , Transtorno Depressivo Maior/patologia , Esquizofrenia/patologia , Estudos Transversais , Encéfalo/patologia , Imageamento por Ressonância Magnética/métodos , FerroRESUMO
Punctate white matter lesions (PWMLs) in infants may be related to neurodevelopmental outcomes based on the location or number of lesions. This study aimed to assess the automatic detectability of PWMLs in infants on deep learning using composite images created from several cases. To create the initial composite images, magnetic resonance (MR) images of two infants with the most PWMLs were used; their PWMLs were extracted and pasted onto MR images of infants without abnormality, creating many composite PWML images. Deep learning models based on a convolutional neural network, You Only Look Once v3 (YOLOv3), were constructed using the training set of 600, 1200, 2400, and 3600 composite images. As a result, a threshold of detection probability of 20% and 30% for all deep learning model sets yielded a relatively high sensitivity for automatic PWML detection (0.908-0.957). Although relatively high false-positive detections occurred with the lower threshold of detection probability, primarily, in the partial volume of the cerebral cortex (≥ 85.8%), those can be easily distinguished from the white matter lesions. Relatively highly sensitive automatic detection of PWMLs was achieved by creating composite images from two cases using deep learning.
Assuntos
Aprendizado Profundo , Substância Branca , Humanos , Lactente , Córtex Cerebral/patologia , Imageamento por Ressonância Magnética/métodos , Probabilidade , Substância Branca/diagnóstico por imagem , Substância Branca/patologiaRESUMO
OBJECTIVE: Brain temperature monitoring using a catheter thermometer has been reported to be a useful technique to predict prognosis in neurosurgery. To investigate the possibility of measuring intracranial cerebrospinal fluid temperature for postoperative monitoring in patients with Moyamoya disease (MMD) after bypass surgery. MATERIALS AND METHODS: This study evaluated fifteen patients with MMD who were indicated for bypass surgery. Diffusion tensor imaging for brain thermometry were performed on a 1.5-T MR scanner. Intracranial cerebrospinal fluid temperature with/without considering the fractional anisotropy component, body temperature, C-reactive protein levels, white blood cell count, and cerebral blood flow measured by 123I-IMP single-photon emission computed tomography were obtained before surgery and 1-3 days after surgery. Pixel values considered to be signal outliers in fractional anisotropy processing were defined as cerebrospinal fluid noise index and calculated. Wilcoxon signed-rank test and effect size were performed to compare the changes before and after revascularization. Spearman's rho correlation coefficient was used to analyze the correlations between each parameter. Statistical significance was defined as p < 0.05. RESULTS: All parameter values became significantly higher compared to those measured before revascularization (p < 0.01 in all cases). The effect sizes were largest for the cerebrospinal fluid temperature with fractional anisotropy processing and for C-reactive protein levels (Rank-biserial correlation = 1.0). The cerebrospinal fluid noise index and cerebrospinal fluid temperatures with fractional anisotropy processing (r = 0.84, p < 0.0001) or without fractional anisotropy processing (r = 0.95, p < 0.0001) showed highly significant positive correlations. Although no significant correlation was observed, cerebrospinal fluid temperatures with fractional anisotropy had small or moderately positive correlations with cerebral blood flow, body temperature, C-reactive protein levels, and white blood cell count (r = 0.37, 0.42, 0.41, and 0.44, respectively; p > 0.05). CONCLUSION: Our findings suggest the possibility of postoperative monitoring for MMD patients by measuring intracranial cerebrospinal fluid temperature with fractional anisotropy processing. Intracranial cerebrospinal fluid temperature might be considered as combined response since cerebrospinal fluid, body temperature, and inflammation are equally correlated.
Assuntos
Imagem de Tensor de Difusão , Doença de Moyamoya , Humanos , Imagem de Tensor de Difusão/métodos , Temperatura , Temperatura Corporal , Proteína C-Reativa , AnisotropiaRESUMO
Arm positions employed during magnetic resonance imaging (MRI) can affect magnetic field distribution, which may result in variability in proton density fat fraction (PDFF) measurements. This study evaluated the effect of arm position on lumbar PDFF measured using chemical-shift-encoded MRI (CSE-MRI). Fifteen healthy volunteers from a single-center underwent lumbar CSE-MRI at two different arm positions (side and elevated) using a single 3T scanner. Scans were performed twice in each position. PDFFs of the L1-L5 vertebrae were independently measured by two readers, and reader measurements were compared by calculating intraclass correlation coefficients (ICC). We compared PDFF measurements from two arm positions and from two consecutive scans using the Wilcoxon test and Bland-Altman analysis. Measurements from the two readers were in high agreement [ICC =0.999; 95% confidence interval (CI), 0.998-0.999]. No significant difference was observed between PDFFs from the first and second scans of all vertebrae for each reader (all P>0.05); however, PDFF for the elevated arm position was significantly higher than that for the side arm position (37.9-44.8% vs. 37.0-43.8%; all P<0.05), except at the L2 level by reader 2. The mean differences in PDFF measurements from the first and second scans [0.1%; 95% limits of agreement (LoA), -1.8% to 1.9%] and from the side arm and elevated arm positions (0.8%; 95% LoA, -1.6% to 3.2%) were small. In conclusion, these preliminary data suggest that different arm positions during CSE-MRI can slightly affect lumbar PDFF; however, the mean absolute differences were very small.
RESUMO
Background: To evaluate the possible clinical use of the compressed sensing-volumetric-interpolated breath-hold examination (CS-VIBE) in patients with liver tumors by evaluating tumor contrast enhancement effect by radiologists. Methods: We examined 22 patients with pathologically confirmed neoplastic lesions in the liver and 62 patients with lesions confirmed by imaging and clinical observation. To evaluate image quality, dynamic contrast-enhanced multiphase breath-hold magnetic resonance imaging was performed. The contrast agent used in this study was gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid. Image quality was assessed by three radiologists experienced in this field. Using a four-point scale, we evaluated the gradual contrast enhancement effect of the portal vein to determine whether a decent arterial phase could be obtained. We assessed interobserver agreement using the Fleiss kappa to evaluate image quality between readers. The detection and evaluation of the tumor itself by its enhancement effects are very important in contrast studies. Thus, we evaluated the contrast enhancement effect of the tumors on a three-point scale in 26 patients already known to have hypervascularized tumors using ultrasound or computed tomography as assessed by experienced radiologists. Results: In terms of contrast enhancement effects of the portal vein, the mean value of the readers was 1.85 in the first phase, 2.07 in the second phase, 2.66 in the third phase, 3.05 in the fourth phase, and 3.24 in the fifth phase. Moreover, the interreader agreement was moderate (kappa 0.400-0.502) for all evaluated scores. In the signal of the portal vein, the score of the second arterial phase increased gradually, and in the third arterial phase, the mean score varied from 2 to 3. Compared with ultrasound or computed tomography, CS-VIBE identified 92.3% tumors with hypervascularized tumors (24 of 26 patients with findings hypervascularized tumors). In the results, the interreader agreement was fair to moderate (kappa 0.414-0.521). Conclusions: We obtained multiphase images, including at least one phase, which are useful for the evaluation of liver tumors. Furthermore, the radiologist was able to detect the tumor as before. Therefore, compressed sensing-volumetric-interpolated breath-hold examination is clinically useful in Ethoxybenzyl liver studies.
RESUMO
To reduce the determination errors of CSF pulsation in diffusion-weighted image (DWI) thermometry, we investigated whether applying second-order motion compensation diffusion tensor imaging (2nd-MC DTI) and fractional anisotropy (FA) processing improves the measurement of intracranial cerebrospinal fluid (CSF) temperature. In a phantom study, we investigated the relationship between temperature and FA in artificial CSF (ACSF) to determine the threshold for FA processing. The calculated temperatures of ACSF were compared with those of water. In a human study, 18 healthy volunteers were scanned using conventional DTI (c-DTI) and 2nd-MC DTI on a 3.0 T magnetic resonance imaging (MRI) system. A temperature map was created using diffusion coefficients from each DWI with/without FA processing. The temperatures of intracranial CSF were compared between each DTI image using Welch's analysis of variance and Games-Howell's multiple comparisons. In the phantom study, FA did not exceed 0.1 at any temperature. Consequently, pixels exceeding the threshold of 0.1 were removed from the temperature map. Intracranial CSF temperatures significantly differed between the four methods (p < 0.0001). The lowest temperature was 2nd-MC DTI with FA processing (mean, 35.62 °C), followed in order by c-DTI with FA processing (mean, 36.16 °C), 2nd-MC DTI (mean, 37.08 °C), and c-DTI (mean, 39.08 °C;p < 0.01 for each). Because the calculated temperature of ACSF was estimated to be lower than that of water, the temperature of 2nd-DTI with FA processing was considered reasonable. The method of 2nd-MC DTI with FA processing enabled determining intracranial CSF temperature with a reduction in CSF pulsation.
Assuntos
Imagem de Difusão por Ressonância Magnética , Imagem de Tensor de Difusão , Anisotropia , Imagem de Difusão por Ressonância Magnética/métodos , Imagem de Tensor de Difusão/métodos , Humanos , Temperatura , ÁguaRESUMO
PURPOSE: To evaluate the influence of arm position on B1 and proton density fat fraction (PDFF) in the liver using chemical shift-encoded magnetic resonance imaging. MATERIALS AND METHODS: Participants were 8 healthy volunteers without liver disease and 36 patients with presumed or proven fatty liver. We assessed two preliminary examinations in healthy subjects, i.e., arm position influence on B1 and the variability of the PDFF between two scans within a short period of time. To verify the changes in PDFF measurement, 36 patients with fatty liver were conducted to compare 2 different arm positions-the elevated arms and side arms positions. The measurement location was based on the Healey & Schroy classification. The Wilcoxon test was used to analyze the difference in B1 in between the elevated arms and side arms positions. The Bland-Altman analysis was used to assess the agreement between two measurements of PDFF: two same scans within a short period of time, and two scans with different arms positions. RESULTS: B1 was significantly different in all segments except for medial segment. The variability of the PDFF between two scans within a short period of time was small in all segments. Some patients had large fluctuations in all segments, although the mean differences in PDFF were small. Upper and lower limits of agreement were 2.064% to 2.871% and - 2.430% to -1.462%, respectively. The relative difference in the rate of PDFF changes as the median (interquartile range [IQR]) in the lateral, medial, anterior, and posterior segments between both the arms positions were 0.0% (9.4), 1.1% (7.3), 1.5% (8.2) and - 0.2% (10.3), respectively. CONCLUSIONS: Arm position can significantly affect B1 and PDFF in the liver. Although the absolute change in PDFF between arm positions was not so large, the difference in arm positions can cause large relative PDFF fluctuations.
Assuntos
Hepatopatia Gordurosa não Alcoólica , Prótons , Humanos , Fígado/diagnóstico por imagem , Imageamento por Ressonância Magnética , Estudos Prospectivos , Reprodutibilidade dos TestesRESUMO
PURPOSE: Enhanced acceleration selective arterial spin labeling (eAccASL) was introduced as non-enhanced and non-gated magnetic resonance angiography (MRA). This technique has not been applied to hand MRA. The objective of this study was to optimize the eAccASL for MRA of the hands and to investigate the factors for MRA visibility of the hands. METHODS: Twenty healthy volunteers were examined on a 1.5 T MR system. To evaluate arterial visualization, we compared four different acceleration-encoding (AENC) values (i.e., 0.12, 0.29, 0.58, and 0.87 m/s2). Image quality score regarding the MRA depiction of the proximal artery (range, 0-10), the distal artery (0-5), and venous contamination (0-5) was evaluated by three radiologists. We measured the peak to peak arterial blood flow velocity (Vpp) measured by phase contrast cine MRI and hand temperature as the factors for arterial visualization. Qualitative scores were compared with Friedman's tests. Spearman's correlation of qualitative scores with Vpp and hand temperature was performed to analyze influencing factors. RESULTS: For the distal arterial depiction, scores at AENC 0.12 (median, 9.0) and AENC 0.29 (8.0) were significantly better (both P < 0.0001) than those at AENC 0.87 (5.5). For the proximal arterial depiction, scores at AENC 0.12 (2.25) and AENC 0.29 (2.0) were significantly better (P < 0.001 and P < 0.01, respectively) than those at AENC 0.87 (1.5). Conversely, venous contamination scores at AENC 0.12 (3.0) and AENC 0.29 (3.0) were significantly worse (both P < 0.0001) than those at AENC 0.87 (4.0). There were significantly negative correlations between venous contamination and Vpp at AENC 0.12 (ρ = -0.56, P = 0.01), and 0.29 (ρ = -0.68, P = 0.001), whereas hand temperatures were not significantly correlated with scores (all P > 0.05). CONCLUSION: eAccASL MRA of the hands was optimized by using low AENC values (0.12-0.29 m/s2). Venous contamination may increase with elevation of arterial blood flow.
Assuntos
Artérias/diagnóstico por imagem , Mãos/diagnóstico por imagem , Angiografia por Ressonância Magnética/métodos , Marcadores de Spin , Aceleração , Adulto , Meios de Contraste , Feminino , Mãos/irrigação sanguínea , Voluntários Saudáveis , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The feasibility of the 3D dynamic improved motion-sensitized driven-equilibrium steady-state free precession (3D dynamic iMSDE SSFP) was evaluated for visualizing CSF motion and the appropriate parameters were determined. Both flow phantom and volunteer studies revealed that linear ordering and the shortest acquisition duration time were optimal. 3D dynamic iMSDE SSFP provides good quality imaging of CSF motion in the whole brain and enables visualization of flow in arbitrary planes from a single 3D volume scan.
Assuntos
Encéfalo/diagnóstico por imagem , Líquido Cefalorraquidiano/diagnóstico por imagem , Imageamento Tridimensional/métodos , Imageamento por Ressonância Magnética/métodos , Humanos , Movimento/fisiologia , Imagens de FantasmasRESUMO
This study aimed to assess the feasibility for applying enhanced acceleration-selective arterial spin labeling (eAccASL) to non-electrocardiogram-gated and non-enhanced peripheral MRA. We compared eAccASL and background suppressed single shot turbo field echo (TFE)-triggered angiography non-contrast-enhanced sequence (BASS TRANCE) required electrocardiographic-gating in eight volunteers and three patients. In the volunteer study, eAccASL demonstrated a comparable arterial visualization compared with BASS TRANCE. In patient observation, the advantages with eAccASL were found in arterial visualization on the collateral vessels and without artifacts affected by arrhythmia events.
Assuntos
Artérias , Angiografia por Ressonância Magnética , Aceleração , Artefatos , Humanos , Imageamento Tridimensional , Marcadores de SpinRESUMO
Background: Superficial siderosis is a progressively disabling disease caused by recurrent subarachnoid hemorrhage with accumulation of hemosiderin in the surface of the central nervous system. Although a wide variety of conditions may cause superficial siderosis, approximately half of the cases are reported to be associated with a defect in the ventral spinal dura mater, in which case treatment entails surgical repair of the defect. Here, we report a case of superficial siderosis and report on our method to pinpoint the dural defect using a combination of magnetic resonance imaging (MRI) techniques. Methods and Results: A 74-year-old female presented suffering from hearing loss and progressive ataxia over a duration of seven years. A T2-weighted MRI study revealed hypointensity in the superficial areas of the central nervous system, leading to the diagnosis of superficial siderosis, and the presence of a fluid-filled collection in the anterior spinal canal of C7 to T10 suggested that a dural defect was the cause of the repeated hemorrhage. A balanced turbo field echo (BTFE) MRI sequence revealed possible dural defects at T1-T2 and T5-T6, and a dynamic improved motion-sensitized driven-equilibrium steady-state free precession (dynamic iMSDE SSFP) sequence revealed an irregular flow of cerebrospinal fluid through the dura at the T5-T6 level. The dural defect was confirmed and sutured through a minimal T5-T6 laminectomy without neurological consequences, and the patient reported mild improvement in gait one year after surgery. Conclusions: A combination of MRI sequences provided the necessary information to confidently perform minimal surgery to repair the dural defect. We recommend coupling a balanced steady-state free precession (SSFP) sequence to provide high resolution, high contrast images of anatomical structures and a dynamic iMSDE SSFP sequence to confirm cerebrospinal fluid motion through the defect.
RESUMO
DWI thermometry is affected by CSF pulsation. To achieve more accurate determination of intraventricular temperature, we compared conventional DWI (c-DWI), acceleration motion compensation DWI (aMC-DWI), and motion compensation DWI (MC-DWI) when using two different b values (commonly used b value [1000 s/mm2] and theoretically optimized b value according to the diffusion coefficient of the CSF [400 s/mm2]). Eight healthy volunteers were scanned using a 3.0-T magnetic resonance (MR) system. The temperature map was created using the diffusion coefficient from DWI with b = 1000 and 400 s/mm2, respectively. The intraventricular temperatures in the lateral ventricles (LV) with less CSF pulsation, and the third ventricle (TV), which has more CSF pulsation, were compared between three techniques using the Friedman test. We measured the body temperature in the axilla to compare it with the intraventricular temperature. With b = 1000 s/mm2, the intraventricular temperatures in TV for c-DWI were significantly higher (43.12 ± 2.86 °C) than those for the aMC-DWI (37.68 ± 1.66 °C; P < 0.05), whereas those in LV were not significantly different (P = 0.093). With b = 400 s/mm2, the intraventricular temperatures in TV for c-DWI (75.07 ± 5.48 °C) were significantly higher than those for the aMC-DWI (38.63 ± 0.92 °C; P < 0.05), whereas those in LV were not significantly different (P = 0.093). aMC-DWI provided an intraventricular temperature that was close to or slightly higher than the body temperature in either condition. However, c-DWI- and MC-DWI-measured temperatures were higher than the body temperature, particularly in the TV. Thus, aMC-DWI can accurately determine the intraventricular temperature.
Assuntos
Ventrículos Cerebrais/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Movimento , Temperatura , Termometria/métodos , Aceleração , Artefatos , Ventrículos Cerebrais/fisiologia , HumanosRESUMO
RATIONALE AND OBJECTIVES: Magnetic resonance thoracic ductography (MRTD) with balanced turbo field echo (bTFE) can visualize both the thoracic duct and its surrounding vessels. This study aimed to investigate the visibility of the terminal thoracic duct into the venous system in the subclavian region using MRTD with bTFE. MATERIALS AND METHODS: MRTD was performed with bTFE as a preoperative workup comprising respiratory gating on a 1.5-T magnetic resonance system for patients with esophageal cancer. The portion and the number of terminal thoracic ducts into the venous system and preterminal branching in the left subclavian region were assessed using MRTD in 132 patients. The confidence level of the visibility using MRTD was also evaluated. RESULTS: The most frequent terminal portion of the thoracic duct was the jugulovenous angle (92 patients, 69.7%), followed by the subclavian vein (27 patients, 20.5%) and the internal jugular vein (8 patients, 6.1%). Four patients also exhibited double entry of the thoracic duct into the venous system. The preterminal branching was single in 96 patients (72.7%) and multiple in 36 patients (27.3%). The confidence level of the visibility of the thoracic duct using MRTD was absolutely certain in 112 patients (84.8%) and was somewhat certain in 20 patients (15.2%). CONCLUSIONS: MRTD with bTFE is a robust imaging modality to visualize the terminal portion of the thoracic duct into the venous system in the subclavian region.
Assuntos
Veias Jugulares/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Veia Subclávia/diagnóstico por imagem , Ducto Torácico/diagnóstico por imagem , Neoplasias Esofágicas/cirurgia , Feminino , Humanos , Imageamento Tridimensional/métodos , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios/métodos , Reprodutibilidade dos TestesRESUMO
PURPOSE: A new sequence for intracranial MRA is developed, named enhanced acceleration-selective arterial spin labeling (eAccASL), to improve main artery visualization at middle cerebral artery (MCA). The aim of this study is to assess the visualization improvement using eAccASL, compared with the previously developed AccASL. METHODS: eAccASL and AccASL were performed in 8 healthy volunteers and images were compared between the 2 sequences. One patient with Moyamoya disease was evaluated by eAccASL and time of flight. For the volunteer images, vessel visualization was assessed by measuring the contrast-to-noise ratio between MCA M1 to M4 and white matter and by counting the peripheral arteries. Venous artifact level was assessed by measuring the contrast-to-noise ratio between the confluence of the sinuses and white matter and by evaluating cortical vein visualization. For the patient images, qualitative assessment of peripheral and collateral vessel visualization was conducted. RESULTS: In the MCA main trunk, higher arterial signal intensity, with reduced flow void, was observed in eAccASL compared with AccASL. Contrast-to-noise ratios of M1 to M3 for eAccASL were significantly higher than those of AccASL. There was no significant difference between AccASL and eAccASL for venous artifact. CONCLUSION: eAccASL could produce better MCA main trunk visualization compared with AccASL, while maintaining good venous signal suppression.
Assuntos
Encéfalo/diagnóstico por imagem , Angiografia por Ressonância Magnética , Artéria Cerebral Média/diagnóstico por imagem , Doença de Moyamoya/diagnóstico por imagem , Marcadores de Spin , Aceleração , Adulto , Artefatos , Meios de Contraste , Voluntários Saudáveis , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Razão Sinal-Ruído , Veias/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Adulto JovemRESUMO
PURPOSE: Signals of some brain regions change along with development in T1-weighted imaging (T1WI) in infants. This study aimed to assess the association of the signal intensity of the pituitary stalk on thin-slice T1WI with infant age. METHODS: This retrospective study was performed in 89 infants (gestational age [GA], 25-41â¯weeks; postmenstrual age [PMA], 36-46â¯weeks; chronological age [CA], 4-141â¯days) without intracranial abnormalities. The signal ratio of the pituitary stalk/pons on thin-slice T1WI was calculated, and its correlations with GA, PMA, and CA were assessed. Additionally, the signal ratio of the anterior pituitary gland/pons was calculated, and its correlation with that of the pituitary stalk was assessed. The signal intensity and distribution of the pituitary stalk were visually rated, and their correlations with GA, PMA, and CA were assessed. RESULTS: The signal ratio of the pituitary stalk was significantly positively correlated with GA (Pâ¯<â¯0.001) and negatively correlated with CA (Pâ¯<â¯0.001), but was not correlated with PMA. Stepwise multiple regression revealed that CA was independently associated with the signal ratio of the pituitary stalk (Pâ¯<â¯0.001). GA was significantly higher (Pâ¯<â¯0.05) and CA was significantly lower (Pâ¯<â¯0.05) in infants with a high signal intensity and wide distribution of high signal intensity of the pituitary stalk. CONCLUSIONS: The signal intensity of the pituitary stalk on T1WI was negatively correlated with CA in infants, which might be related to postnatal changes in the pars tuberalis of the pituitary stalk after birth in infants.