diffusion magnetic resonance imaging

磁共振扩散成像
  • 文章类型: Journal Article
    探讨表观扩散系数(ADC)直方图与葡萄膜黑色素瘤(UM)预后相关的高危临床病理特征之间的相关性。
    这项回顾性研究包括2015年8月至2024年3月期间接受扩散加权成像(DWI)的53例UM患者。采用单次自旋回波回波平面成像序列进行轴向DWI。ADCmean的ADC直方图参数,ADC50%,四分位数间距(IQR),偏斜度,峰度,和熵是从DWI获得的。直方图参数与包括肿瘤大小在内的高危临床病理特征之间的关系,术前视网膜脱离,组织学亚型,Ki-67指数,和染色体状态,采用Spearman相关分析,Mann-WhitneyU测试,或者Kruskal-Wallis测试.
    共有53名患者(平均±SD年龄,55±15岁;22名男性)进行了评估。最大基底直径(LBD)与峰度相关(r=0.311,P=0.024)。肿瘤突出度(TP)与熵值(r=0.581,P<0.001)和峰度(r=0.273,P=0.048)相关。此外,发现Ki-67指数与ADCmean之间存在显着相关性(r=-0.444,P=0.005),ADC50%(r=-0.487,P=0.002),和偏度(r=0.394,P=0.014)。最后,熵与二元性3相关(r=0.541,P=0.017)。
    ADC直方图提供了对UM高危临床病理特征的有价值的见解,并在早期预测UM预后方面具有前景。
    UNASSIGNED: To investigate the correlation between apparent diffusion coefficient (ADC) histograms and high-risk clinicopathologic features related to uveal melanoma (UM) prognosis.
    UNASSIGNED: This retrospective study included 53 patients with UM who underwent diffusion-weighted imaging (DWI) between August 2015 and March 2024. Axial DWI was performed with a single-shot spin-echo echo-planar imaging sequence. ADC histogram parameters of ADCmean, ADC50%, interquartile range (IQR), skewness, kurtosis, and entropy were obtained from DWI. The relationships between histogram parameters and high-risk clinicopathological characteristics including tumor size, preoperative retinal detachment, histological subtypes, Ki-67 index, and chromosome status, were analyzed by Spearman correlation analysis, Mann-Whitney U test, or Kruskal-Wallis test.
    UNASSIGNED: A total of 53 patients (mean ± SD age, 55 ± 15 years; 22 men) were evaluated. The largest basal diameter (LBD) was correlated with kurtosis (r = 0.311, P = 0.024). Tumor prominence (TP) was correlated with entropy (r = 0.581, P < 0.001) and kurtosis (r = 0.273, P = 0.048). Additionally, significant correlations were identified between the Ki-67 index and ADCmean (r = -0.444, P = 0.005), ADC50% (r = -0.487, P = 0.002), and skewness (r = 0.394, P = 0.014). Finally, entropy was correlated with monosomy 3 (r = 0.541, P = 0.017).
    UNASSIGNED: The ADC histograms provided valuable insights into high-risk clinicopathologic features of UM and hold promise in the early prediction of UM prognosis.
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  • 文章类型: Journal Article
    背景:口腔手术和牙科手术导致的医源性下颌神经损伤对患者和口腔外科医生来说都是痛苦和巨大的挑战,主要是因为缺乏诊断神经损伤的客观和定量方法,使得治疗和赔偿含糊不清,同时往往导致医学法律纠纷。这项研究的目的是在特定的磁共振成像(MRI)方案中检查创伤性下颌神经的辨别因素,并为三叉神经周围损伤提供切实的诊断标准。
    方法:26例同侧下颌神经损伤患者行T2Flex水,三维短tau反转恢复(STIR),和弥散加权成像(DWI)通过周期性旋转重叠的平行线和增强重建(PROPELLER)脉冲序列获得;因此,在解剖学上相应的部位将26条受伤的神经与对侧健康神经进行了比较。T2Flex表观信噪比(FSNR),T2Flex表观神经-肌肉对比度噪声比(FNMCNR)3DSTIR表观信噪比(SSNR),3DSTIR表观神经-肌肉对比度噪声比(SNMCNR),评估表观扩散系数(ADC)和横截面神经面积(Area)。
    结果:混合模型分析显示,FSNR和FNMCNR是下颌神经创伤的双重鉴别器(p<0.05)。两个参数的诊断性能也用接收器工作特征曲线下面积确定(FSNR的AUC=0.712;FNMCNR的95%置信区间[CI]:0.5660,0.8571/AUC=0.7056;95%置信区间[CI]:1.011,1.112)。
    结论:我们的MRI序列中FSNR和FNMCNR的增加似乎是存在创伤性神经的准确指标。这项前瞻性研究可以作为大型患者队列中诊断三叉神经创伤的复杂模型的基础。
    BACKGROUND: Iatrogenic mandibular nerve damage resulting from oral surgeries and dental procedures is painful and a formidable challenge for patients and oral surgeons alike, mainly because the absence of objective and quantitative methods for diagnosing nerve damage renders treatment and compensation ambiguous while often leading to medico-legal disputes. The aim of this study was to examine discriminating factors of traumatic mandibular nerve within a specific magnetic resonance imaging (MRI) protocol and to suggest tangible diagnostic criteria for peripheral trigeminal nerve injury.
    METHODS: Twenty-six patients with ipsilateral mandibular nerve trauma underwent T2 Flex water, 3D short tau inversion recovery (STIR), and diffusion-weighted imaging (DWI) acquired by periodically rotating overlapping parallel lines with enhanced reconstruction (PROPELLER) pulse sequences; 26 injured nerves were thus compared with contra-lateral healthy nerves at anatomically corresponding sites. T2 Flex apparent signal to noise ratio (FSNR), T2 Flex apparent nerve-muscle contrast to noise ratio (FNMCNR) 3D STIR apparent signal to noise ratio (SSNR), 3D STIR apparent nerve-muscle contrast to noise ratio (SNMCNR), apparent diffusion coefficient (ADC) and area of cross-sectional nerve (Area) were evaluated.
    RESULTS: Mixed model analysis revealed FSNR and FNMCNR to be the dual discriminators for traumatized mandibular nerve (p < 0.05). Diagnostic performance of both parameters was also determined with area under the receiver operating characteristic curve (AUC for FSNR = 0.712; 95% confidence interval [CI]: 0.5660, 0.8571 / AUC for FNMCNR = 0.7056; 95% confidence interval [CI]: 1.011, 1.112).
    CONCLUSIONS: An increase in FSNR and FNMCNR within our MRI sequence seems to be accurate indicators of the presence of traumatic nerve. This prospective study may serve as a foundation for sophisticated model diagnosing trigeminal nerve trauma within large patient cohorts.
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  • 文章类型: Journal Article
    本研究系统综述了扩散加权成像(DWI)在乳腺癌分子预后标志物评估中的作用。重点研究表观扩散系数(ADC)与激素受体状态和预后标志物的相关性。我们的荟萃分析包括来自52项研究的数据,这些研究检查了与雌激素受体(ER)相关的ADC值,孕激素受体(PgR),人表皮生长因子受体2(HER2),和Ki-67状态。结果表明,不同受体状态之间的ADC值存在显着差异,ER阳性,PgR阳性,HER2阴性,和Ki-67阳性肿瘤与阴性肿瘤相比具有较低的ADC值。这项研究还强调了先进的DWI技术的潜力,例如体素内不相干运动和非高斯DWI,以提供超出ADC的其他见解。尽管有这些有希望的发现,这些研究的高度异质性凸显了需要标准化的DWI方案,以提高其在乳腺癌治疗中的临床应用.
    This study systematically reviewed the role of diffusion-weighted imaging (DWI) in the assessment of molecular prognostic biomarkers in breast cancer, focusing on the correlation of apparent diffusion coefficient (ADC) with hormone receptor status and prognostic biomarkers. Our meta-analysis includes data from 52 studies examining ADC values in relation to estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2), and Ki-67 status. The results indicated significant differences in ADC values among different receptor statuses, with ER-positive, PgR-positive, HER2-negative, and Ki-67-positive tumors having lower ADC values compared to their negative counterparts. This study also highlights the potential of advanced DWI techniques such as intravoxel incoherent motion and non-Gaussian DWI to provide additional insights beyond ADC. Despite these promising findings, the high heterogeneity among the studies underscores the need for standardized DWI protocols to improve their clinical utility in breast cancer management.
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  • 文章类型: Journal Article
    已发现与L/L载体相比,5-HTTLPR的S/S载体寻求损失的风险更大。这一发现可能是由于涉及杏仁核和腹侧纹状体的信号通路改变而导致额叶皮层自上而下控制减少的结果。已知5-羟色胺能系统参与神经发育和神经可塑性。因此,这项研究的目的是调查白质的结构差异是否可以解释寻求风险行为的差异.与L/L载波相比,S/S中的结构连通性较低,并且假设寻求损失的风险与连通性之间存在负相关关系。扩散加权成像用于计算175个基因型个体的额纹状体和钩束的扩散参数。结果表明,扩散参数与风险寻求损失之间没有显着关系。此外,我们没有发现S/S的扩散参数与L/L组。S/L组仅在额叶纹状体存在组间差异,显示出更强的结构连通性,这也反映在整个大脑的方法中。因此,数据不支持以下假设:5-HTTLPR与寻求损失风险之间的关联与决策中涉及的白质通路差异有关.
    S/S carriers of 5-HTTLPR have been found to be more risk seeking for losses compared to L/L carriers. This finding may be the result of reduced top-down control from the frontal cortex due to altered signal pathways involving the amygdala and ventral striatum. The serotonergic system is known to be involved in neurodevelopment and neuroplasticity. Therefore, the aim of this study was to investigate whether structural differences in white matter can explain the differences in risk-seeking behaviour. Lower structural connectivity in S/S compared to L/L carriers and a negative relationship between risk seeking for losses and connectivity were assumed. Diffusion-weighted imaging was used to compute diffusion parameters for the frontostriatal and uncinate tract in 175 genotyped individuals. The results showed no significant relationship between diffusion parameters and risk seeking for losses. Furthermore, we did not find significant differences in diffusion parameters of the S/S vs. L/L group. There were only group differences in the frontostriatal tract showing stronger structural connectivity in the S/L group, which is also reflected in the whole brain approach. Therefore, the data do not support the hypothesis that the association between 5-HTTLPR and risk seeking for losses is related to differences in white matter pathways implicated in decision-making.
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  • 文章类型: Journal Article
    目标:随着全球人口老龄化,需要更好地了解健康的老年人和年轻人的大脑结构与功能的关系。
    方法:34名健康参与者分为年龄较大(17;平均值=70.9,SD=5.4)和年龄较小的成年人(17;平均值=28.1,SD=2.8)进行了扩散加权成像和神经心理学评估,包括加州言语学习测试第二版和跟踪测试(TMT-A和TMT-B)。老年人和年轻人白质微观结构的差异以及DTI指标(分数各向异性,FA;平均扩散系数,使用基于道的空间统计(p<0.05,校正)分析MD)和认知表现。
    结果:在广泛的脑区,老年人的FA和MD明显低于年轻人。右上/前冠状放射状体和call体的老年人执行功能(TMT-B)与MD之间存在显着负相关。在年轻成年人的DTI指标与执行功能或两组的记忆表现之间均未检测到显着关系。
    结论:研究结果强调需要检查大脑行为关系作为年龄的函数。未来的研究应该包括对更大寿命样本的全面评估,以更好地了解衰老的大脑。
    OBJECTIVE: With a globally aging population, there is a need to better understand how brain structure relates to function in healthy older and younger adults.
    METHODS: 34 healthy participants divided into older (17; Mean = 70.9, SD = 5.4) and younger adults (17; Mean = 28.1, SD = 2.8) underwent diffusion-weighted imaging and neuropsychological assessment, including the California Verbal Learning Test 2nd Edition and the Trail Making Test (TMT-A and TMT-B). Differences in white matter microstructure for older and younger adults and the association between DTI metrics (fractional anisotropy, FA; mean diffusivity, MD) and cognitive performance were analyzed using tract-based spatial statistics (p < 0.05, corrected).
    RESULTS: Older adults had significantly lower FA and higher MD than younger adults in widespread brain regions. There was a significant negative correlation between executive function (TMT-B) and MD for older adults in the right superior/anterior corona radiata and the corpus callosum. No significant relationship was detected between DTI metrics and executive function in younger adults or with memory performance in either group.
    CONCLUSIONS: The findings underscore the need to examine brain-behaviour relationships as a function of age. Future studies should include comprehensive assessments in larger lifespan samples to better understand the aging brain.
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  • 文章类型: Journal Article
    蓝斑-去甲肾上腺素系统在整个生命周期中支持大脑健康方面发挥着关键作用,特别是通过其对神经炎症的调节作用。采用超高场扩散磁共振成像,我们检查了蓝斑中的微观结构特性(神经突密度指数和取向分散指数)是否与皮质和皮质下区域有关,以及这是否受血浆胶质纤维酸性蛋白水平的调节,作为星形胶质细胞反应性的代表。在我们的60名健康个体(30至85岁,50%女性),较高的胶质纤维酸性蛋白与额叶皮质区较低的神经突密度指数相关,海马体,还有杏仁核.此外,在较高水平的神经胶质原纤维酸性蛋白下(皮质区高于〜150pg/mL,皮质下区域高于〜145pg/mL),在额颞叶皮质区域和皮质下区域,较低的蓝斑方向分散指数与较低的方向分散指数相关。有趣的是,具有较高的蓝斑取向分散指数的个体在这些(亚)皮层区域表现出更高的取向分散指数,尽管有较高的胶质纤维酸性蛋白水平。一起,这些结果表明,蓝斑-去甲肾上腺素细胞与星形胶质细胞之间的相互作用可为大脑完整性发出有害或神经保护通路的信号,并支持维持蓝斑神经元健康在衰老和预防年龄相关神经退行性疾病中的重要性.
    The locus coeruleus-norepinephrine system plays a key role in supporting brain health along the lifespan, notably through its modulatory effects on neuroinflammation. Using ultra-high field diffusion magnetic resonance imaging, we examined whether microstructural properties (neurite density index and orientation dispersion index) in the locus coeruleus were related to those in cortical and subcortical regions, and whether this was modulated by plasma glial fibrillary acidic protein levels, as a proxy of astrocyte reactivity. In our cohort of 60 healthy individuals (30 to 85 yr, 50% female), higher glial fibrillary acidic protein correlated with lower neurite density index in frontal cortical regions, the hippocampus, and the amygdala. Furthermore, under higher levels of glial fibrillary acidic protein (above ~ 150 pg/mL for cortical and ~ 145 pg/mL for subcortical regions), lower locus coeruleus orientation dispersion index was associated with lower orientation dispersion index in frontotemporal cortical regions and in subcortical regions. Interestingly, individuals with higher locus coeruleus orientation dispersion index exhibited higher orientation dispersion index in these (sub)cortical regions, despite having higher glial fibrillary acidic protein levels. Together, these results suggest that the interaction between locus coeruleus-norepinephrine cells and astrocytes can signal a detrimental or neuroprotective pathway for brain integrity and support the importance of maintaining locus coeruleus neuronal health in aging and in the prevention of age-related neurodegenerative diseases.
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  • 文章类型: Journal Article
    背景:骨质疏松症(OP)是一种常见的慢性代谢性骨病,其特征是骨矿物质含量降低和微结构损伤,导致骨折风险增加。传统的骨密度测量方法在准确区分椎体方面存在局限性,并且受到椎体退变和周围组织的影响。因此,需要新的方法来定量评估骨密度的变化并提高OP的准确诊断。
    方法:本研究旨在探讨具有回声不对称和最小二乘估计铁(IDEAL-IQ)序列的水和脂肪迭代分解结合体素内不相干运动扩散加权成像(IVIM-DWI)诊断骨质疏松症的应用价值。数据来自135名接受双能X线骨密度仪(DXA)的患者,理想智商,前瞻性地收集和分析IVIM-DWI。比较了从IVIM-DWI和IDEAL-IQ序列获得的各种参数,并对其诊断效能进行评价。
    结果:观察到三组之间FF的统计学差异,R2*,f,D,DDC值,和BMD值。FF和f值与BMD值呈负相关,r分别为-0.313和-0.274,而R2*,D,DDC值与BMD值呈正相关,r分别为0.327、0.532和0.390。在这些参数中,D对骨质疏松症的诊断效能最高(AUC=0.826),其次是FF(AUC=0.713)。D*在区分骨质疏松症组与其他两组方面表现出最低的诊断性能。只有D在性别之间表现出显著差异。理想智商的AUC,IVIM-DWI,其组合分别为0.74、0.89和0.90。
    结论:IDEAL-IQ联合IVIM-DWI为骨质疏松症的诊断提供了有价值的信息,并为临床决策提供了依据。IVIM-DWI的卓越诊断性能,特别是D值,提示与IDEAL-IQ相比,其作为诊断骨质疏松症更灵敏,更准确的方法的潜力。这些发现强调了将先进的成像技术整合到临床实践中以改善骨质疏松症管理的重要性,并强调需要进一步研究以探索这些成像方式的全部临床意义。
    BACKGROUND: Osteoporosis (OP) is a common chronic metabolic bone disease characterized by decreased bone mineral content and microstructural damage, leading to increased fracture risk. Traditional methods for measuring bone density have limitations in accurately distinguishing vertebral bodies and are influenced by vertebral degeneration and surrounding tissues. Therefore, novel methods are needed to quantitatively assess changes in bone density and improve the accurate diagnosis of OP.
    METHODS: This study aimed to explore the applicative value of the iterative decomposition of water and fat with echo asymmetry and least-squares estimation-iron (IDEAL-IQ) sequence combined with intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) for the diagnosis of osteoporosis. Data from 135 patients undergoing dual-energy X-ray absorptiometry (DXA), IDEAL-IQ, and IVIM-DWI were prospectively collected and analyzed. Various parameters obtained from IVIM-DWI and IDEAL-IQ sequences were compared, and their diagnostic efficacy was evaluated.
    RESULTS: Statistically significant differences were observed among the three groups for FF, R2*, f, D, DDC values, and BMD values. FF and f values exhibited negative correlations with BMD values, with r=-0.313 and - 0.274, respectively, while R2*, D, and DDC values showed positive correlations with BMD values, with r = 0.327, 0.532, and 0.390, respectively. Among these parameters, D demonstrated the highest diagnostic efficacy for osteoporosis (AUC = 0.826), followed by FF (AUC = 0.713). D* exhibited the lowest diagnostic performance for distinguishing the osteoporosis group from the other two groups. Only D showed a significant difference between genders. The AUCs for IDEAL-IQ, IVIM-DWI, and their combination were 0.74, 0.89, and 0.90, respectively.
    CONCLUSIONS: IDEAL-IQ combined with IVIM-DWI provides valuable information for the diagnosis of osteoporosis and offers evidence for clinical decisions. The superior diagnostic performance of IVIM-DWI, particularly the D value, suggests its potential as a more sensitive and accurate method for diagnosing osteoporosis compared to IDEAL-IQ. These findings underscore the importance of integrating advanced imaging techniques into clinical practice for improved osteoporosis management and highlight the need for further research to explore the full clinical implications of these imaging modalities.
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  • 文章类型: Journal Article
    游离水分数(FWF)表示每单位体积的脑实质的水量,不与大分子结合。其在多发性硬化症(MS)中的过量与组织损失增加有关。使用mcDESPOT(多分量驱动单脉冲观测T1和T2),一种利用T1和T2对比的3D成像方法,允许FWF在临床上可行的时间内得出。然而,此方法尚未用于量化FWF的变化及其在MS中的潜在临床影响。本研究的目的是探讨MS患者FWF的变化及其与组织损伤和认知功能的关系。假设FWF是临床上有意义的组织损失的代表。为了这个目标,我们测试了FWF之间的关系,MS病变负荷和信息处理速度,通过符号数字模式测试(SDMT)评估。除了标准序列,用于T1和T2加权病变勾画,在3T下采用具有1.7mm各向同性分辨率的mcDESPOT序列和扩散加权成像方案(b=0,1200s/mm2,40个扩散方向)。从扩散数据导出的分数各向异性图用于定义受试者特定白质(WM)图谱。脑实质分割返回灰质(GM)和WM的掩模,和正常的WM(NAWM),除了T1和T2病变面罩(T1L和T2L,分别)。九十九名复发缓解型MS患者(年龄=43.3±9.9岁,疾病持续时间12.3±7.7年)进行了研究,与25名健康对照(HC,年龄=38.8±11.0岁)。MS患者的GM和NAWM中FWF较高,与HC的GM和WM相比(均p<.001)。在MS患者中,FWF在T1L和GM中最高,其次是T2L和NAWM,分别。FWF随T1L和T2L体积显著增加(ρ范围从0.40到0.58,p<.001)。T2L中的FWF与T1L体积和T1L/T2L体积比密切相关(ρ=0.73,p<.001)。MS患者在处理速度测试中的表现比HC差(MS的平均值±SD:54.1±10.3,HC为63.8±10.8)。通用汽车的FWF,T2L,病灶周围组织和NAWM随着SDMT评分的降低而增加(对于T2L,ρ分别=-0.30,-0.29,-0.33,r=-.30,所有p<.005)。区域分析,进行,以确定哪些NAWM区域对解释FWF和认知障碍之间的关系特别重要,显示FWF空间方差与call体和上纵束的SDMT得分呈负相关,已知与认知障碍相关的WM结构,除了左皮质脊髓束,矢状地层,内囊的右前肢。总之,我们在MS患者的脑实质中发现了过量的游离水,不仅涉及MS病变的改变,还有通用汽车和NAWM,影响大脑功能,并与认知处理速度负相关。我们建议FWF度量,源自非侵入性,快速的MRI采集和良好的生物学可解释性,作为MS组织损伤和相关认知障碍的MRI生物标志物可能被证明是有价值的。
    Free water fraction (FWF) represents the amount of water per unit volume of brain parenchyma, which is not bound to macromolecules. Its excess in multiple sclerosis (MS) is related to increased tissue loss. The use of mcDESPOT (multicomponent driven single pulse observation of T1 and T2), a 3D imaging method which exploits both the T1 and T2 contrasts, allows FWF to be derived in clinically feasible times. However, this method has not been used to quantify changes of FWF and their potential clinical impact in MS. The aim of this study is to investigate the changes in FWF in MS patients and their relationship with tissue damage and cognition, under the hypothesis that FWF is a proxy of clinically meaningful tissue loss. To this aim, we tested the relationship between FWF, MS lesion burden and information processing speed, evaluated via the Symbol Digit Modalities Test (SDMT). In addition to standard sequences, used for T1- and T2-weighted lesion delineation, the mcDESPOT sequence with 1.7 mm isotropic resolution and a diffusion weighted imaging protocol (b = 0, 1200 s/mm2, 40 diffusion directions) were employed at 3 T. The fractional anisotropy map derived from diffusion data was used to define a subject-specific white matter (WM) atlas. Brain parenchyma segmentation returned masks of gray matter (GM) and WM, and normal-appearing WM (NAWM), in addition to the T1 and T2 lesion masks (T1L and T2L, respectively). Ninety-nine relapsing-remitting MS patients (age = 43.3 ± 9.9 years, disease duration 12.3 ± 7.7 years) were studied, together with twenty-five healthy controls (HC, age = 38.8 ± 11.0 years). FWF was higher in GM and NAWM of MS patients, compared to GM and WM of HC (both p < .001). In MS patients, FWF was the highest in the T1L and GM, followed by T2L and NAWM, respectively. FWF increased significantly with T1L and T2L volume (ρ ranging from 0.40 to 0.58, p < .001). FWF in T2L was strongly related to both T1L volume and the volume ratio T1L/T2L (ρ = 0.73, p < .001). MS patients performed worse than HC in the processing speed test (mean ± SD: 54.1 ± 10.3 for MS, 63.8 ± 10.8 for HC). FWF in GM, T2L, perilesional tissue and NAWM increased with SDMT score reduction (ρ = -0.30, -0.29, -0.33 respectively and r = -.30 for T2L, all with p < .005). A regional analysis, conducted to determine which NAWM regions were of particular importance to explain the relationship between FWF and cognitive impairment, revealed that FWF spatial variance was negatively related to SDMT score in the corpus callosum and the superior longitudinal fasciculus, WM structures known to be associated with cognitive impairment, in addition to the left corticospinal tract, the sagittal stratum, the right anterior limb of internal capsule. In conclusion, we found excess free water in brain parenchyma of MS patients, an alteration that involved not only MS lesions, but also the GM and NAWM, impinging on brain function and negatively associated with cognitive processing speed. We suggest that the FWF metric, derived from noninvasive, rapid MRI acquisitions and bearing good biological interpretability, may prove valuable as an MRI biomarker of tissue damage and associated cognitive impairment in MS.
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  • 文章类型: Journal Article
    亲密伴侣暴力(IPV)在退伍军人中非常普遍。建议的IPV危险因素包括战斗暴露,创伤后应激障碍(PTSD),抑郁症,酒精使用,和轻度创伤性脑损伤(mTBI)。虽然与IPV感染相关的潜在脑部病理生理特征在很大程度上仍然未知,先前的研究将侵略和暴力与边缘系统的改变联系起来。这里,我们调查了退伍军人的IPV感染是否与边缘微结构异常相关.Further,我们测试潜在风险因素的影响(即,创伤后应激障碍,抑郁症,物质使用障碍,mTBI,和与战区相关的压力)对IPV流行的影响。
    结构和扩散加权磁共振成像(dMRI)数据来自TBI和应激障碍转化研究中心(TRACTS)研究的49名伊拉克和阿富汗战争(持久自由行动/伊拉克自由行动;OEF/OIF)的男性退伍军人。使用修订的冲突战术量表(CTS2)的心理侵略和人身攻击子量表评估IPV的发生率。计算赔率以评估具有以下任一诊断的退伍军人IPV发生的可能性:PTSD,抑郁症,物质使用障碍,或者mTBI.计算边缘灰质结构(杏仁核-海马复合体,扣带回,海马旁回,内嗅皮层)。计算了IPV穿透率之间的偏相关,神经精神症状,和FA。
    诊断为PTSD的退伍军人,抑郁症,物质使用障碍,或mTBI有较高的发生IPV的几率。更大的战区相关压力,和创伤后应激障碍的症状严重程度,抑郁症,mTBI与IPV感染显著相关。CTS2(心理攻击),一种IPV行为的衡量标准,与右杏仁核-海马复合体中更高的FA相关(r=0.400,p=0.005)。
    患有精神疾病和/或mTBI的退伍军人参与IPV的几率更高。Further,创伤后应激障碍的症状越严重,抑郁症,或TBI,与战区有关的压力越大,IPV渗透的频率越大。此外,我们报道了对亲密伴侣的心理攻击与右侧杏仁核-海马复合体的微结构改变之间的显著关联.这些发现表明,大脑结构可能与潜在的IPV行为相关,需要进一步研究。
    UNASSIGNED: Intimate partner violence (IPV) perpetration is highly prevalent among veterans. Suggested risk factors of IPV perpetration include combat exposure, post-traumatic stress disorder (PTSD), depression, alcohol use, and mild traumatic brain injury (mTBI). While the underlying brain pathophysiological characteristics associated with IPV perpetration remain largely unknown, previous studies have linked aggression and violence to alterations of the limbic system. Here, we investigate whether IPV perpetration is associated with limbic microstructural abnormalities in military veterans. Further, we test the effect of potential risk factors (i.e., PTSD, depression, substance use disorder, mTBI, and war zone-related stress) on the prevalence of IPV perpetration.
    UNASSIGNED: Structural and diffusion-weighted magnetic resonance imaging (dMRI) data were acquired from 49 male veterans of the Iraq and Afghanistan wars (Operation Enduring Freedom/Operation Iraqi Freedom; OEF/OIF) of the Translational Research Center for TBI and Stress Disorders (TRACTS) study. IPV perpetration was assessed using the psychological aggression and physical assault sub-scales of the Revised Conflict Tactics Scales (CTS2). Odds ratios were calculated to assess the likelihood of IPV perpetration in veterans with either of the following diagnoses: PTSD, depression, substance use disorder, or mTBI. Fractional anisotropy tissue (FA) measures were calculated for limbic gray matter structures (amygdala-hippocampus complex, cingulate, parahippocampal gyrus, entorhinal cortex). Partial correlations were calculated between IPV perpetration, neuropsychiatric symptoms, and FA.
    UNASSIGNED: Veterans with a diagnosis of PTSD, depression, substance use disorder, or mTBI had higher odds of perpetrating IPV. Greater war zone-related stress, and symptom severity of PTSD, depression, and mTBI were significantly associated with IPV perpetration. CTS2 (psychological aggression), a measure of IPV perpetration, was associated with higher FA in the right amygdala-hippocampus complex (r = 0.400, p = 0.005).
    UNASSIGNED: Veterans with psychiatric disorders and/or mTBI exhibit higher odds of engaging in IPV perpetration. Further, the more severe the symptoms of PTSD, depression, or TBI, and the greater the war zone-related stress, the greater the frequency of IPV perpetration. Moreover, we report a significant association between psychological aggression against an intimate partner and microstructural alterations in the right amygdala-hippocampus complex. These findings suggest the possibility of a structural brain correlate underlying IPV perpetration that requires further research.
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  • 文章类型: Journal Article
    UNASSIGNED: Recent studies have demonstrated the usefulness of diffusion-weighted MR neurography (DW MRN) for assessing nerve roots. This study aimed to evaluate the utility of DW MRN with a unidirectional motion-probing gradient (MPG) for the lumbar nerve roots at 1.5T MR.
    UNASSIGNED: Sixty-four lumbar spine MRI scans with DW MRN using anteroposterior unidirectional MPG were retrospectively analyzed. Any changes in the 512 lumbar spinal nerve roots from L3 to S1 were evaluated using T2-weighted imaging (T2WI), contrast-enhanced T1-weighted imaging (CE T1WI), and DW MRN, with agreement and correlation analysis.
    UNASSIGNED: T2WI revealed compression of 78 nerve roots, and CE T1WI revealed 52 instances of nerve root enhancement. Sixty-seven nerve roots showed swelling and hyperintensity on DW MRN. A total of 42 nerve roots showed changes in the CE T1WI and DW MRN sequences. Moderate to substantial agreement and moderate positive correlation were observed between DW MRN and CE T1WI, as well as DW MRN and T2WI (κ = 0.59-0.65, ρ = 0.600-0.653).
    UNASSIGNED: DW MRN with unidirectional anteroposterior MPG can help evaluate neuritis-related changes in spinal nerve roots and could serve as a sequence capable of complementing or substituting gadolinium CE imaging.
    UNASSIGNED: 최근 확산강조 자기공명신경조영(diffusion-weighted MR neurography; 이하 DW MRN)이 신경근 평가에 도움이 된다고 보고되었다. 본 연구는 1.5T MR에서 단일방향 경사자장을 사용한 DW MRN의 요추 신경근 평가의 유용성을 확인하고자 한다.
    UNASSIGNED: 앞뒤 방향 경사자장의 DW MRN을 포함한 64요추 MR을 후향적으로 분석했다. 제3 요추에서 제1 천추까지 총 512개 요추 신경근의 변화를 T2 강조영상, 조영증강 T1 강조영상, 그리고 DW MRN에서 평가하고 일치도와 상관관계 분석을 했다.
    UNASSIGNED: T2 강조영상에서 78개의 신경근 압박이 있었고, 조영증강 T1 강조영상에서 52개 신경근이 조영증강되었다. DW MRN에서 67개 신경근의 부종과 고신호강도가 있었다. 조영증강 T1 강조영상과 DW MRN 모두 신경근의 변화가 나타난 경우는 42개였다. DW MRN과 조영증강 T1 강조영상, T2 강조영상 간에 중간 또는 상당한 일치도와 양의 상관관계를 보였다(κ = 0.59–0.65, ρ = 0.600–0.653).
    UNASSIGNED: 앞뒤 단일방향을 사용한 DW MRN은 척추 신경근의 변화 평가에 도움이 되며, 가돌리늄 조영증강을 대체 또는 보완하는 역할을 할 수 있을 것이다.
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