Abstract
The aim was to explore the application value of brain image segmentation algorithm based on diffusion kurtosis imaging (DKI) in the structural remodeling of white matter (WM) in patients with hypoxic-ischemic encephalopathy (HIE). 120 patients with leukoencephalopathy and hypoxic-ischemic encephalopathy were selected as the research objects. Their heads were scanned by conventional magnetic resonance imaging (MRI) and DKI sequence. Besides, DKI based on the image segmentation algorithm was applied to process DKI images, DKE software was employed to obtain the values of fractional anisotropy (FA) and mean kurtosis (MK), and the differences in FA and MK were compared between acute and chronic phases. The results showed that the proposed algorithm could realize the best values of Jaccard similarity (JS) and Dice similarity coefficient (DSC) in WM, gray matter (GM), and cerebrospinal fluid (CSF), and the segmentation accuracy was better than other algorithms. FA values at the acute and chronic phases were compared in the area around lesions (0.421 ± 0.065 vs. 0.454 ± 0.052), the posterior limb of internal capsule on the affected side (0.498 ± 0.027 vs. 0.504 ± 0.046), and the pedunculus cerebri on the affected side (0.558 ± 0.038 vs. 0.568 ± 0.042), and the differences were statistically substantial ( P < 0.05 ). Moreover, MK values at the acute and chronic phases were also compared in the area around lesions (1.362 ± 0.098 vs. 1.407 ± 0.077), the centrum semiovale on the affected side (1.305 ± 0.102 vs. 1.343 ± 0.076), the posterior limb of internal capsule on the affected side (1.338 ± 0.543 vs. 1.382 ± 0.076), and the pedunculus cerebri on the affected side (1.329 ± 0.089 vs. 1.398 ± 0.099), showing a statistical meaning ( P < 0.05 ). The results indicated that the changes of FA and MK were related to the structural remodeling of WM. The DKI image segmentation algorithm could be applied in the diagnosis of leukoencephalopathy in patients with hypoxic-ischemic encephalopathy, and DKI technology was of great significance for the research of structural remodeling of WM.
Highlights
hypoxic-ischemic encephalopathy (HIE) is the most important cause of morbidity and mortality in full-term babies [1, 2] and is a brain injury caused by hypoxia in the perinatal period
Jaccard similarity (JS) and Dice similarity coefficient (DSC) indexes were applied to quantitatively evaluate the performance of the image segmentation algorithm. e segmentation results of fuzzy C-means (FCM), fuzzy local information c-means clustering (FLICM), self-organizing mapping (SOM) + genetic algorithm (GA), and the algorithm in this study are shown in Table 1. e JS coefficients of the algorithm proposed in this study for the segmentation of white matter (WM), gray matter (GM), and cerebrospinal fluid (CSF) were 0.8408, 0.7417, and 0.6882, respectively, and the DSC coefficients for the segmentation of WM, GM, and CSF were 0.9106, 0.8507, and 0.8025, respectively. erefore, the JS and DSC indexes of WM, GM, and CSF in this algorithm were all the best compared with FCM, FLICM, and SOM + GA, indicating that the segmentation accuracy of this algorithm was better than other traditional algorithms
Comparison on fractional anisotropy (FA) Values of WM in the Different Parts. e FA values of patients with HIE were compared at the acute phase (2–7 days) and the chronic phase (2-3 months), and the results are shown in Figures 1–3. ere were statistically great differences of FA values at the acute phase and chronic phase in the area around lesions (0.421 ± 0.065 vs. 0.454 ± 0.052), posterior limb of internal capsule on the affected side (0.498 ± 0.027 vs. 0.504 ± 0.046), and pedunculus cerebri on the affected side (0.558 ± 0.038 vs. 0.568 ± 0.042) (P < 0.05)
Summary
HIE is the most important cause of morbidity and mortality in full-term babies [1, 2] and is a brain injury caused by hypoxia in the perinatal period. HIE can lead to neurodevelopmental delay, cerebral palsy, hearing and visual impairment, and epilepsy if it is relatively severe [3]. There is a high incidence of HIE among newborn babies in China. HIE is a great threat to the lives of newborn babies, which is related to the overall national quality. Studies have found that HIE may cause leukoencephalopathy [4]. Leukoencephalopathy is a general term for various WM lesions, most of which are caused by hypoxia and ischemia [5]. Erefore, timely diagnosis and treatment is of great significance for the prevention and treatment of HIE and leukoencephalopathy Leukoencephalopathy is a general term for various WM lesions, most of which are caused by hypoxia and ischemia [5]. erefore, timely diagnosis and treatment is of great significance for the prevention and treatment of HIE and leukoencephalopathy
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