1
|
High-fidelity diffusion tensor imaging of the cervical spinal cord using point-spread-function encoded EPI. Neuroimage 2021; 236:118043. [PMID: 33857617 DOI: 10.1016/j.neuroimage.2021.118043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/16/2021] [Accepted: 03/31/2021] [Indexed: 01/21/2023] Open
Abstract
Diffusion tensor imaging (DTI) of the spinal cord is technically challenging due to the size of its structure and susceptibility-induced field inhomogeneity, which impedes clinical applications. This study aimed to achieve high-fidelity spinal cord DTI with reasonable SNR and practical acquisition efficiency. Particularly, a distortion-free multi-shot EPI technique, namely point-spread-function encoded EPI (PSF-EPI), was adopted for diffusion imaging of the cervical spinal cord (CSC). The shot number can be reduced to six for sagittal scans through titled-CAIPI acceleration and partial Fourier undersampling, consequently rendering this technique beneficial in clinics. Fifteen healthy volunteers and seven patients with metallic implants underwent sagittal scans using tilted-CAIPI PSF-EPI at 3T. Unsuppressed fat signals were further removed by retrospective water/fat separation using the intrinsic chemical-shift encoded signals. Compared with multi-shot interleaved EPI method, highly accelerated PSF-EPI method provided evidently improved distortion reduction and higher consistency with anatomical references even with metallic implants. Additionally, axial DTI scans using PSF-EPI were also evaluated quantitatively, and the measured DTI metrics are similar to those obtained from the zonal oblique multi-slice EPI (ZOOM-EPI) method and reported values. The high anatomical consistency, practical scan time and quantitative reliability indicate PSF-EPI's clinical potential for CSC diffusion imaging.
Collapse
|
2
|
Han X, Ma X, Li D, Wang J, Jiang W, Cheng X, Li G, Guo H, Tian W. The Evaluation and Prediction of Laminoplasty Surgery Outcome in Patients with Degenerative Cervical Myelopathy Using Diffusion Tensor MRI. AJNR Am J Neuroradiol 2020; 41:1745-1753. [PMID: 32816762 DOI: 10.3174/ajnr.a6705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/09/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE DTI has been proved valuable for the diagnosis of degenerative cervical myelopathy, whereas its capacity for predicting the outcome of surgery is still under debate. Here we conduct a prospective cohort study to analyze the capacity of DTI for evaluating and predicting laminoplasty surgery outcome for degenerative cervical myelopathy. MATERIALS AND METHODS We recruited 55 patients with degenerative cervical myelopathy who underwent DTI before surgery and at 3- and 6-month follow-up stages, and 20 healthy subjects. For clinical assessment, the modified Japanese Orthopedic Association scale was recorded for each patient at different stages. DTI metrics were compared between patients before surgery and healthy subjects. Spearman correlation and receiver operating characteristic were used to analyze the evaluation and prediction capacity of DTI for the modified Japanese Orthopedic Association scale, respectively. We analyzed different vertebral levels: maximal compression level, average of all compression levels, and C2 level. RESULTS DTI metrics were significantly different between patients before surgery and healthy subjects. Before surgery, DTI for the maximal compression level or DTI for the average of all compression levels had no significant correlation with the modified Japanese Orthopedic Association scale. For all stages, DTI at the C2 level was correlated with the modified Japanese Orthopedic Association scale. DTI metrics at the C2 level before surgery were significantly correlated with the postoperative modified Japanese Orthopedic Association scale recovery rate. Receiver operating characteristic analysis demonstrated that fractional anisotropy at C2 was capable of predicting the postoperative modified Japanese Orthopedic Association scale recovery rate (P = .04). CONCLUSIONS The DTI metrics before laminoplasty surgery, especially fractional anisotropy at the C2 level, have the potential for evaluating and predicting the degenerative cervical myelopathy surgery outcome.
Collapse
Affiliation(s)
- X Han
- From the Department of Spine Surgery (X.H., D.L., J.W., W.T.), Beijing Jishuitan Hospital, Beijing, China.,Beijing Institute of Traumatology and Orthopaedics (X.H.), Beijing, China
| | - X Ma
- Center for Magnetic Resonance Research (X.M.), University of Minnesota, Minneapolis, Minnesota
| | - D Li
- From the Department of Spine Surgery (X.H., D.L., J.W., W.T.), Beijing Jishuitan Hospital, Beijing, China.,National Center of Gerontology (D.L.), Beijing, China
| | - J Wang
- From the Department of Spine Surgery (X.H., D.L., J.W., W.T.), Beijing Jishuitan Hospital, Beijing, China
| | - W Jiang
- Department of Radiology (W.J., X.C., G.L.), Beijing Jishuitan Hospital, Beijing, China
| | - X Cheng
- Department of Radiology (W.J., X.C., G.L.), Beijing Jishuitan Hospital, Beijing, China
| | - G Li
- Department of Radiology (W.J., X.C., G.L.), Beijing Jishuitan Hospital, Beijing, China
| | - H Guo
- Center for Biomedical Imaging Research (H.F.), Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, China
| | - W Tian
- From the Department of Spine Surgery (X.H., D.L., J.W., W.T.), Beijing Jishuitan Hospital, Beijing, China
| |
Collapse
|
3
|
He Z, Wang N, Kang L, Cui J, Wan Y. Analysis of pathological parameters of cervical spondylotic myelopathy using magnetic resonance imaging. Clin Neurol Neurosurg 2019; 189:105631. [PMID: 31846844 DOI: 10.1016/j.clineuro.2019.105631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/06/2019] [Accepted: 12/06/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Cervical spondylotic myelopathy is a cervical degenerative disease that seriously jeopardizes the physical and mental health of patients. The aim of this study was to use magnetic resonance imaging (MRI) to compare differences in pathological parameters among the healthy group, latent cervical spondylosis (LCS) group, and cervical spondylotic myelopathy (CSM) group. PATIENTS AND METHODS Magnetic resonance imaging (MRI) describes cervical spine changes from the Pavlov ratio of the cervical spinal canal on sagittal T2-weighted images (T2WI), trace value and fractional anisotropy (FA) value of cervical spinal cord on Diffusion tensor images (DTI). In our study, above mentioned parameters were compared among Group A (healthy group), Group B (LCS group) and Group C (CSM group). RESULTS In Pavlov ratio, there were statistical differences on 7 levels of 10 levels between Group A and B, on all levels between Group C and another two groups. On trace value, there was no statistical difference on all levels between Group A and B. There are statistical differences on 7 levels of 10 levels between Group C and another two groups. On FA value, there was also no statistical difference on all levels between Group A and B. There were statistical differences on 3 levels of 10 levels between Group A and C, on 5 levels of 10 levels between Group B and C. The Pearson correlation between trace value and FA value is -0.526 (p = 0). CONCLUSION The MRI scan results showed that there was a significant difference among the three groups for the parameter Pavlovian ratio, but not for the parameter trace value and FA value.
Collapse
Affiliation(s)
- Zhen He
- Graduate School of Tianjin Medical University, Tianjin, 300070, China; Department of Radiology, Tianjin hospital, Tianjin, 300211, China
| | - Nan Wang
- Department of Radiology, Tianjin hospital, Tianjin, 300211, China
| | - Liqing Kang
- Department of Radiology, Cangzhou Central Hospital, Cangzhou, 061000, Hebei, China.
| | - Jiaolong Cui
- The University of Hong Kong, Hong Kong, 999077, China
| | - Yeda Wan
- Department of Radiology, Tianjin hospital, Tianjin, 300211, China
| |
Collapse
|
4
|
Kong H, Wang C, Gao F, Zhang X, Yang M, Yang L, Wang X, Zhang J. Early assessment of acute kidney injury using targeted field of view diffusion-weighted imaging: An in vivo study. Magn Reson Imaging 2018; 57:1-7. [PMID: 30393098 DOI: 10.1016/j.mri.2018.10.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/09/2018] [Accepted: 10/18/2018] [Indexed: 12/24/2022]
Abstract
Acute kidney injury (AKI) is a common complication in various clinical settings. In recent years, AKI diagnostics have been investigated intensively showing the emerging need for early characterization of this disease. To verify whether targeted field-of-view diffusion-weighted imaging (tFOV-DWI) is feasible to significantly improve the performance of traditional full field-of-view diffusion-weighted imaging (fFOV-DWI) in the early assessment of AKI. 14 rabbits with unilateral AKI were induced by injection of microspheres under the guidance of digital subtraction angiography (DSA). All rabbits underwent tFOV-DWI and fFOV-DWI immediately after the surgery. Artifacts, distortion and lesion identification were graded by two experienced radiologists, and the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were measured. Apparent diffusion coefficient (ADC) maps were then derived. Blood samples were collected pre- and post-surgery and serum creatinine weres measured. Renal specimen and biopsy were performed as the reference standard. Student t-test was used to ascertain statistical significance between the above parameters for tFOV-DWI and fFOV-DWI. The interobserver agreement and ADC measurements agreement were assessed. A higher percentage of renal lesions (17 out of 19) were detected in tFOV-DWI compared with fFOV-DWI (14 out of 19). Significant differences were observed in ADC value for both techniques between the lesion regions and normal tissues (p < 0.001). Histological findings were inversely correlated with ADC values of tFOV-DWI (r = -0.97, P < 0.001 for cortex; r = -0.98, P < 0.001 for medulla) and fFOV-DWI sequences (r = -0.95, P < 0.001 for cortex; r = -0.98, P < 0.001 for medulla). Those tFOV-DW images rated by the radiologists exhibit superior performance in terms of all assessed measures (P < 0.05), and interobserver agreement was excellent (ICC, 0.78 to 0.92). Besides, the ADC values derived from tFOV-DWI had a satisfactory agreement with those estimated by fFOV-DWI. The animal study demonstrates that the tFOV-DWI strategy provided visually better image quality and lesion depiction than conventional fFOV-DWI for early assessment of AKI.
Collapse
Affiliation(s)
- Hanjing Kong
- Academy for Advanced Interdisciplinary Studies, Peking University, 100871 Beijing, China
| | - Chengyan Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, 100871 Beijing, China
| | - Fei Gao
- College of Engineering, Peking University, 100871 Beijing, China
| | - Xiaodong Zhang
- Department of Radiology, Peking University First Hospital, 100034 Beijing, China
| | - Min Yang
- Department of Interventional Radiology and Vascular Surgery, 100034 Beijing, China
| | - Li Yang
- Renal Division, Peking University First Hospital, 100034 Beijing, China
| | - Xiaoying Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, 100871 Beijing, China; Department of Radiology, Peking University First Hospital, 100034 Beijing, China.
| | - Jue Zhang
- Academy for Advanced Interdisciplinary Studies, Peking University, 100871 Beijing, China; College of Engineering, Peking University, 100871 Beijing, China.
| |
Collapse
|
5
|
Mohamed FF, Almassry HN, Ismail AM. What can be achieved by using MR-DWI and ADC value in cases of intramedullary spinal cord lesions of non-traumatic causes? THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2018. [DOI: 10.1016/j.ejrnm.2018.03.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
|
6
|
Thapa B, Sapkota N, Lee Y, Jeong K, Rose J, Shah LM, Bisson E, Jeong EK. Ultra-high-b radial diffusion-weighted imaging (UHb-rDWI) of human cervical spinal cord. J Magn Reson Imaging 2018; 49:204-211. [PMID: 29707845 DOI: 10.1002/jmri.26169] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 04/05/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Injury in the cervical spinal cord (CSC) can lead to varying degrees of neurologic deficit and persistent disability. Diffusion tensor imaging (DTI) is a promising method to evaluate white matter integrity and pathology. However, the conventional DTI results are limited with respect to the specific details of neuropathology and microstructural architecture. In this study we used ultrahigh-b radial-DWI (UHb-rDWI) with b-values ranging from 0 to ∼7500 s/mm2 and calculated decay constant (DH ) at the high b-values, which gives much deeper insight about the microscopic environment of CSC white matter. PURPOSE To evaluate a novel diffusion MRI, UHb-rDWI technique for imaging of the CSC. STUDY TYPE Longitudinal. SUBJECTS Four healthy controls, each scanned twice. FIELD STRENGTH/SEQUENCE 3T/2D single shot diffusion-weighted stimulated echo planar imaging with reduced field of view. ASSESSMENT The signal from each pixel of b0 (b = 0) and b-value (b ≠ 0) images were fitted to a biexponential function and normalized. The signal-b curve is obtained by dividing the latter curve by the former. DH was obtained from the curve at b >4000 s/mm2 . A Monte-Carlo Simulation (MCS) was performed to investigate how DH changes upon the increased water-exchange at the CSC. RESULTS The signal-b curves plotted at multiple levels of healthy CSC are almost identical on two successive scans and show a biexponential decay behavior: fast exponential decay at lower b-values and much slower decay at UHb-values. The mean values of DH were measured as (0.0607 ± 0.02531) ×10-3 and (0.0357 ± 0.02072) ×10-3 s/mm2 at the lateral funiculus and posterior column, respectively. MCS of diffusion MRI shows that the DH is elevated by increased water exchange between the intra- and extraaxonal spaces. DATA CONCLUSION UHb-rDWI signal-b plots of the normal CSC were highly reproducible on successive scans and their biexponential decay behavior can be used to characterize normal spinal white matter. LEVEL OF EVIDENCE 2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2019;49:204-211.
Collapse
Affiliation(s)
- Bijaya Thapa
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA.,Department of Physics and Astronomy, University of Utah, Salt Lake City, Utah, USA
| | - Nabraj Sapkota
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA.,Department of Physics and Astronomy, University of Utah, Salt Lake City, Utah, USA
| | - YouJung Lee
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA
| | - Kyle Jeong
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA.,Department of Bioengineering, University of Utah, Salt Lake City, Utah, USA
| | | | - Lubdha M Shah
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Erica Bisson
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA
| | - Eun-Kee Jeong
- Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, Utah, USA.,Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| |
Collapse
|
7
|
Crombe A, Alberti N, Hiba B, Uettwiller M, Dousset V, Tourdias T. Cervical Spinal Cord DTI Is Improved by Reduced FOV with Specific Balance between the Number of Diffusion Gradient Directions and Averages. AJNR Am J Neuroradiol 2016; 37:2163-2170. [PMID: 27365330 DOI: 10.3174/ajnr.a4850] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/25/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Reduced-FOV DTI is promising for exploring the cervical spinal cord, but the optimal set of parameters needs to be clarified. We hypothesized that the number of excitations should be favored over the number of diffusion gradient directions regarding the strong orientation of the cord in a single rostrocaudal axis. MATERIALS AND METHODS Fifteen healthy individuals underwent cervical spinal cord MR imaging at 3T, including an anatomic 3D-Multi-Echo Recombined Gradient Echo, high-resolution full-FOV DTI with a NEX of 3 and 20 diffusion gradient directions and 5 sets of reduced-FOV DTIs differently balanced in terms of NEX/number of diffusion gradient directions: (NEX/number of diffusion gradient directions = 3/20, 5/16, 7/12, 9/9, and 12/6). Each DTI sequence lasted 4 minutes 30 seconds, an acceptable duration, to cover C1-C4 in the axial plane. Fractional anisotropy maps and tractograms were reconstructed. Qualitatively, 2 radiologists rated the DTI sets blinded to the sequence. Quantitatively, we compared distortions, SNR, variance of fractional anisotropy values, and numbers of detected fibers. RESULTS Qualitatively, reduced-FOV DTI sequences with a NEX of ≥5 were significantly better rated than the full-FOV DTI and the reduced-FOV DTI with low NEX (N = 3) and a high number of diffusion gradient directions (D = 20). Quantitatively, the best trade-off was reached by the reduced-FOV DTI with a NEX of 9 and 9 diffusion gradient directions, which provided significantly fewer artifacts, higher SNR on trace at b = 750 s/mm2 and an increased number of fibers tracked while maintaining similar fractional anisotropy values and dispersion. CONCLUSIONS Optimized reduced-FOV DTI improves spinal cord imaging. The best compromise was obtained with a NEX of 9 and 9 diffusion gradient directions, which emphasizes the need for increasing the NEX at the expense of the number of diffusion gradient directions for spinal cord DTI contrary to brain DTI.
Collapse
Affiliation(s)
- A Crombe
- From the Centre Hospitalier Universitaire de Bordeaux (A.C., V.D., T.T.), Service de NeuroImagerie Diagnostique de Thérapeutique, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale U1215 (A.C., V.D., T.T.), Physiopathologie de la Plasticité Neuronale, Bordeaux, France
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
| | - N Alberti
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
- Centre de Résonance Magnétique des Systèmes Biologiques (N.A., B.H.), Centre National de la Recherche Scientifique Unité Mixte de Recherche 5536, Bordeaux, France
| | - B Hiba
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
- Centre de Résonance Magnétique des Systèmes Biologiques (N.A., B.H.), Centre National de la Recherche Scientifique Unité Mixte de Recherche 5536, Bordeaux, France
- Institut de Neurosciences Cognitives et Intégratives d'Aquitaine (B.H.), Centre National de la Recherche Scientifique Unité Mixte de Recherche 5287, Bordeaux, France
| | - M Uettwiller
- GE Healthcare (M.U.), Vélizy-Villacoublay, France
| | - V Dousset
- From the Centre Hospitalier Universitaire de Bordeaux (A.C., V.D., T.T.), Service de NeuroImagerie Diagnostique de Thérapeutique, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale U1215 (A.C., V.D., T.T.), Physiopathologie de la Plasticité Neuronale, Bordeaux, France
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
| | - T Tourdias
- From the Centre Hospitalier Universitaire de Bordeaux (A.C., V.D., T.T.), Service de NeuroImagerie Diagnostique de Thérapeutique, Bordeaux, France
- Institut National de la Santé et de la Recherche Médicale U1215 (A.C., V.D., T.T.), Physiopathologie de la Plasticité Neuronale, Bordeaux, France
- Institut de Bio-Imagerie de Bordeaux (A.C., N.A., B.H., V.D., T.T.), Université de Bordeaux, Bordeaux, France
| |
Collapse
|
8
|
Lee S, Lee YH, Chung TS, Jeong EK, Kim S, Yoo YH, Kim IS, Yoon CS, Suh JS, Park JH. Accuracy of Diffusion Tensor Imaging for Diagnosing Cervical Spondylotic Myelopathy in Patients Showing Spinal Cord Compression. Korean J Radiol 2015; 16:1303-12. [PMID: 26576120 PMCID: PMC4644752 DOI: 10.3348/kjr.2015.16.6.1303] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 07/21/2015] [Indexed: 11/15/2022] Open
Abstract
Objective To assess the performance of diffusion tensor imaging (DTI) for the diagnosis of cervical spondylotic myelopathy (CSM) in patients with deformed spinal cord but otherwise unremarkable conventional magnetic resonance imaging (MRI) findings. Materials and Methods A total of 33 patients who underwent MRI of the cervical spine including DTI using two-dimensional single-shot interleaved multi-section inner volume diffusion-weighted echo-planar imaging and whose spinal cords were deformed but showed no signal changes on conventional MRI were the subjects of this study. Mean diffusivity (MD), longitudinal diffusivity (LD), radial diffusivity (RD), and fractional anisotropy (FA) were measured at the most stenotic level. The calculated performance of MD, FA, MD∩FA (considered positive when both the MD and FA results were positive), LD∩FA (considered positive when both the LD and FA results were positive), and RD∩FA (considered positive when both the RD and FA results were positive) in diagnosing CSM were compared with each other based on the estimated cut-off values of MD, LD, RD, and FA from receiver operating characteristic curve analysis with the clinical diagnosis of CSM from medical records as the reference standard. Results The MD, LD, and RD cut-off values were 1.079 × 10-3, 1.719 × 10-3, and 0.749 × 10-3 mm2/sec, respectively, and that of FA was 0.475. Sensitivity, specificity, positive predictive value and negative predictive value were: 100 (4/4), 44.8 (13/29), 20 (4/20), and 100 (13/13) for MD; 100 (4/4), 27.6 (8/29), 16 (4/25), and 100 (8/8) for FA; 100 (4/4), 58.6 (17/29), 25 (4/16), and 100 (17/17) for MD∩FA; 100 (4/4), 68.9 (20/29), 30.8 (4/13), and 100 (20/20) for LD∩FA; and 75 (3/4), 68.9 (20/29), 25 (3/12), and 95.2 (20/21) for RD∩FA in percentage value. Diagnostic performance comparisons revealed significant differences only in specificity between FA and MD∩FA (p = 0.003), FA and LD∩FA (p < 0.001), FA and RD∩FA (p < 0.001), MD and LD∩FA (p = 0.024) and MD and RD∩FA (p = 0.024). Conclusion Fractional anisotropy combined with MD, RD, or LD is expected to be more useful than FA and MD for diagnosing CSM in patients who show deformed spinal cords without signal changes on MRI.
Collapse
Affiliation(s)
- Seungbo Lee
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Young Han Lee
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Tae-Sub Chung
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Eun-Kee Jeong
- Department of Radiology, Utah Center for Advanced Imaging Research, University of Utah, Salt Lake City, UT 84112, USA
| | - Sungjun Kim
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Yeon Hwa Yoo
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | | | - Choon-Sik Yoon
- Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| | - Jin-Suck Suh
- Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Jung Hyun Park
- Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea
| |
Collapse
|
9
|
Role of Diffusion Tensor MR Imaging in Degenerative Cervical Spine Disease: a Review of the Literature. Clin Neuroradiol 2015; 26:265-76. [DOI: 10.1007/s00062-015-0467-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 09/10/2015] [Indexed: 12/13/2022]
|
10
|
Duval T, McNab JA, Setsompop K, Witzel T, Schneider T, Huang SY, Keil B, Klawiter EC, Wald LL, Cohen-Adad J. In vivo mapping of human spinal cord microstructure at 300mT/m. Neuroimage 2015; 118:494-507. [PMID: 26095093 DOI: 10.1016/j.neuroimage.2015.06.038] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 05/27/2015] [Accepted: 06/11/2015] [Indexed: 11/19/2022] Open
Abstract
The ability to characterize white matter microstructure non-invasively has important applications for the diagnosis and follow-up of several neurological diseases. There exists a family of diffusion MRI techniques, such as AxCaliber, that provide indices of axon microstructure, such as axon diameter and density. However, to obtain accurate measurements of axons with small diameters (<5μm), these techniques require strong gradients, i.e. an order of magnitude higher than the 40-80mT/m currently available in clinical systems. In this study we acquired AxCaliber diffusion data at a variety of different q-values and diffusion times in the spinal cord of five healthy subjects using a 300mT/m whole body gradient system. Acquisition and processing were optimized using state-of-the-art methods (e.g., 64-channel coil, template-based analysis). Results consistently show an average axon diameter of 4.5+/-1.1μm in the spinal cord white matter. Diameters ranged from 3.0μm (gracilis) to 5.9μm (spinocerebellar tracts). Values were similar across laterality (left-right), but statistically different across spinal cord pathways (p<10(-5)). The observed trends are similar to those observed in animal histology. This study shows, for the first time, in vivo mapping of axon diameter in the spinal cord at 300mT/m, thus creating opportunities for applications in spinal cord diseases.
Collapse
Affiliation(s)
- Tanguy Duval
- Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada
| | - Jennifer A McNab
- Department of Radiology, Stanford University, Stanford, CA, United States
| | - Kawin Setsompop
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Thomas Witzel
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Torben Schneider
- NMR Research Unit, Department of Neuroinflammation, Queen Square MS Centre, UCL Institute of Neurology, London, London, United Kingdom
| | - Susie Yi Huang
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Boris Keil
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Eric C Klawiter
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Lawrence L Wald
- A.A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, United States
| | - Julien Cohen-Adad
- Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, QC, Canada; Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, QC, Canada.
| |
Collapse
|
11
|
Diffusion tensor imaging focusing on lower cervical spinal cord using 2D reduced FOV interleaved multislice single-shot diffusion-weighted echo-planar imaging: comparison with conventional single-shot diffusion-weighted echo-planar imaging. Magn Reson Imaging 2015; 33:401-6. [DOI: 10.1016/j.mri.2015.01.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 09/16/2014] [Accepted: 01/10/2015] [Indexed: 11/19/2022]
|
12
|
Guan X, Fan G, Wu X, Gu G, Gu X, Zhang H, He S. Diffusion tensor imaging studies of cervical spondylotic myelopathy: a systemic review and meta-analysis. PLoS One 2015; 10:e0117707. [PMID: 25671624 PMCID: PMC4363894 DOI: 10.1371/journal.pone.0117707] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 12/30/2014] [Indexed: 11/19/2022] Open
Abstract
A meta-analysis was conducted to assess alterations in measures of diffusion tensor imaging (DTI) in the patients of cervical spondylotic myelopathy (CSM), exploring the potential role of DTI as a diagnosis biomarker. A systematic search of all related studies written in English was conducted using PubMed, Web of Science, EMBASE, CINAHL, and Cochrane comparing CSM patients with healthy controls. Key details for each study regarding participants, imaging techniques, and results were extracted. DTI measurements, such as fractional anisotropy (FA), apparent diffusion coefficient (ADC), and mean diffusivity (MD) were pooled to calculate the effect size (ES) by fixed or random effects meta-analysis. 14 studies involving 479 CSM patients and 278 controls were identified. Meta-analysis of the most compressed levels (MCL) of CSM patients demonstrated that FA was significantly reduced (ES -1.52, 95% CI -1.87 to -1.16, P < 0.001) and ADC was significantly increased (ES 1.09, 95% CI 0.89 to 1.28, P < 0.001). In addition, a notable ES was found for lowered FA at C2-C3 for CSM vs. controls (ES -0.83, 95% CI -1.09 to -0.570, P < 0.001). Meta-regression analysis revealed that male ratio of CSM patients had a significant effect on reduction of FA at MCL (P = 0.03). The meta-analysis of DTI studies of CSM patients clearly demonstrated a significant FA reduction and ADC increase compared with healthy subjects. This result supports the use of DTI parameters in differentiating CSM patients from health subjects. Future researches are required to investigate the diagnosis performance of DTI in cervical spondylotic myelopathy.
Collapse
Affiliation(s)
- Xiaofei Guan
- Department of Orthopedics, Shanghai Tenth People’s
Hospital, Tongji University School of Medicine, Shanghai,
China
| | - Guoxin Fan
- Department of Orthopedics, Shanghai Tenth People’s
Hospital, Tongji University School of Medicine, Shanghai,
China
| | - Xinbo Wu
- Department of Orthopedics, Shanghai Tenth People’s
Hospital, Tongji University School of Medicine, Shanghai,
China
| | - Guangfei Gu
- Department of Orthopedics, Shanghai Tenth People’s
Hospital, Tongji University School of Medicine, Shanghai,
China
| | - Xin Gu
- Department of Orthopedics, Shanghai Tenth People’s
Hospital, Tongji University School of Medicine, Shanghai,
China
| | - Hailong Zhang
- Department of Orthopedics, Shanghai Tenth People’s
Hospital, Tongji University School of Medicine, Shanghai,
China
| | - Shisheng He
- Department of Orthopedics, Shanghai Tenth People’s
Hospital, Tongji University School of Medicine, Shanghai,
China
| |
Collapse
|
13
|
Lin E, Long H, Li G, Lei W. Does diffusion tensor data reflect pathological changes in the spinal cord with chronic injury. Neural Regen Res 2014; 8:3382-90. [PMID: 25206660 PMCID: PMC4146007 DOI: 10.3969/j.issn.1673-5374.2013.36.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 11/17/2013] [Indexed: 11/29/2022] Open
Abstract
Magnetic resonance diffusion tensor imaging has been shown to quantitatively measure the early pathological changes in chronic cervical spondylotic myelopathy. In this study, a novel spongy polyurethane material was implanted in the rat C3–5 epidural space to establish a rat model of chronic cervical spondylotic myelopathy. Diffusion tensor data were used to predict pathological changes. Results revealed that the fractional anisotropy value gradually decreased at 4, 24, and 72 hours and 1 week after injury in rat spinal cord, showing a time-dependent manner. Average diffusion coefficient increased at 72 hours and 1 week after implantation. Hematoxylin-eosin staining and Luxol-fast-blue staining exhibited that the number of neurons in the anterior horn of the spinal cord gray matter and the nerve fiber density of the white matter gradually reduced with prolonged compression time. Neuronal loss was most significant at 1 week after injury. Results verified that the fractional anisotropy value and average diffusion coefficient reflected the degree of pathological change in the site of compression in rat models at various time points after chronic spinal cord compression injury, which potentially has a reference value in the early diagnosis of chronic cervical spondylotic myelopathy.
Collapse
Affiliation(s)
- Erjian Lin
- Department of Radiology, the Eastern Hospital of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, Guangdong Province, China
| | - Houqing Long
- Department of Spinal Surgery, Huangpu Branch, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510700, Guangdong Province, China
| | - Guangsheng Li
- Department of Orthopedics, Affiliated Hospital of Guangdong Medical College, Zhanjiang 524001, Guangdong Province, China
| | - Wanlong Lei
- Department of Human Anatomy and Histoembryology, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510086, Guangdong Province, China
| |
Collapse
|
14
|
Gangadharan J, Sharath Kumar G, Prasad C, Somanna S, Devi BI. Can diffusion tensor imaging predict outcome in acute traumatic deterioration of degenerative cervical spine disease. INDIAN JOURNAL OF NEUROTRAUMA 2013. [DOI: 10.1016/j.ijnt.2013.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
15
|
Abstract
We describe a cardiac gated high in-plane resolution axial human cervical spinal cord diffusion tensor imaging (DTI) protocol. Multiple steps were taken to optimize both image acquisition and image processing. The former includes slice-by-slice cardiac triggering and individually tiltable slices. The latter includes (i) iterative 2D retrospective motion correction, (ii) image intensity outlier detection to minimize the influence of physiological noise, (iii) a non-linear DTI estimation procedure incorporating non-negative eigenvalue priors, and (iv) tract-specific region-of-interest (ROI) identification based on an objective geometry reference. Using these strategies in combination, radial diffusivity (λ(⊥)) was reproducibly measured in white matter (WM) tracts (adjusted mean [95% confidence interval]=0.25 [0.22, 0.29] μm(2)/ms), lower than previously reported λ(⊥) values in the in vivo human spinal cord DTI literature. Radial diffusivity and fractional anisotropy (FA) measured in WM varied from rostral to caudal as did mean translational motion, likely reflecting respiratory motion effect. Given the considerable sensitivity of DTI measurements to motion artifact, we believe outlier detection is indispensable in spinal cord diffusion imaging. We also recommend using a mixed-effects model to account for systematic measurement bias depending on cord segment.
Collapse
|
16
|
Age-related diffusion patterns in human lumbar intervertebral discs: a pilot study in asymptomatic subjects. Magn Reson Imaging 2012; 30:181-8. [DOI: 10.1016/j.mri.2011.09.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 09/23/2011] [Accepted: 09/23/2011] [Indexed: 11/19/2022]
|
17
|
Qian W, Chan Q, Mak H, Zhang Z, Anthony MP, Yau KKW, Khong PL, Chan KH, Kim M. Quantitative assessment of the cervical spinal cord damage in neuromyelitis optica using diffusion tensor imaging at 3 Tesla. J Magn Reson Imaging 2011; 33:1312-20. [PMID: 21590999 DOI: 10.1002/jmri.22575] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
PURPOSE To investigate whether quantitative MRI measures of cervical spinal cord white matter (WM) using diffusion tensor imaging (DTI) in neuromyelitis optica (NMO) differed from controls and correlated with clinical disability. MATERIALS AND METHODS Ten referred patients and 12 healthy volunteers were imaged on a 3 Tesla scanner and patients were clinically assessed on the Expanded Disability Status Scale (EDSS). Two raters quantified DTI-derived indices from all participants, including fractional anisotropy (FA), mean diffusivity (MD), parallel diffusivity (lambda[parallel]) and perpendicular diffusivity (lambda[perpendicular]) at C1-C6 for lateral and dorsal columns. After the inter-rater reliability test, univariate correlations between DTI measures and disability were assessed using the Spearman's rho correlation coefficient. Multiple regression analysis was performed to investigate which DTI measures independently correlated with the clinical score. RESULTS Statistical test results indicated high reliability of all DTI measurements between two raters. NMO patients showed reduced FA, increased MD and lambda[perpendicular] compared with controls while lambda[parallel] did not show any significant difference. The former three DTI metrics also showed significant correlations with disability scores, and especially FA was found to be sensitive to mild NMO (EDSS ≤ 3) CONCLUSION FA is a potentially useful quantitative biomarker of otherwise normal appearing WM damage in NMO. Such damage is associated with clinical disability.
Collapse
Affiliation(s)
- Wenshu Qian
- Department of Diagnostic Radiology, The University of Hong Kong, Hong Kong
| | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Zollinger LV, Kim TH, Hill K, Jeong EK, Rose JW. Using diffusion tensor imaging and immunofluorescent assay to evaluate the pathology of multiple sclerosis. J Magn Reson Imaging 2011; 33:557-64. [PMID: 21516179 DOI: 10.1002/jmri.22502] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To determine the ability of the principal diffusion tensor imaging (DTI) indices to predict the underlying histopathology evaluated with immunofluorescent assay (IFA). MATERIALS AND METHODS Conventional T2 and 3D multishot-diffusion weighted echoplanar imaging (3D ms-DWEPI) was performed on a fixed, ex vivo human cervical spinal cord (CSC) from a patient with a history of multiple sclerosis (MS). In all, 170 regions of interest (ROIs) were selected within the white matter and categorized as a high intensity lesion (HIL), low intensity lesion (LIL), and normal-appearing white matter (NAWM). The longitudinal diffusivity (λl), radial diffusivity (λr), and fractional anisotropy (FA) were obtained from each ROI. The underlying histopathology was then evaluated using immunofluorescent assay with antibodies directed to myelin and neurofilament staining. RESULTS The mean values for λl and λr were significantly elevated within HIL relative to NAWM and LIL. IFA analysis of HIL demonstrated significant demyelination, without significant if any axon loss. The FA values were significantly reduced in HIL and LILs. FA values were also reduced in lesions with increased λl and λr values relative to normal. CONCLUSION Aberrant λl, λr, and FA relative to normal values are strong indicators of demyelination. DTI indices are not specific for axon loss. IFA analysis is a reliable method to demonstrate myelin and axon pathology within the ex vivo setting.
Collapse
Affiliation(s)
- Lauren V Zollinger
- University of Utah Department of Radiology, Salt Lake City, Utah 84123-2140, USA.
| | | | | | | | | |
Collapse
|
19
|
Park JK, Kim SE, Trieman GS, Parker D, Jeong EK. High-resolution diffusion-weighted imaging of neck lymph nodes using 2D-single-shot interleaved multiple inner volume imaging diffusion-weighted echo-planar imaging at 3T. AJNR Am J Neuroradiol 2011; 32:1173-7. [PMID: 21659484 DOI: 10.3174/ajnr.a2539] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE 2D-ss-IMIV-DWEPI is an ss-DWEPI with greatly reduced geometric distortion. The purposes of this paper are to 1) evaluate of the utility of 2D-ss-IMIV-DWEPI for high-resolution neck LN imaging; 2) determine whether 2D-ss-IMIV-DWEPI can depict normal LN hilum; and 3) evaluate whether the inclusion of LN hilum within ROIs affects the measured LN ADC. MATERIALS AND METHODS HR-DWI was acquired with 1-mm² in-plane resolution and 2-mm section thickness by using 2D-ss-IMIV-DWEPI. In total, 58 LNs from 18 subjects were evaluated. The ADC map was calculated by using DWI with b = 10 and 300 s/mm². In those LNs where the LN hilum could be recognized, the LN ADC was measured with and without inclusion of the hilum, and the mean difference of the resulting ADC values was determined. RESULTS The hilar structure was identified by DWI in 15 LNs. The ADC of the hilum was 1.981 ± 0.331 × 10⁻³ mm²/s. In these 15 LNs, the ADC value excluding hilar structure was significantly lower than the ADC value including hilar structure (0.983 ± 0.169 versus 1.206 ± 0.244 × 10⁻³ mm²/s; P < .0001). The mean ADC in a total of 58 LNs excluding the hilar structure was significantly lower than the value obtained including the hilar structure (1.034 ± 0.183 versus 1.095 ± 0.213 × 10⁻³ mm²/s; P = .0002). CONCLUSIONS HR-DWI of neck LNs obtained by using 2D-ss-IMIV-DWEPI could identify the hilar structure. The ADC of normal neck LNs seemed significantly different when the hilum was included. The results suggest that HR-DWI may be helpful to aid selection of proper ROIs within LNs for accurate and reliable ADC measurements.
Collapse
Affiliation(s)
- J K Park
- Utah Center for Advanced Imaging Research,University of Utah, Salt Lake City, Utah, USA
| | | | | | | | | |
Collapse
|
20
|
Zaharchuk G, Saritas EU, Andre JB, Chin CT, Rosenberg J, Brosnan TJ, Shankaranarayan A, Nishimura DG, Fischbein NJ. Reduced field-of-view diffusion imaging of the human spinal cord: comparison with conventional single-shot echo-planar imaging. AJNR Am J Neuroradiol 2011; 32:813-20. [PMID: 21454408 DOI: 10.3174/ajnr.a2418] [Citation(s) in RCA: 81] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE DWI of the spinal cord is challenging because of its small size and artifacts associated with the most commonly used clinical imaging method, SS-EPI. We evaluated the performance of rFOV spinal cord DWI and compared it with the routine fFOV SS-EPI in a clinical population. MATERIALS AND METHODS Thirty-six clinical patients underwent 1.5T MR imaging examination that included rFOV SS-EPI DWI of the cervical spinal cord as well as 2 comparison diffusion sequences: fFOV SS-EPI DWI normalized for either image readout time (low-resolution fFOV) or spatial resolution (high-resolution fFOV). ADC maps were created and compared between the methods by using single-factor analysis of variance. Two neuroradiologists blinded to sequence type rated the 3 DWI methods, based on susceptibility artifacts, perceived spatial resolution, signal intensity-to-noise ratio, anatomic detail, and clinical utility. RESULTS ADC values for the rFOV and both fFOV sequences were not statistically different (rFOV: 1.01 ± 0.18 × 10(-3) mm(2)/s; low-resolution fFOV: 1.12 ± 0.22 × 10(-3) mm(2)/s; high-resolution fFOV: 1.10 ± 0.21 × 10(-3) mm(2)/s; F = 2.747, P > .05). The neuroradiologist reviewers rated the rFOV diffusion images superior in terms of all assessed measures (P < 0.0001). Particular improvements were noted in patients with metal hardware, degenerative disease, or both. CONCLUSIONS rFOV DWI of the spinal cord overcomes many of the problems associated with conventional fFOV SS-EPI and is feasible in a clinical population. From a clinical standpoint, images were deemed superior to those created by using standard fFOV methods.
Collapse
Affiliation(s)
- G Zaharchuk
- Department of Radiology, Stanford University, California, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Advanced imaging of anterior visual pathway ischemia: state of the art and future directions. J Neuroophthalmol 2010; 30:213-5. [PMID: 20818205 DOI: 10.1097/wno.0b013e3181f3a4a7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|