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The development of generic pharmaceuticals involves a bioequivalence study to ensure the therapeutic equivalence of the test formulation to the original innovative product. The formulation characteristics of generic products are expected to be maintained in the long term after approval. This study analyzed the factors contributing to the changes in the dissolution profiles of approved products during their life cycles. Cumulative data on the dissolution similarity of 1675 products of 127 ingredients tested by official laboratories in Japan were assessed according to Japanese bioequivalence guidelines with slight modifications. The products showing dissimilarities in dissolution profiles were analyzed for reporting year, therapeutic category, co-development, physical properties of the active pharmaceutical ingredient (API), and suspected reasons for dissolution change. The increase in the number of dissimilar products is related to the co-development of generic products. Although the solubility of the API was not associated with the dissolution change in the analysis of the total dissolution data, control of the API particle size is suggested to be important for drugs with poorly soluble APIs. Additionally, a risk factor for dissolution changes in the test solutions at a certain pH was the presence of acidic or basic residues. These results indicate the importance of proper development through a thorough evaluation of the formulation and process factors affecting the dissolution properties throughout the product lifecycle.
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Medicamentos Genéricos , Equivalência Terapêutica , Solubilidade , Medicamentos Genéricos/química , JapãoRESUMO
PURPOSE: Phase difference enhanced (PADRE) imaging can enhance myelin density and delineate the superior cerebellar peduncle (SCP). We aimed to determine if SCP atrophy was distinguishable on PADRE imaging and evaluate its diagnostic performance compared with previous MRI progressive supranuclear palsy (PSP) findings. METHODS: Two reviewers measured the SCP widths on PADRE in 20 PSP and 31 Parkinson's disease (PD) patients. The SCP and middle cerebellar peduncle (MCP) widths and the pons and midbrain areas were measured on 3D-T1WI, and the ratio of the area of the pons to the area of the midbrain, the MCP/SCP ratio, and the magnetic resonance parkinsonism index (MRPI) were calculated. We used the Steel-Dwass test to compare PSP, PD, and HS, and receiver operating characteristic curve (ROC) analyses to assess the sensitivity and specificity for diagnosing PSP from PD. A comparison of ROC curves was performed between the SCP on PADRE and these 3D-T1WI parameters. RESULTS: In radiologist 1, the SCP on PADRE in PSP (1.1 ± 0.3 mm) was significantly smaller than those in PD (2.4 ± 0.4 mm) (P < 0.001); the area under the curve (AUC) was 0.97. At a 1.75-mm cutoff value, the diagnostic sensitivity and specificity for differentiating PSP from PD were 93.5% and 100%, respectively. The AUC of the SCP on PADRE was significantly higher than the 3D-T1WI parameters (the SCP, MCP, pons area, MCP/SCP ratio, and MRPI). CONCLUSION: Assessing SCP with PADRE imaging may yield high diagnostic accuracy for discriminating PSP from PD.
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Doença de Parkinson , Transtornos Parkinsonianos , Paralisia Supranuclear Progressiva , Humanos , Doença de Parkinson/diagnóstico por imagem , Doença de Parkinson/patologia , Paralisia Supranuclear Progressiva/diagnóstico por imagem , Paralisia Supranuclear Progressiva/patologia , Sensibilidade e Especificidade , Curva ROC , Imageamento por Ressonância Magnética/métodos , Diagnóstico DiferencialRESUMO
Osmium is defined in the international council for harmonization (ICH-Q3D) guidelines as an element whose concentration can be determined by validated methods including microwave-assisted nitric acid digestion and inductively coupled plasma mass spectrometry. However, microwave digestion using nitric acid is known to result in osmium recoveries higher than the theoretical values in spiked tests because of the formation of highly volatile osmium tetroxide in an oxidation reaction. To stabilize osmium, the addition of thiourea as a complexing agent has been tested and proved its utility. It remains unclear whether other compounds can prevent the over-recovery of osmium. In this study, we investigated four compounds, thiourea, ascorbic acid, sodium sulfite, and potassium metabisulfite, that could reduce the overestimation of osmium isotopes. The minimum amounts of thiourea, ascorbic acid, sodium sulfite, and potassium metabisulfite required to stabilize 10 ng/mL osmium in blank matrix were 1.0, 1.0, 2.5, and 2.5 g/L, respectively. The relative standard deviations obtained from 12 analyses for each stabilization solution were less than 3.3% in thiourea, 12.7% in ascorbic acid, 9.0% in sodium sulfite, and 10.6% in potassium metabisulfite. The stabilization solutions were investigated in a digested tablet matrix and were found to be effective. The impact of adding stabilization solutions on the determination of all ICH-Q3D element concentrations was also evaluated. As stabilization solutions had a small or significant impact on the determination of some elements, it was concluded that osmium determination should be conducted independently.
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Micro-Ondas , Osmio/análise , Concentração de Íons de Hidrogênio , Isótopos , Espectrometria de MassasRESUMO
A polychromatic simultaneous wavelength-dispersive X-ray fluorescence (PS-WDXRF) spectrometer can measure the valence changes of 3d transition metals with high precision in the laboratory. Adjustment and maintenance of the drive mechanism are unnecessary, and high-precision measurements are possible in a short time because the optical system has no moving parts and is compact. We have developed a PS-WDXRF spectrometer with improved analytical precision that can measure simultaneously the valence changes of three main elements, Mn, Co, and Ni, which are used as cathode materials in Li-ion batteries (LIBs). In this study, the analytical precision of the spectrometer is evaluated, and its precision is confirmed with actual battery cathodes. The identification precision of the fluorescent X-ray peak energy is <0.015 eV, and the valence identification precision is obtained to be <0.06. LiNi0.5Co0.2Mn0.3O2 (NCM523)-based LIB cathodes are analyzed under conditions maintaining this precision, and the valence changes of the 3d transition metals in NCM523 during charging and discharging are found to be 0.68 for Ni, 0.19 for Co, and 0.08 for Mn. These results indicate that Ni contributes the most to the redox process in NCM523-based LIBs, Co contributes slightly, and Mn does not contribute.
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BACKGROUND AND PURPOSE: The infantile brain is continuously undergoing development. Non-invasive methods to assess the neurological development of infants are important for the early detection of abnormalities. Some microstructures in the brain have been demonstrated via phase difference-enhanced imaging (PADRE), which may reflect myelin-related microstructures. We aimed to assess the white matter (WM) signal distribution in infants using PADRE and compared it with that using T1-weighted images (T1WI) and diffusion tensor imaging (DTI) on magnetic resonance imaging (MRI). MATERIALS AND METHOD: This study included 18 infants (postmenstrual age at MRI, 37-40 weeks) without abnormal findings on MRI. Signal distribution using T1WI, a fractional anisotropy (FA) map and PADRE was assessed regarding the following intraparenchymal structures: the optic radiation (OR), internal capsule (IC), corpus callosum, corticospinal tract (CST), semiovale center and subcortical regions. RESULTS: We found that the signal distribution was significantly different (P<0.001) with a relatively large signal change found at the IC and CST across the three imaging methods. Signal changes were also greater at the OR and rolandic subcortical WM on PADRE, whereas these were smaller on T1WI and FA. CONCLUSION: PADRE demonstrated a characteristic phase shift distribution in infantile WM, which was different from that observed on T1WI and FA maps, and may demonstrate the developing myelin-related structures. PADRE can be a unique indicator of infantile brain development.
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Encéfalo/diagnóstico por imagem , Aumento da Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Substância Branca/diagnóstico por imagem , Anisotropia , Encéfalo/crescimento & desenvolvimento , Imagem de Tensor de Difusão , Humanos , LactenteRESUMO
Background The white matter in the Heschl's gyrus (HG-WM) may appear differently to the other gyri on phase difference enhanced imaging (PADRE), which can enhance the myelin density. Purpose To evaluate the signal intensity (SI) of HG-WM using the PADRE technique and to compare the images with susceptibility-weighted imaging (SWI)-like images. Material and Methods The participants included 19 normal controls (38 HGs; mean age, 60.1 years; age range, 28-80 years). Coronal PADRE and SWI-like images were acquired using a 3T magnetic resonance (MR) system. The SI of the HG-WM was classified into three grades based on a comparison with the SI of the superior temporal gyrus: Grade 1, isointense; Grade 2, slightly hypointense, and Grade 3, markedly hypointense. Results In the assessment of the SI of the HG-WM, the HG-WM appeared hypointense in all 38 sites of the 19 participants; the hypointensity corresponded to Grade 2 in 13 (34%) images and Grade 3 in 25 (66%) images. On the other hand, the HG-WM was classified as Grade 1 (isointense) in all of the SWI-like images. Conclusion The HG-WM appears hypointense on PADRE, which probably reflects the higher myelin content. PADRE may be useful for identifying the HG through the assessment of the SI of the HG-WM.
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Córtex Auditivo/diagnóstico por imagem , Imageamento por Ressonância Magnética , Substância Branca/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Aumento da Imagem , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
OBJECTIVE: We compared the precentral gyri (PG) on the PADRE of patients with amyotrophic lateral sclerosis (ALS) and healthy subjects (HSs) in order to determine whether it is possible to discriminate between ALS patients and HSs on an individual basis. METHODS: First, two radiologists reviewed the appearance of the normal PG and that of ALS patients on PADRE in a non-blinded manner, and deviations from the appearance of the normal PG were recorded. Next, based on the presence of PG abnormalities on PADRE, we performed an observer performance study using 16 ALS patients and 16 HSs. RESULTS: The radiologists were able to consensually define the PG as abnormal on PADRE when a low-signal-intensity layer was observed in the gray matter of the PG; a three- or four-layer organization (zebra sign) was characterized by the low-signal-intensity layer. The observer performance study demonstrated that the sensitivity, specificity, and accuracy of PG abnormalities on PADRE for discriminating ALS patients from HSs were 94 %, 94 %, and 94 %, respectively, for reviewers 1 and 2. CONCLUSIONS: It was possible to discriminate between ALS patients and HSs based on the presence of PG abnormalities on PADRE, which may reflect upper motor neuron impairment in ALS. KEY POINTS: ⢠PADRE reveals low-signal-intensity layer in the PG of ALS ⢠By PADRE findings on PG, we can discriminate ALS from HSs ⢠PADRE may be a useful method for detecting UMN impairment in ALS.
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Esclerose Lateral Amiotrófica/diagnóstico por imagem , Lobo Frontal/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Idoso , Idoso de 80 Anos ou mais , Animais , Feminino , Substância Cinzenta/diagnóstico por imagem , Humanos , Aumento da Imagem , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
The syn (aR*,5R*) and anti (aS*,5R*) diastereomers of N-benzoyl-C5-substituted-1-benzazepines originating in the chiralities at C5 and the Ar-N(CâO) axis were first stereoselectively synthesized by biasing the conformation with a substituent at C6 and C9, respectively. Detailed examination of the stereochemistry (i.e., conformation and configuration) of these N-benzoyl-1-benzazepines by X-ray crystallographic analysis, VT NMR, and DFT calculations revealed new physicochemical aspects of these heterocycles including revision of the stereochemistry previously reported.
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Background The superficial white matter (SWM), which fills the space between the deep white matter and the cortex, has not been well characterized. Purpose To determine whether the assessment of the relative signal intensity (SI) of the SWM in the precentral and postcentral gyri on phase difference enhanced (PADRE) images contributes in establishing anatomical landmark. Material and Methods The study population consisted of 43 normal subjects (28 women, 15 men; mean age, 52.9 years; age range, 22-90 years). By the consensus of two observers, the precentral gyri, postcentral gyri, and superior frontal cortex (SFC) were identified based on the established anatomical methods. The SI of the SWM in the precentral and postcentral gyri on PADRE images was divided into three grades in comparison with that of the SFC: Grade I, isointense; Grade II, slightly hypointense; and Grade III, markedly hypointense. Results The SWM in the precentral and postcentral gyri showed hypointensity on PADRE images. In the SI analyses of the PADRE images, the Grade I, Grade II, and Grade III appearances were found in one (1%), 20 (23%), and 65 (76%) of the 86 precentral gyri (43 subjects), respectively, and in one (1%), 23 (27%), and 62 (72%) of the 86 postcentral gyri, respectively. Conclusion On PADRE images, the perirolandic SWM showed hypointensity compared to other cerebral cortices, which probably reflects differences in the concentrations of the nerve fibers, as well as the higher myelin content. PADRE may be useful for the identification of the central sulcus by assessing the SI of the SWM.
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Pontos de Referência Anatômicos/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Imagem de Tensor de Difusão/métodos , Interpretação de Imagem Assistida por Computador/métodos , Substância Branca/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Aumento da Imagem/métodos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
The atropisomeric and conformational properties of 1,5-benzodiazepines with an N-sulfonyl (p-tosyl/mesyl) group (IIa/b) were investigated by comparison with those of the N-benzoyl congeners (I). Similar to I, when the Ar-N(SO2) axis was frozen by a C9-substitution in the molecules, IIa/b were separated into the (aR)- and (aS)-atropisomers. The conformation of IIa/b revealed that the substituent (p-tolyl/methyl group) in the sulfonyl moiety occupies the position over the diazepine ring (folded form) in both the solid and solution states [e.g., (+)-(aR)-N-p-tosyl-1,5-benzodiazepin-2-one (IIa-2)], whereas that of I is anti to the diazepine ring [e.g., (-)-(aR)-N-benzoyl-1,5-benzodiazepin-2-one (I-2)], which was further supported by a computational study. The stereochemical stability also differed between the two congeners (e.g., ΔG(): 104 kJ/mol for I-2 and 132 kJ/mol for IIa-2).
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Benzodiazepinas/química , Compostos de Tosil/química , Benzodiazepinas/síntese química , Cristalografia por Raios X , Conformação Molecular , Técnicas de Síntese em Fase Sólida , Estereoisomerismo , Relação Estrutura-Atividade , Compostos de Tosil/síntese químicaRESUMO
OBJECTIVES: To determine whether it is possible to diagnose patients with Parkinson's disease (PD) on an individual basis using magnetic resonance imaging with phase difference enhanced imaging (PADRE). METHODS: PADRE delineated the crural fibres as a layer of low signal intensity and the substantia nigra as a layer of medium signal intensity in a healthy volunteer, and showed a clear boundary between the crural fibres and the substantia nigra (BCS). Twenty-four PD patients and 24 control subjects were enrolled. Contrast ratios between the substantia nigra and occipital white matter were calculated, and two radiologists independently reviewed the PADRE findings regarding BCS obscuration. RESULTS: Mean contrast ratio in PD patients was significantly higher than in control subjects (0.56 vs 0.39, P < 0.01). The BCS on PADRE was obscured significantly more frequently in any subgroups with PD patients compared with control subjects (P < 0.01). The observation of BCS obscuration had a sensitivity, specificity and accuracy for the diagnosis of PD of 92 %, 88 % and 90 % for radiologist 1 and 83 %, 88 % and 85 % for radiologist 2, respectively. CONCLUSION: PADRE is able to identify PD in patients as a loss of delineation between the crural fibres and the substantia nigra on an individual basis.
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Algoritmos , Encéfalo/patologia , Aumento da Imagem/métodos , Interpretação de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Doença de Parkinson/patologia , Idoso , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Oxidation of 1,5-benzothiazepin-4-one (5-A) stereoselectively afforded the S-oxide 8I-A (aS,1S) in preference to the diastereomer 8II-A (aS,1R) affected by the remote stereogenic axis. All the enantiomers (8I-A/8I-B and 8II-A/8II-B) were separated and isolated, and the interconversion between 8I and 8II (equilibrium ratio ≈5:1) was unequivocally verified to be caused by the rotation around the axis.
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Óxidos S-Cíclicos/química , Enxofre/química , Tiazepinas/química , Oxirredução , EstereoisomerismoRESUMO
PURPOSE: While amyloid-ß deposition in the cerebral cortex for Alzheimer's disease (AD) is often evaluated by amyloid positron emission tomography (PET), amyloid-ß-related iron can be detected using phase difference enhanced (PADRE) imaging; however, no study has validated the association between PADRE imaging and amyloid PET. This study investigated whether the degree of hypointense areas on PADRE imaging correlated with the uptake of amyloid PET. METHODS: PADRE imaging and amyloid PET were performed in 8 patients with AD and 10 age-matched normal controls. ROIs in the cuneus, precuneus, superior frontal gyrus (SFG), and superior temporal gyrus (STG) were automatically segmented. The degree of hypointense areas on PADRE imaging in each ROI was evaluated using 4-point scaling of visual assessment or volumetric semiquantitative assessment (the percentage of hypointense volume within each ROI). The mean standardized uptake value ratio (SUVR) of amyloid PET in each ROI was also calculated. The Spearman's correlation coefficient between the 4-point scale of PADRE imaging and SUVR of amyloid PET or between the semiquantitative hypointense volume percentage and SUVR in each ROI was evaluated. RESULTS: In the precuneus, a significant positive correlation was identified between the 4-point scale of PADRE imaging and SUVR of amyloid PET (Rs = 0.5; P = 0.034) in all subjects. In the cuneus, a significant positive correlation was identified between the semiquantitative volume percentage of PADRE imaging and SUVR of amyloid PET (Rs = 0.55; P = 0.02) in all subjects. CONCLUSION: Amyloid-ß-enhancing PADRE imaging can be used to predict the SUVR of amyloid PET, especially in the cuneus and precuneus, and may have the potential to be used for diagnosing AD by detecting amyloid deposition.
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Doença de Alzheimer , Humanos , Doença de Alzheimer/diagnóstico por imagem , Doença de Alzheimer/patologia , Tomografia por Emissão de Pósitrons/métodos , Peptídeos beta-Amiloides/metabolismo , Imageamento por Ressonância Magnética/métodos , Córtex CerebralRESUMO
Visual hallucinations (VH) occur commonly in Lewy body disease (LBD), including Parkinson's disease (PD), PD with dementia, and dementia with Lewy bodies. We aimed to use phase difference enhanced imaging (PADRE) to assess structural abnormalities of optic radiation (OR) in patients with Lewy body disease (LBD) concomitant with VH. Firstly, two radiologists reviewed the OR appearances in healthy subjects (HS) on PADRE. Next, based on the OR abnormalities, two reviewers assessed the PADRE images from 18 HS and 38 and 110 patients with LBD, with and without VH, respectively, in a blinded manner. Finally, all patients with LBD without VH were eventually followed up for at least 5 years after magnetic resonance imaging to determine the appearance of VH. The radiologists identified three layers, namely external sagittal stratum, internal sagittal stratum, and tapetum, in OR on the PADRE in HS. Moreover, they were able to consensually define the OR as abnormal when the layers were obscured and the disappearance of the cranial side. The sensitivity/specificity of abnormal OR for each case was 68%/81% (LBD with VH vs. LBD without VH). Furthermore, VH appeared in 12 of the 21 (57%) patients with LBD and abnormal OR during the follow-up period. However, no patients without abnormal OR reported VH. Patients with LBD and VH demonstrated the abnormal OR. This, in turn, might be a useful marker to distinguish the patients with VH from those without VH and HS. Moreover, abnormal OR on PADRE may precede the appearance of VH in LBD.
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Doença por Corpos de Lewy , Doença de Parkinson , Humanos , Doença por Corpos de Lewy/diagnóstico por imagem , Alucinações/diagnóstico por imagem , Alucinações/complicações , Imageamento por Ressonância Magnética/métodos , Doença de Parkinson/diagnóstico por imagem , Doença de Parkinson/complicações , Atrofia/complicaçõesRESUMO
PURPOSE: This study aimed to evaluate whether quantification of myocardial susceptibility by cardiac magnetic resonance imaging (CMR) can be an imaging biomarker for cardiac amyloidosis (CA). MATERIALS AND METHODS: Twenty-six patients with CA underwent CMR, including magnetic phase imaging with a 3.0-T magnetic resonance imaging scanner. Myocardial susceptibility was quantified as a phase shift slope value by magnetic phase analysis. Those values from patients with CA were compared with corresponding values from 18 controls and 15 healthy volunteers. A univariate logistic regression analysis was conducted to identify significant parameters related to CA. RESULTS: The phase shift slope, a quantitative parameter of myocardial susceptibility, was significantly lower in the CA group compared with the control group and compared with healthy volunteers (p < 0.01). From a total of 17 tested variables, 6 were considered to be significant predictors of CA (p ≤ 0.05) during the univariate analysis. The phase shift slope yielded the best AUC of 0.89 (95% CI = 0.79-0.98) for the prediction of CA (p < 0.01). The phase shift slope was significantly correlated with the end-diastolic thickness of the interventricular septum (r = - 0.39, p < 0.01) and posterior wall of the left ventricle (r = - 0.35, p = 0.02). CONCLUSION: Myocardial susceptibility analysis by CMR helps in the diagnosis of patients with CA and can be a new quantitative imaging biomarker for CA.
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Amiloidose , Cardiomiopatias , Amiloidose/diagnóstico por imagem , Amiloidose/patologia , Biomarcadores , Cardiomiopatias/diagnóstico por imagem , Humanos , Imagem Cinética por Ressonância Magnética/métodos , Miocárdio/patologia , Valor Preditivo dos TestesRESUMO
PURPOSE: Tissue magnetic susceptibility sign can potentially be detected on susceptibility weighted imaging (SWI) phase (SW-P). This study aims to investigate its performance for depicting brain susceptibility structures. METHODS: A simulation was performed to depict magnetic susceptibility structures of various geometries on SW-P and quantitative susceptibility mapping (QSM). Brain MRI was performed on 25 subjects using SWI on a 3 T MRI system. QSM was generated from the same data. SW-P and QSM were analyzed according to radiological assessment for depicting globus pallidus nuclei, optic radiation white matter tracts, and lateral ventricular choroid plexus calcifications. In 11 of these subjects, CT was available and correlated with SW-P and QSM to assess their performance in quantifying calcifications in the choroid plexus. RESULTS: In simulation, the appearance of a sphere on SW-P ranged from centric nodule to mixed positive and negative values as the diameter increased. Large cylinders also appeared as mixed positive and negative values. In comparison, QSM correctly depicted the susceptibility distribution of all magnetic structures. On human brain images, SW-P depicted the globus pallidus and optic radiation with mixed positive and negative values, consistent with simulation, and small choroid plexus calcifications as either mixed positive and negative values or as centric nodules; QSM depicted all structures as solid structures with the expected signs. For measuring calcification in the choroid plexus, QSM vs CT linear regression had a higher coefficient of determination compared to SW-P vs CT and SW-P vs QSM. CONCLUSION: Appearance of susceptibility sources on SW-P changes with object size. This problem can be overcome using QSM.
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Imageamento por Ressonância Magnética , Substância Branca , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Humanos , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: To develop a new tract imaging technique for visualising small fibre tracts of the brainstem and for detecting the abnormalities in multiple system atrophy of the cerebellar type (MSA-C) using a phase difference enhanced (PADRE) imaging technique, in which the phase difference between the target and surrounding tissue is selectively enhanced. METHODS: Two neuroradiologists compared the high-spatial-resolution PADRE imaging, which was acquired from six healthy volunteers, three patients with MSA-C, and 7 patients with other types of neurodegenerative diseases involving the brainstem or cerebellum. RESULTS: Various fine fibre tracts in the brainstem, the superior and inferior cerebellar peduncles, medial lemniscus, spinothalamic tract, medial longitudinal fasciculus, central tegmental tract, corticospinal tract and transverse pontine fibres, were identified on PADRE imaging. PADRE imaging from MSA-C demonstrated the disappearance of transverse pontine fibres and significant atrophy of the inferior cerebellar peduncles, while the superior cerebellar peduncles were intact. PADRE imaging also demonstrated that the transverse pontine fibres and inferior cerebellar peduncle were not involved in the other neurodegenerative diseases. CONCLUSION: PADRE imaging can offer a new form of tract imaging of the brainstem and may have the potential to reinforce the clinical utility of MRI in differentiating MSA from other conditions.
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Tronco Encefálico/patologia , Diagnóstico por Imagem/métodos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Atrofia de Múltiplos Sistemas/diagnóstico , Atrofia de Múltiplos Sistemas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Artefatos , Cerebelo/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Movimento (Física) , Doenças Neurodegenerativas/patologiaRESUMO
We evaluated cerebral gyri (CG) on phase difference enhanced imaging (PADRE) of corticobasal syndrome (CBS), progressive supranuclear palsy (PSP), and Parkinson's disease (PD) patients to determine whether it is possible to discriminate among them on an individual basis. Two radiologists reviewed appearance of the normal CG and that of CBS patients on PADRE, and deviations from the appearance of the normal CG were recorded. Next, based on the CG abnormalities, two other reviewers reviewed PADRE images from 12 CBS, 14 PSP, and 30 PD patients. In healthy subjects on the PADRE images, the signal intensity (SI) of the gray matter (GM) was homogeneously, slightly hyperintense to the subcortical white matter (SCWM), and the SI of the SCWM was homogeneously hypointense. In CBS patients, hypointense layer in superficial GM and disappearance of hypointense in SCWM. The frequency of the abnormal findings on PADRE in the blinded manner by two readers was 100% (12/12), 3% (1/30), and 29% (4/14 in Reader 1) or 36% (5/14 in Reader 2) in CBS PD, and PSP patients, respectively. Laterality of the PADRE findings was showed in 12 (100%) CBS patients and 3 (21%) PSP, but not in any PD patients. The previously reported typical findings in CBS on conventional magnetic resonance image (MRIs) were observed in only 42% (5/12) of CBS patients. In conclusion, the abnormal findings in CG on PADRE appears more useful than conventional MRI findings for discriminating CBS from PD on an individual basis.
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Doença de Parkinson , Paralisia Supranuclear Progressiva , Substância Branca , Córtex Cerebral/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Doença de Parkinson/complicações , Doença de Parkinson/diagnóstico por imagem , Paralisia Supranuclear Progressiva/diagnóstico por imagem , Substância Branca/diagnóstico por imagemRESUMO
Background and objective: Phase difference enhanced imaging (PADRE), a new phase-related MRI technique, can enhance both paramagnetic and diamagnetic substances, and select which phases to be enhanced. Utilizing these characteristics, we developed color map of PADRE (Color PADRE), which enables simultaneous visualization of myelin-rich structures and veins. Our aim was to determine whether Color PADRE is sufficient to delineate the characteristics of non-gadolinium-enhancing T2-hyperintense regions related with metastatic tumors (MTs), diffuse astrocytomas (DAs) and glioblastomas (GBs), and whether it can contribute to the differentiation of MTs from GBs. Methods: Color PADRE images of 11 patients with MTs, nine with DAs and 17 with GBs were created by combining tissue-enhanced, vessel-enhanced and magnitude images of PADRE, and then retrospectively reviewed. First, predominant visibility of superficial white matter and deep medullary veins within non-gadolinium-enhancing T2-hyperintense regions were compared among the three groups. Then, the discriminatory power to differentiate MTs from GBs was assessed using receiver operating characteristic analysis. Results: The degree of visibility of superficial white matter was significantly better in MTs than in GBs (p = 0.017), better in GBs than in DAs (p = 0.014), and better in MTs than in DAs (p = 0.0021). On the contrary, the difference in the visibility of deep medullary veins was not significant (p = 0.065). The area under the receiver operating characteristic curve to discriminate MTs from GBs was 0.76 with a sensitivity of 80% and specificity of 64%. Conclusion: Visibility of superficial white matter on Color PADRE reflects inferred differences in the proportion of vasogenic edema and tumoral infiltration within non-gadolinium-enhancing T2-hyperintense regions of MTs, DAs and GBs. Evaluation of peritumoral areas on Color PADRE can help to distinguish MTs from GBs.
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PURPOSE: Implantation of carmustine wafers (Gliadel) in vivo is accompanied by characteristic serial changes on MRI and CT, such as transient hyperintensity of the wafers on T1-weighted images (T1WIs) and considerable gas accumulation in surgical resection cavities. The purpose of this study was to evaluate intrinsic imaging changes to carmustine wafers in vitro. METHODS: Three phantoms simulating a surgical resection cavity were constructed. Each contained either a carmustine wafer fixed with oxidized regenerated cellulose and fibrin sealant, an unfixed carmustine wafer, or a fixed polyethylene control disk, immersed in phosphate-buffered saline. Image acquisition of the phantoms was performed on MRI and CT until 182 days after construction. The radiological appearances of the object in each phantom were assessed by visual evaluation and quantification of the region of interest. The volume of gas around the objects at 24 h after constructing the phantoms was also measured. RESULTS: The carmustine wafers showed low signal intensities on T1WIs and T2-weighted images (T2WIs), and high densities on CT images at 24 h. The signal intensities and CT densities gradually approximated those of saline over a period of months. However, the carmustine wafers never showed hyperintensity on T1WIs in vitro. The fixed carmustine wafer showed slower radiological changes, as compared to the unfixed wafer. The gas volume around the fixed carmustine wafer was greater than that around the fixed control disk. CONCLUSION: Changes to the carmustine wafers probably reflected penetration of fluid inside and degradation of the hydrophobic matrix. Reported transient hyperintensity of wafers on T1WIs in vivo is regarded as the result of biological reactions, whereas the initial production of gas is considered as an intrinsic characteristic of wafers.