Magnetic Resonance Spectroscopy

磁共振波谱
  • 文章类型: Systematic Review
    背景:氘代谢成像(DMI)已成为研究体内代谢的一种有前途的非侵入性技术。这篇综述旨在总结当前的发展,并讨论在体内DMI技术的未来。
    方法:根据两位作者的PRISMA2020声明进行了系统的文献综述。具体的技术细节和潜在的体内应用进行了总结。包括氘代代谢物检测策略,氘标记的示踪剂和相应的体内代谢途径,潜在的临床应用,示踪剂管理的途径,代谢的定量评估,和空间分辨率。
    结果:在最初检索的2,248篇文章中,最终包括34个,重点介绍了2种检测氘代代谢物的策略:直接和间接MI。各种氘代示踪剂(例如,[6,6'-2H2]葡萄糖,[2,2,2'-2H3]乙酸盐)在dmi中用于检测和量化不同的代谢途径,如糖酵解,三羧酸循环,和脂肪酸氧化。量化(例如,乳酸水平,乳酸/谷氨酰胺和谷氨酸比率)有望诊断恶性肿瘤和评估早期抗肿瘤治疗反应。示踪剂可以口服给药,静脉注射,或者腹膜内,通过推注或连续输注。对于代谢量化,连续时间点方法(包括动力学分析和曲线下面积的计算)和单时间点定量方法都是可行的。然而,空间分辨率不足仍然是STI的主要挑战(例如,3.3-mL空间分辨率,在3T下采集10分钟)。
    结论:提高空间分辨率可以促进临床翻译。此外,优化示踪剂合成,管理协议,和量化方法将进一步增强其临床适用性。
    结论:氘代谢显像,一种有前途的非侵入性技术,在这篇综述中系统地讨论了它目前的进展,局限性,以及研究体内能量代谢的未来方向,显示相关的临床潜力。
    结论:•氘代谢成像(dreuteriummetabolicimaging,简称dmi)显示出研究体内能量代谢的前景。•这篇评论探讨了dmi的当前状态,limits,和未来的研究方向。•DMA的临床翻译主要受到空间分辨率限制的阻碍。
    BACKGROUND: Deuterium metabolic imaging (DMI) has emerged as a promising non-invasive technique for studying metabolism in vivo. This review aims to summarize the current developments and discuss the futures in DMI technique in vivo.
    METHODS: A systematic literature review was conducted based on the PRISMA 2020 statement by two authors. Specific technical details and potential applications of DMI in vivo were summarized, including strategies of deuterated metabolites detection, deuterium-labeled tracers and corresponding metabolic pathways in vivo, potential clinical applications, routes of tracer administration, quantitative evaluations of metabolisms, and spatial resolution.
    RESULTS: Of the 2,248 articles initially retrieved, 34 were finally included, highlighting 2 strategies for detecting deuterated metabolites: direct and indirect DMI. Various deuterated tracers (e.g., [6,6\'-2H2]glucose, [2,2,2\'-2H3]acetate) were utilized in DMI to detect and quantify different metabolic pathways such as glycolysis, tricarboxylic acid cycle, and fatty acid oxidation. The quantifications (e.g., lactate level, lactate/glutamine and glutamate ratio) hold promise for diagnosing malignancies and assessing early anti-tumor treatment responses. Tracers can be administered orally, intravenously, or intraperitoneally, either through bolus administration or continuous infusion. For metabolic quantification, both serial time point methods (including kinetic analysis and calculation of area under the curves) and single time point quantifications are viable. However, insufficient spatial resolution remains a major challenge in DMI (e.g., 3.3-mL spatial resolution with 10-min acquisition at 3 T).
    CONCLUSIONS: Enhancing spatial resolution can facilitate the clinical translation of DMI. Furthermore, optimizing tracer synthesis, administration protocols, and quantification methodologies will further enhance their clinical applicability.
    CONCLUSIONS: Deuterium metabolic imaging, a promising non-invasive technique, is systematically discussed in this review for its current progression, limitations, and future directions in studying in vivo energetic metabolism, displaying a relevant clinical potential.
    CONCLUSIONS: • Deuterium metabolic imaging (DMI) shows promise for studying in vivo energetic metabolism. • This review explores DMI\'s current state, limits, and future research directions comprehensively. • The clinical translation of DMI is mainly impeded by limitations in spatial resolution.
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  • 文章类型: Journal Article
    使用质子磁共振波谱的研究揭示了大脑谷氨酸水平的实质性不一致,谷氨酰胺和谷氨酸+谷氨酰胺跨精神分裂症谱系障碍。本系统综述采用定性和定量方法分析谷氨酸能代谢物之间的模式和关系,精神分裂症谱系障碍和大脑区域。
    使用各种数据库进行文献检索,关键词包括谷氨酸,谷氨酰胺,精神分裂症,精神病和质子磁共振波谱学。纳入标准仅限于病例对照研究,这些研究报告了患有精神分裂症谱系障碍的成年患者的谷氨酸能代谢物水平-即首发精神病,精神分裂症,治疗抗性精神分裂症和/或超治疗抗性精神分裂症-使用3T或以上的质子磁共振波谱。汇总研究数据进行综合和分析。
    共有92项研究符合纳入标准,包括2721名健康对照和2822名精神分裂症谱系障碍参与者。基底神经节的Glu水平较高,首发精神病参与者的额叶皮质和内侧前额叶,相比之下,精神分裂症参与者的总体水平较低。对于Gln来说,在基底节区,代谢物水平存在明显差异,背外侧前额叶皮质和额叶皮质,首发精神病在基底神经节显示出明显较高的水平。在谷氨酸+谷氨酰胺中,在精神分裂症谱系障碍组中发现了较高的代谢物水平,特别是在抗治疗精神分裂症参与者的基底神经节和背外侧前额叶皮质。发现代谢物水平和药物状态之间存在显著关系,临床措施和方法学变量。
    该综述强调了整个精神分裂症谱系障碍和特定大脑区域的谷氨酸能代谢异常水平。由于相当多的文献异质性,该综述强调了使用质子磁共振波谱评估谷氨酸能代谢物的标准化未来研究的重要性。
    UNASSIGNED: Studies using proton magnetic resonance spectroscopy reveal substantial inconsistencies in the levels of brain glutamate, glutamine and glutamate + glutamine across schizophrenia spectrum disorders. This systematic review employs qualitative and quantitative methods to analyse the patterns and relationships between glutamatergic metabolites, schizophrenia spectrum disorders and brain regions.
    UNASSIGNED: A literature search was conducted using various databases with keywords including glutamate, glutamine, schizophrenia, psychosis and proton magnetic resonance spectroscopy. Inclusion criteria were limited to case-control studies that reported glutamatergic metabolite levels in adult patients with a schizophrenia spectrum disorder diagnosis - i.e. first-episode psychosis, schizophrenia, treatment-resistant schizophrenia and/or ultra-treatment-resistant schizophrenia - using proton magnetic resonance spectroscopy at 3 T or above. Pooled study data were synthesized and analysed.
    UNASSIGNED: A total of 92 studies met the inclusion criteria, including 2721 healthy controls and 2822 schizophrenia spectrum disorder participants. Glu levels were higher in the basal ganglia, frontal cortex and medial prefrontal of first-episode psychosis participants, contrasting overall lower levels in schizophrenia participants. For Gln, strong differences in metabolite levels were evident in the basal ganglia, dorsolateral prefrontal cortex and frontal cortex, with first-episode psychosis showing significantly higher levels in the basal ganglia. In glutamate + glutamine, higher metabolite levels were found across schizophrenia spectrum disorder groups, particularly in the basal ganglia and dorsolateral prefrontal cortex of treatment-resistant schizophrenia participants. Significant relationships were found between metabolite levels and medication status, clinical measures and methodological variables.
    UNASSIGNED: The review highlights abnormal glutamatergic metabolite levels throughout schizophrenia spectrum disorders and in specific brain regions. The review underscores the importance of standardized future research assessing glutamatergic metabolites using proton magnetic resonance spectroscopy due to considerable literature heterogeneity.
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  • 文章类型: Systematic Review
    1H-磁共振波谱(MRS)是一种非侵入性技术,可用于量化体内脑中代谢物的浓度。自闭症背景下的MRS研究结果不一致且相互矛盾。我们对测量谷氨酸和γ-氨基丁酸(GABA)的MRS研究进行了系统评价和荟萃分析,以及参与能量代谢的脑代谢物(谷氨酰胺,肌酸),神经和神经胶质的完整性(例如N-乙酰天冬氨酸(NAA),胆碱,自闭症队列中的肌醇)和氧化应激(谷胱甘肽)。数据被提取并按代谢物分组,在计算标准化效应大小之前,大脑区域和其他几个因素。总的来说,我们发现自闭症患者的GABA和NAA浓度明显降低,指示大脑回路内兴奋/抑制之间的平衡中断,以及神经完整性。进一步的分析发现,这些改变在自闭症儿童和与自闭症表型相关的边缘大脑区域最为明显。此外,我们展示了研究结果如何因人口统计学和方法论因素而变化,强调符合标准化共识研究设计和透明报告的重要性。
    1H-Magnetic Resonance Spectroscopy (MRS) is a non-invasive technique that can be used to quantify the concentrations of metabolites in the brain in vivo. MRS findings in the context of autism are inconsistent and conflicting. We performed a systematic review and meta-analysis of MRS studies measuring glutamate and gamma-aminobutyric acid (GABA), as well as brain metabolites involved in energy metabolism (glutamine, creatine), neural and glial integrity (e.g. n-acetyl aspartate (NAA), choline, myo-inositol) and oxidative stress (glutathione) in autism cohorts. Data were extracted and grouped by metabolite, brain region and several other factors before calculation of standardised effect sizes. Overall, we find significantly lower concentrations of GABA and NAA in autism, indicative of disruptions to the balance between excitation/inhibition within brain circuits, as well as neural integrity. Further analysis found these alterations are most pronounced in autistic children and in limbic brain regions relevant to autism phenotypes. Additionally, we show how study outcome varies due to demographic and methodological factors , emphasising the importance of conforming with standardised consensus study designs and transparent reporting.
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  • 文章类型: Journal Article
    代谢组学的新兴领域引起了研究人员对良性胆囊疾病的兴趣,其中包括胆囊息肉等病症,胆结石,和胆囊炎,这是常见的消化系统疾病。随着代谢组学的不断进步,研究人员越来越关注其在良性胆囊疾病研究中的适用性,为诊断提供新的视角,治疗性的,和预后评估。这篇全面的综述主要描述了液相色谱-质谱联用技术,气相色谱-质谱,和核磁共振及其在良性胆囊疾病研究中的应用。代谢组学在这些疾病的各个方面都取得了显著的进展,从早期诊断开始,病因学研究,评估疾病进展和预后,和优化治疗策略。然而,代谢组学在良性胆囊疾病的研究中仍然存在挑战。其中包括与数据处理和分析有关的问题,生物标志物发现和验证,跨学科研究整合,以及个性化医疗的发展。本文试图总结迄今为止的研究成果,突出未来的研究方向,为良性胆囊疾病的代谢组学研究提供参考。
    The burgeoning field of metabolomics has piqued the interest of researchers in the context of benign gallbladder diseases, which include conditions such as gallbladder polyps, gallstones, and cholecystitis, which are common digestive system disorders. As metabolomics continues to advance, researchers have increasingly focused their attention on its applicability in the study of benign gallbladder diseases to provide new perspectives for diagnostic, therapeutic, and prognostic evaluation. This comprehensive review primarily describes the techniques of liquid chromatography-mass spectrometry, gas chromatography-mass spectrometry, and nuclear magnetic resonance and their respective applications in the study of benign gallbladder disease. Metabolomics has made remarkable progress in various aspects of these diseases, ranging from early diagnosis, etiological research, assessment of disease progression and prognosis, and optimization of therapeutic strategies. However, challenges remain in the field of metabolomics in the study of benign gallbladder diseases. These include issues related to data processing and analysis, biomarker discovery and validation, interdisciplinary research integration, and the advancement of personalized medicine. This article attempts to summarize research findings to date, highlight future research directions, and provide a reference point for metabolomics research in benign gallbladder disease.
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  • 文章类型: Journal Article
    磁共振波谱(MRS)是一种成像技术,用于测量组织中的代谢变化。由于缺乏证据,MRS不是诊断神经退行性疾病的优先事项,因为它是一种相对专业的技术,需要专门的设备和专业知识来执行和解释。本系统综述旨在全面收集最常见的神经退行性疾病的MRS结果。
    对四个电子数据库的系统搜索(PubMed,Scopus,WebofScience,和ScienceDirect)是针对2017年至2022年发表的研究进行的。选择了提供特定生物标志物水平的文章,以及通过治疗评估疾病的研究,应用除1H以外的原子核的特色MRS,或比较不同的动物模型均被排除。
    共25篇,在引言中加上3篇文章以获取额外信息,包括在这次审查中。六种最常见的神经退行性疾病,即,老年痴呆症和帕金森氏症,亨廷顿舞蹈病,共济失调,多发性硬化症(MS),多系统萎缩(MSA),通过MRS检查进行性核上性麻痹(PSP)。在所有这些疾病中都可以看到N-乙酰天冬氨酸(NAA)的变化和比例,这可能导致早期诊断。然而,还有其他生物标志物,如Cr和Chon,这可以给出令人信服的结果。
    这项观察性研究是使用MRS作为诊断方法证明神经退行性疾病期间代谢变化的最新证据的首次综合。研究结果表明,阿尔茨海默病(AD)中的N-乙酰天冬氨酸(NAA)和NAA/Cr比率降低,帕金森病(PD),共济失调,MS,反映神经元丢失或功能障碍。在一些研究中发现胆碱和肌醇增加,提示细胞膜更新和神经炎症。其他代谢物如谷氨酸和γ-氨基丁酸的研究结果不太一致。然而,由于缺乏对相同兴趣量(VOI)的研究以及参与者数量少,因此存在局限性.
    UNASSIGNED: Magnetic resonance spectroscopy (MRS) is an imaging technique used to measure metabolic changes in the tissue. Due to the lack of evidence, MRS is not a priority in diagnosing neurodegenerative diseases because it is a relatively specialized technique that requires specialized equipment and expertise to perform and interpret. This systematic review aimed to present a comprehensive collection of MRS results in the most common neurodegenerative diseases.
    UNASSIGNED: A systematic search of four electronic databases (PubMed, Scopus, Web of Science, and ScienceDirect) was conducted for studies published from 2017 to 2022. Articles that provided specific biomarker levels were selected, and studies that assessed the diseases via treatment, featured MRS applying nuclei other than 1H, or compared different animal models were excluded.
    UNASSIGNED: A total of 25 articles, plus 3 articles for extra information in the introduction, were included in this review. Six of the most common neurodegenerative diseases, i.e., Alzheimer\'s and Parkinson\'s disease, Huntington chorea, ataxia, multiple sclerosis (MS), multiple system atrophy (MSA), and progressive supranuclear palsy (PSP) were examined via MRS. The changes and ratios of N-acetylaspartate (NAA) could be seen in all of these disorders, which could lead to early diagnosis. However, there are other biomarkers, such as Cr and Chon, which can give convincing results.
    UNASSIGNED: This observational study is the first synthesis of the latest evidence proving metabolic changes during neurodegenerative diseases using MRS as a diagnosis method. The findings indicate decreased N-acetylaspartate (NAA) and NAA/Cr ratios in Alzheimer\'s disease (AD), Parkinson\'s disease (PD), ataxias, and MS, reflecting neuronal loss or dysfunction. Increased choline and myo-inositol were noted in some studies, suggesting cell membrane turnover and neuroinflammation. Findings were less consistent for other metabolites like glutamate and gamma-aminobutyric acid. However, there were limitations due to the lack of studies on the same volumes of interest (VOIs) and the small number of participants.
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  • 文章类型: Systematic Review
    背景:甲状腺癌(TC)是内分泌系统中的主要恶性肿瘤。然而,TC诊断的标准方法缺乏识别所有甲状腺病变病理状况的能力。代谢组学方法有可能通过识别差异代谢物来解决这个问题。
    目的:本研究对基于NMR的代谢组学研究进行了系统综述和荟萃分析,以确定与TC相关的显著改变的代谢产物。
    方法:在包括Embase、PubMed,Scopus被指挥了.在353篇主要文章中,12项研究符合纳入系统评价的标准。其中,属于3篇文章的5份报告符合荟萃分析的条件.正交偏最小二乘判别分析的相关系数,代谢组学数据多元统计分析中的流行模型,选择进行荟萃分析。根据至少在三项研究中发现的事实选择改变的代谢物。
    结果:总计,鉴定了49种化合物,其中40是代谢产物。与正常样本相比,甲状腺病变中增加的代谢物包括乳酸,牛磺酸,丙氨酸,谷氨酸,谷氨酰胺,亮氨酸,赖氨酸,苯丙氨酸,丝氨酸,酪氨酸,缬氨酸,胆碱,甘氨酸,和异亮氨酸.脂质是甲状腺病变中减少的化合物。恶性和良性甲状腺病变的乳酸和丙氨酸增加,while,肌醇,scyllo-肌醇,柠檬酸盐胆碱,发现磷酸胆碱减少。荟萃分析对乳酸的三种代谢物产生了重要的结果,丙氨酸,恶性和良性标本中的柠檬酸盐。
    结论:在这项研究中,我们提供了12项纳入代谢组学研究的简明摘要,使未来的研究人员更容易将他们的结果与先前的发现进行比较。
    结论:看来TC代谢组学领域将取得显著进展,导致发现值得信赖的诊断和预后生物标志物。
    BACKGROUND: Thyroid cancer (TC) is the predominant malignancy within the endocrine system. However, the standard method for TC diagnosis lacks the capability to identify the pathological condition of all thyroid lesions. The metabolomics approach has the potential to manage this problem by identifying differential metabolites.
    OBJECTIVE: This study conducted a systematic review and meta-analysis of the NMR-based metabolomics studies in order to identify significant altered metabolites associated with TC.
    METHODS: A systematic search of published literature in any language in three databases including Embase, PubMed, and Scopus was conducted. Out of 353 primary articles, 12 studies met the criteria for inclusion in the systematic review. Among these, five reports belonging to three articles were eligible for meta-analysis. The correlation coefficient of the orthogonal partial least squares discriminant analysis, a popular model in the multivariate statistical analysis of metabolomic data, was chosen for meta-analysis. The altered metabolites were chosen based on the fact that they had been found in at least three studies.
    RESULTS: In total, 49 compounds were identified, 40 of which were metabolites. The increased metabolites in thyroid lesions compared normal samples included lactate, taurine, alanine, glutamic acid, glutamine, leucine, lysine, phenylalanine, serine, tyrosine, valine, choline, glycine, and isoleucine. Lipids were the decreased compounds in thyroid lesions. Lactate and alanine were increased in malignant versus benign thyroid lesions, while, myo-inositol, scyllo-inositol, citrate, choline, and phosphocholine were found to be decreased. The meta-analysis yielded significant results for three metabolites of lactate, alanine, and citrate in malignant versus benign specimens.
    CONCLUSIONS: In this study, we provided a concise summary of 12 included metabolomic studies, making it easier for future researchers to compare their results with the prior findings.
    CONCLUSIONS: It appears that the field of TC metabolomics will experience notable advancement, leading to the discovery of trustworthy diagnostic and prognostic biomarkers.
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  • 文章类型: Journal Article
    色谱法是一种强大而可靠的分离方法,可以使用各种固定相来分离代谢组学中常见的复杂混合物。这篇综述通过质谱(MS)和核磁共振(NMR)光谱等方法研究了靶向或非靶向代谢组学中使用的色谱和固定相的类型。考虑了代谢组学中样品预处理和分离的一般考虑因素,以及已用于此类工作的色谱的各种支持和分离格式。将检查代谢组学中最广泛使用的液相色谱(LC)类型,如反相液相色谱法和亲水液相相互作用色谱法。此外,在代谢组学的更有限应用中使用的其他形式的LC(例如,离子交换,尺寸排除,和亲和方法)将进行讨论,以说明如何将这些技术用于该领域的新研究和未来研究。还讨论了多维LC方法,以及气相色谱和超临界流体色谱在代谢组学中的应用。此外,色谱在NMR-vs.中的作用考虑基于MS的代谢组学。每种类型的色谱在代谢组学领域中都有应用,以及这些分离方法的潜在优点或局限性。
    Chromatography is a robust and reliable separation method that can use various stationary phases to separate complex mixtures commonly seen in metabolomics. This review examines the types of chromatography and stationary phases that have been used in targeted or untargeted metabolomics with methods such as mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy. General considerations for sample pretreatment and separations in metabolomics are considered, along with the various supports and separation formats for chromatography that have been used in such work. The types of liquid chromatography (LC) that have been most extensively used in metabolomics will be examined, such as reversed-phase liquid chromatography and hydrophilic liquid interaction chromatography. In addition, other forms of LC that have been used in more limited applications for metabolomics (e.g., ion-exchange, size-exclusion, and affinity methods) will be discussed to illustrate how these techniques may be utilized for new and future research in this field. Multidimensional LC methods are also discussed, as well as the use of gas chromatography and supercritical fluid chromatography in metabolomics. In addition, the roles of chromatography in NMR- vs. MS-based metabolomics are considered. Applications are given within the field of metabolomics for each type of chromatography, along with potential advantages or limitations of these separation methods.
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  • 文章类型: Meta-Analysis
    N-乙酰天冬氨酸(NAA)是神经元完整性和代谢的标志物。神经元可塑性和代谢低下与重度抑郁症(MDD)病理生理学有关。为了测试大脑NAA浓度是否在MDD过程中逐渐降低,我们对质子磁共振波谱(1H-MRS)研究进行了预注册的荟萃分析,比较了慢性MDD(n=1308)和首发抑郁症(n=242)患者的NAA浓度与健康对照(HC,n=1242)。使用每个大脑区域的随机效应模型对62项研究进行了荟萃分析。与额叶内的HC相比,慢性MDD中的NAA浓度显着降低(Hedges\'g=-0.330;p=0.018),枕叶(Hedges\'g=-0.677;p=0.007),丘脑(对冲=-0.673;p=0.016),额叶(Hedges\'g=-0.471;p=0.034)和脑室周围白质(Hedges\'g=-0.478;p=0.047)。我们强调了有关首发抑郁症患者NAA水平的知识差距。敏感性分析表明,抗抑郁治疗可以逆转额叶的NAA改变。我们强调了体素灰质的场强和校正,作为NAA水平检测的调节剂。未来的研究应评估NAA改变在疾病的早期阶段及其纵向进展。
    N-acetyl aspartate (NAA) is a marker of neuronal integrity and metabolism. Deficiency in neuronal plasticity and hypometabolism are implicated in Major Depressive Disorder (MDD) pathophysiology. To test if cerebral NAA concentrations decrease progressively over the MDD course, we conducted a pre-registered meta-analysis of Proton Magnetic Resonance Spectroscopy (1H-MRS) studies comparing NAA concentrations in chronic MDD (n = 1308) and first episode of depression (n = 242) patients to healthy controls (HC, n = 1242). Sixty-two studies were meta-analyzed using a random-effect model for each brain region. NAA concentrations were significantly reduced in chronic MDD compared to HC within the frontal lobe (Hedges\' g = -0.330; p = 0.018), the occipital lobe (Hedges\' g = -0.677; p = 0.007), thalamus (Hedges\' g = -0.673; p = 0.016), and frontal (Hedges\' g = -0.471; p = 0.034) and periventricular white matter (Hedges\' g = -0.478; p = 0.047). We highlighted a gap of knowledge regarding NAA levels in first episode of depression patients. Sensitivity analyses indicated that antidepressant treatment may reverse NAA alterations in the frontal lobe. We highlighted field strength and correction for voxel grey matter as moderators of NAA levels detection. Future studies should assess NAA alterations in the early stages of the illness and their longitudinal progression.
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  • 文章类型: Systematic Review
    COVID后病症(PCC)涵盖了2019年冠状病毒病(COVID-19)幸存者经历的一系列挥之不去的症状。神经和神经精神后遗症在PCCs中很常见。先进的磁共振成像(MRI)技术可以揭示大脑结构的细微变化,函数,以及这些后遗症背后的灌注。本系统综述旨在综合使用高级MRI表征患有PCCs的个体的大脑变化的研究结果。在PubMed和Scopus数据库中进行了详细的文献检索,以确定使用先进MRI模式的相关研究。如结构磁共振成像(sMRI),扩散张量成像(DTI),功能磁共振成像(fMRI)和灌注加权成像(PWI),评估PCCs的大脑变化。25项研究符合纳入标准,由1219名参与者组成。sMRI最一致的发现是皮质和皮质下区域的灰质体积(GMV)和皮质厚度(CTh)减少。DTI经常显示平均扩散系数(MD)增加,径向扩散系数(RD),并减少白质束(WMT)中的各向异性分数(FA),例如call体,日冕辐射,和上纵束。功能磁共振成像在默认模式下显示了功能连接(FC)的改变,显著性,额顶叶,躯体运动,皮质下,和小脑网络。PWI显示额颞区的脑血流量(CBF)减少,丘脑,和基底神经节.先进的MRI显示了大脑网络和PCC区域的变化,这可能会导致神经和神经精神问题。多模式神经成像可能有助于理解大脑行为关系。纵向研究对于更好地了解这些大脑异常的进展是必要的。
    Post-COVID conditions (PCCs) cover a wide spectrum of lingering symptoms experienced by survivors of coronavirus disease 2019 (COVID-19). Neurological and neuropsychiatric sequelae are common in PCCs. Advanced magnetic resonance imaging (MRI) techniques can reveal subtle alterations in brain structure, function, and perfusion that underlie these sequelae. This systematic review aimed to synthesize findings from studies that used advanced MRI to characterize brain changes in individuals with PCCs. A detailed literature search was conducted in the PubMed and Scopus databases to identify relevant studies that used advanced MRI modalities, such as structural MRI (sMRI), diffusion tensor imaging (DTI), functional MRI (fMRI), and perfusion-weighted imaging (PWI), to evaluate brain changes in PCCs. Twenty-five studies met the inclusion criteria, comprising 1219 participants with PCCs. The most consistent findings from sMRI were reduced gray matter volume (GMV) and cortical thickness (CTh) in cortical and subcortical regions. DTI frequently reveals increased mean diffusivity (MD), radial diffusivity (RD), and decreased fractional anisotropy (FA) in white matter tracts (WMTs) such as the corpus callosum, corona radiata, and superior longitudinal fasciculus. fMRI demonstrated altered functional connectivity (FC) within the default mode, salience, frontoparietal, somatomotor, subcortical, and cerebellar networks. PWI showed decreased cerebral blood flow (CBF) in the frontotemporal area, thalamus, and basal ganglia. Advanced MRI shows changes in the brain networks and regions of the PCCs, which may cause neurological and neuropsychiatric problems. Multimodal neuroimaging may help understand brain-behavior relationships. Longitudinal studies are necessary to better understand the progression of these brain anomalies.
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  • 文章类型: Meta-Analysis
    目的:前循环动脉粥样硬化斑块(ACAP)和后循环动脉粥样硬化斑块(PCAP)引起的卒中的临床特征和机制是不同的。我们的目标是比较脆弱性的差异,形态学,基于高分辨率磁共振成像(HR-MRI)的ACAP和PCAP之间的分布。
    方法:PubMed,Embase,科克伦图书馆,中国国家知识基础设施(CNKI),和万方数据库从成立到2023年5月检索。Meta分析采用R4.2.1软件进行。文献的质量由医疗保健研究和质量机构(AHRQ)评估。进行亚组分析以探讨合并结果的异质性。
    结果:共13篇,包括1194个ACAP和1037个PCAP。汇总的估计值表明,PCAP中斑块内出血的发生率更高(OR1.72,95CI1.35-2.18)。PCAP的斑块长度(SMD0.23,95CI0.06-0.39)和重塑指数(SMD0.29,95CI0.14-0.44)均大于ACAP。然而,两组间的显著强化或狭窄程度无明显差异。
    结论:PCAP中有更多不稳定的功能,强调后循环复发性缺血性卒中的风险升高。此外,由于分布较广,PCAP容易发生穿透性动脉疾病。然而,后循环动脉表现出更大的向外重塑倾向,这可能导致治疗团队在血管造影检测中被忽视而错过最佳干预阶段。
    OBJECTIVE: The clinical characteristics and mechanisms of stroke caused by anterior circulation atherosclerotic plaques (ACAPs) and posterior circulation atherosclerotic plaques (PCAPs) are distinct. We aimed to compare the differences in vulnerability, morphology, and distribution between ACAPs and PCAPs based on hign-resolution magnetic resonance imaging (HR-MRI).
    METHODS: The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang database were retrieved from inception through May 2023. Meta-analysis was performed by R 4.2.1 software. The quality of the literature was assessed by the Agency for Healthcare Research and Quality (AHRQ). Subgroup analysis was conducted to explore the heterogeneity of the pooled results.
    RESULTS: There were a total of 13 articles, including 1194 ACAPs and 1037 PCAPs. The pooled estimates demonstrated that the incidence of intraplaque hemorrhage in the PCAPs was higher (OR 1.72, 95%CI 1.35-2.18). The plaque length (SMD 0.23, 95%CI 0.06-0.39) and remodeling index (SMD 0.29, 95%CI 0.14-0.44) of PCAPs were larger than those in ACAPs. However, there were no evident differences in significant enhancement or stenosis degree between the two groups.
    CONCLUSIONS: There were more unstable features in PCAPs, highlighting an elevated risk of recurrent ischemic stroke in the posterior circulation. Furthermore, PCAPs were prone to developing penetrating artery disease due to their wider distribution. Nevertheless, posterior circulation arteries exhibited a greater propensity for outward remodeling, which may lead treatment team to miss the optimal intervention stage by being overlooked on angiographic detection.
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