Underwent MRI Scans Research Articles

T1 relaxation time is prolonged in healthy aging: a whole brain study.

: Measurement of tissue characteristics such as the longitudinal relaxation time (T1) provides complementary information to the volumetric and surface based structural analyses. We aimed to investigate T1 relaxation time characteristics in healthy aging via an exploratory design in the whole brain. The data processing pipeline was designed to minimize errors related to aging effects such as atrophy. Sixty healthy participants underwent MRI scanning (28 F, 32 M, age range: 18-78, 30 young and 30 old) in November 2017-March 2018 at the Bilkent University UMRAM Center. Four images with varying flip angles with FLASH (fast low angle shot magnetic resonance imaging) sequence and a high-resolution structural image with MP-RAGE (Magnetization Prepared - RApid Gradient Echo) were acquired. T1 relaxation times of the entire brain were mapped by using the region of interest (ROI) based method on 134 brain areas in young and old populations. T1 prolongation was observed in various subcortical (bilateral hippocampus, caudate and thalamus) and cortical brain structures (bilateral precentral gyrus, bilateral middle frontal gyrus, bilateral supplementary motor area (SMA), left middle occipital gyrus, bilateral postcentral gyrus and bilateral Heschl's gyrus) as well as cerebellar regions (GM regions of cerebellum: bilateral cerebellum III, cerebellum IV V, cerebellum X, cerebellar vermis u 4 5, cerebellar vermis u 9 and WM cerebellar regions: left cerebellum IX, bilateral cerebellum X and cerebellar vermis u 4 5). T1 mapping provides a practical quantitative MRI (qMRI) methodology for studying the tissue characteristics in healthy aging. T1 values are significantly increased in the aging group among half of the studied ROIs (57 ROIs out of 134).

Association of anosmia and neutralizing antibody production in adolescents with SARS-CoV-2.

To monitor olfactory/gustatory dysfunction and its relationship to SARS-CoV-2 IgG antibody responses in an adolescent population. Adolescents with changes in olfactory/gustatory functions were enrolled in a 15-month study. The patients were evaluated with 1) SNOT-22, 2) pediatric smell wheel, and 3) SARS-CoV-2 antibody testing. The relationship between these scores and length of anosmia, and the amount of SARS-CoV-2 IgG antibodies were assessed. A brain MRI was performed in cases of persistent special sensory symptoms. Eighteen patients were identified with smell and/or taste complaints. Most of the patients were female (67%) and median age was 15 years (range 11-17). Twelve patients had prior SARS-CoV-2 PCR testing, with only five patients with a positive result. The median SNOT-22 score was 16 (range 0-52) and the median smell wheel score was 6.5 (range 1-11). Patients with taste difficulty were more likely to have a score less than eight. 78% of the patients tested positive for antibodies and there was a strong negative correlation between smell wheel score and antibody level (Spearman, ρ=-0.798, p=0.002). Five patients underwent MRI scan, and all resulted as normal olfactory bulb structures. 66% received nasal corticosteroids. 11 patients presented in follow up. Adolescents presenting to a pediatric ENT clinic during the SARS-CoV-2 pandemic were likely to have prolonged (>6 weeks) symptoms of SARS-CoV-2. The majority do not report positive PCR testing result but do report systemic symptoms including anosmia. This suggests that anosmia may be both a late and prolonged symptom of SARS-CoV-2.

Investigating Longitudinal Continuity of Persistent White Matter Alterations in Sport-related Concussion Using Individualized Analyses

Background: Sport-related concussion (SRC) has been shown to lead to acute and long-term alterations in white matter (WM) organization. The Centers for Disease Control estimates around 283,000 children each year seek medical attention for SRC/recreation-related traumatic brain injury. However, literature on subject-specific longitudinal WM abnormalities in SRC is limited.Purpose: Given the heterogeneous nature of SRC on WM microstructure, the goal of this study is to investigate the longitudinal continuity of persistent white matter alterations using a subject-specific approach.
 Methods: MRI is a non-invasive imaging modality suitable for detecting neuropathophysiological changes after SRC. Compared to conventional anatomical MRI, using diffusion MRI to probe WM microarchitecture may provide additional sensitivity.The diffusion MRI data from 50 participants were obtained from the CARE consortium, a prospective multisite study examining the natural history of concussion. Each concussed athlete underwent MRI scan at three time points: (1) 24-48 hours after concussion, (2) asymptomatic state, and (3) 7-days after returned to play. Diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) metrics were computed and Z-scored based on a normal distribution template created from non-contact sport controls. Potential WM alterations indicated by extreme deviations of Z-score maps were calculated for all diffusion metrics in each concussed participant and time point.
 Results: WM alterations persistent across all three timepoints manifested in 76%, 62%, and 82% of the participants as quantified by increases of mean, axial, and radial diffusivity, respectively. 58% of the participants had fractional anisotropy decreases. For NODDI metrics, 82% and 86% of the participants showed increases of isotropic volume fraction and orientation dispersion index, respectively.
 Conclusion: This study demonstrated that by applying subject-specific analysis, extreme Z-score voxels can be identified across time in the same or spatially proximal brain regions suggesting persistent WM abnormalities beyond apparent clinical recovery.

Cocaine use disorder is associated with widespread surface-based alterations of the basal ganglia

Cocaine use is a major public health problem with significant negative consequences at the individual and societal levels. Cocaine use disorder (CUD) is closely associated with brain structure alterations, which are mainly analyzed using voxel-based morphometric and traditional volumetric methods with certain limitations. This study conducted vertex-wise shape analysis to examine the effects of cocaine use on surface-based alterations of the basal ganglia in CUD. A total of 68 CUD individuals and 52 matched healthy controls (HCs) were enrolled in the study and underwent MRI scans and clinical measures. There were no significant differences in the volume of brain tissues and subcortical structures between groups. Related to HCs, CUD individuals showed regional surface atrophy of the left medial anterior thalamus, right medial posterior thalamus, and right dorsal anterior caudate, which were found to exhibit more significant surface atrophy in CUD individuals with onset age of cocaine use below 18. Furthermore, surface-based alteration of the right dorsal anterior caudate was significantly associated with years of cocaine use and the onset age of cocaine use in CUD individuals. Furthermore, both CUD individuals with onset age of cocaine use below 18 and CUD individuals with onset age of cocaine use above 18 showed similar significant relationship patterns between regional surface alteration of right dorsal anterior caudate and the onset age of cocaine use. These findings shed light on the effect of cocaine use on basal ganglia, help us understand the neural basis of cocaine dependence, and further provide effective interventions for CUD.

Preoperative Nomogram Incorporating Clinical Factors, Serological Markers and LI-RADS MRI Features to Predict Early Recurrence of Hepatocellular Carcinoma Treated with Transarterial Chemoembolization

To develop and validate a preoperative nomogram model that incorporates clinical factors, serological markers and liver imaging reporting and data system (LI-RADS v2018) MRI features for predicting early recurrence (ER) of hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE). One hundred and fourteen patients with HCC who underwent MRI scanning before TACE were enrolled retrospectively and divided into a training cohort (n=80) and a test cohort (n=34). The clinical factors, serological markers and LI-RADS v2018 MRI features associated with ER were determined by univariable and multivariable analyses. A nomogram model predicting ER after TACE was developed, and its discriminatory ability, goodness-of-fit and clinical application were evaluated by receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA), respectively. In total, 74 (64.9%) patients were diagnosed with ER according to the follow-up results. Increased alpha fetoprotein (AFP) levels, larger tumor size, nonsmooth margin, mosaic architecture satellite nodules and corona enhancement were independent predictors associated with ER (p < 0.05). For the established nomogram model that incorporated these six significant predictors, the AUC values were 0.94 (95% CI: 0.89-0.99) and 0.95 (95% CI: 0.88-1.00) for predicting ER after TACE in the training and test cohorts, respectively. The calibration curve and DCA results demonstrate the good goodness-of-fit and clinical benefits of this nomogram. A preoperative nomogram model based on serological markers and LI-RADS v2018 MRI features could adequately predict ER in HCC patients after TACE, which may provide personalized guidance for predicting prognosis.

Study of bone marrow microstructure in healthy young adults using intravoxel incoherent motion diffusion-weighted MRI.

Bone marrow is one of the most important organs in the human body. The evaluation of bone marrow microstructure and gender-related cellular and capillary networks in healthy young adults can help to better understand the process of bone metabolism. Intravoxel incoherent motion (IVIM) provides both diffusion and perfusion quantifications without requiring intravenous contrast agent injection. In this prospective study, 60 healthy young age-matched volunteers (30 men and 30 women) underwent MRI scans at 1.5 T using multi-b-value diffusion-weighted imaging on sagittal planes covering the lumbar bone marrow. The apparent diffusion coefficient (ADC), true ADC (D), pseudo-ADC (D*), and perfusion fraction (f) were calculated from the diffusion-weighted images using the mono- and bi-exponential models. Lumbar cancellous bone (L2-L4) was selected as the region of interest. An independent t-test was used to detect significant differences in ADC values and IVIM parameters between men and women. The differences in IVIM parameters among the L2, L3, and L4 groups were compared with analysis of variance. The D and f values in women were significantly higher than that in men (p = 0.001, 0.026). However, D* was significantly lower in women than that in men (p = 0.001). Furthermore, there was no significant gender difference for the conventional ADC value (p = 0.186). Moreover, there were no significant differences in the D, f, and D* values among the L2, L3, and L4 vertebras of women or men. IVIM parameters can show differences in bone marrow between young women and men. As a non-invasive method, it can assess bone marrow microstructure, such as cellularity and perfusion.

Effects of aromatherapy and music therapy on patients' anxiety during MRI examinations: a randomized controlled trial.

Many patients experience anxiety during MRI examinations. However, little attention has been focused on decreasing patient anxiety and minimizing on-site cancellations. Here, we aimed to investigate the effects of aromatherapy and music therapy on alleviating anxiety during MRI examinations. This single-center, double-blinded, randomized control trial was conducted between November 1, 2021, and January 10, 2022. Patients undergoing MRI examinations were assigned randomly into either the aromatherapy group (AG), music therapy group (MG), aromatherapy plus music therapy group (AMTG), or routine care group (RG) at a ratio of 1:1:1:1. Aromatherapy was conducted through inhalation of lavender oil. Music therapy was performed using Pachelbel's Canon in D major. The primary outcome was the change in anxiety before and after the MRI scan, assessed using both the State-Trait Anxiety Inventory form 1 (STAI-1) and Self-Rating Anxiety Scale (SAS). The second outcome was the participant's comfort, measured using Kolcaba's General Comfort Questionnaire (GCQ). A total of 200 participants (mean age: 48.3 ± 14.9 years; 126 [63.0%] females) were enrolled, with 50 per group. The mean anxiety scores of the AMTG showed greater reduction compared with the AG, MG, and RG (ΔSTAI-1: 6.5 vs 2.6 vs 2.7 vs 1.9, p < 0.001; ΔSAS: 4.0 vs 1.4 vs 1.7 vs 0.6, p < 0.001). The mean GCQ score of the AMTG was higher compared with the AG, MG, and RG (98.0 vs 92.6 vs 91.2 vs 89.2, respectively, p < 0.001). Aromatherapy combined with music therapy is effective for reducing patients' anxiety and improving their comfort level during MRI scans. • In this randomized control trial of 200 participants undergoing MRI scans, aromatherapy plus music therapy is effective in reducing STAI-1 and SAS, as well as improving GCQ scores. • Although there was a significant difference between the aromatherapy plus music therapy and the single-intervention modalities, no significant differences were observed between the aromatherapy and music therapy themselves for state anxiety and comfort score. • Aromatherapy plus music therapy is a safe, non-invasive, nonpharmacological, and inexpensive patient-centered intervention for reducing anxiety and improving comfort in adults undergoing MRI examinations.

Altered brain network centrality in Parkinson's disease patients after deep brain stimulation: a functional MRI study using a voxel-wise degree centrality approach.

After deep brain stimulation (DBS), patients with Parkinson's disease (PD) show improved motor symptoms and decreased verbal fluency, an effect that occurs before the initiation of DBS in the subthalamic nucleus. However, the underlying mechanism remains unclear. This study aimed to evaluate the effects of DBS on whole-brain degree centrality (DC) and seed-based functional connectivity (FC) in PD patients. The authors obtained resting-state functional MRI data of 28 PD patients before and after DBS surgery. All patients underwent MRI scans in the off-stimulation state. The DC method was used to evaluate the effects of DBS on whole-brain FC at the voxel level. Seed-based FC analysis was used to examine network function changes after DBS. After DBS surgery, PD patients showed significantly weaker DC values in the left middle temporal gyrus, left supramarginal gyrus, and left middle frontal gyrus, but significantly stronger DC values in the midbrain, left precuneus, and right precentral gyrus. FC analysis revealed decreased FC values within the default mode network (DMN). This study demonstrated that the DC of DMN-related brain regions decreased in PD patients after DBS surgery, whereas the DC of the motor cortex increased. These findings provide new evidence for the neural effects of DBS on voxel-based whole-brain networks in PD patients.

Three-dimensional ultrasound integrating nomogram and the blood flow image for prostate cancer diagnosis and biopsy: A retrospective study.

Prostate cancer (PCa) is the second most common male cancer in the world and based on its high prevalence and overwhelming effect on patients, more precise diagnostic and therapeutic methods are essential research topics. As such, this study aims to evaluate the value of three-dimensional transrectal ultrasound (3D-TRUS) in the detection, diagnosis and biopsy of PCa, and to provide a basis for clinical practice of PCa. Retrospective analysis and comparison of a total of 401 male patients who underwent prostate TRUS in our hospital from 2019 to 2020 were conducted, with all patients having prostate biopsy. Nomogram was used to estimate the probability of different ultrasound signs in diagnosing prostate cancer. The ROC curve was used to estimate the screening and diagnosis rates of 3D-TRUS, MRI and TRUS for prostate cancer. A total of 401 patients were randomly divided into two groups according to different methods of prostate ultrasonography, namely the TRUS group (251 patients) and the 3D-TRUS group (150 patients). Of these cases, 111 patients in 3D-TRUS group underwent MRI scan. The nomogram further determined the value of 3D-TRUS for prostate cancer. The ROC AUC of prostate cancer detected by TRUS, MRI and 3D-TRUS was 0.5580, 0.6216 and 0.6267 respectively. Biopsy complications were lower in 3D-TRUS group than TRUS group, which was statistically significant (P<0.005). The accuracy of 3D-TRUS was higher in diagnosis and biopsy of prostate cancer. Meanwhile, the positive rate of biopsy could be improved under direct visualization of 3D-TRUS, and the complications could be decreased markedly. Therefore, 3D-TRUS was of high clinical value in diagnosis and biopsy of prostate cancer.

Obesity is associated with greater cognitive function in patients with type 2 diabetes mellitus.

The impact of obesity on cognitive function in patients with type 2 diabetes mellitus (T2DM) remains controversial. This study aimed to evaluate whether obesity, assessed by body mass index (BMI) was associated with cognitive function among T2DM patients and whether the effect of obesity on cognitive function was through brain structure. This was a post-hoc analysis of the Action to Control Cardiovascular Risk in Diabetes-Memory in Diabetes (ACCORD-MIND) study. The cognitive test battery included the Digit Symbol Substitution Test (DSST), Mini-Mental State Exam (MMSE), Rey Auditory Verbal Learning Test (RAVLT), and STROOP test, which were administered at baseline, and at 20, 40, and 80 months. A subgroup (n = 614) of the ACCORD-MIND study underwent MRI scanning at baseline and at 40 and 80 months. The total brain volume (TBV), abnormal white matter volume (AWM), abnormal gray matter volume (AGM), and abnormal basal ganglia volume (ABG) were estimated. The outcomes of this study were cognitive function and brain structure. In the adjusted analyses, BMI was positively associated with the MMSE (β:0.08, 95%CI,0.01-0.16, per standard deviation [SD] increase) and RAVLT scores (β:0.09, 95%CI,0.01-0.18). It was also associated with a greater TBV (β:7.48, 95%CI,0.29-14.67). BMI was not associated with the DSST or STROOP scores, and AWM, AGM, ABG. Mediation analysis found that the effect of BMI on MMSE/RAVLT was mediated through TBV. Obesity may be associated with greater cognitive function and the effect of BMI on cognitive function may be mediated by TBV among patients with T2DM. http://www.clinicaltrials.gov, identifier NCT00000620.

Abnormal cerebellar-prefrontal cortical pathways in obstructive sleep apnea with/without mild cognitive impairment.

Obstructive sleep apnea (OSA), a common respiratory sleep disorder, is often associated with mild cognitive impairment (MCI), which is a precursor stage to Alzheimer's disease (AD). However, the neuroimaging changes in patients with OSA with/without MCI are still under discussion. This study aimed to investigate the temporal variability of spontaneous brain activity in OSA. Fifty-two OSA patients (26 with OSA with MCI (OSA-MCI), 26 OSA without MCI (OSA-nMCI), and 26 healthy controls (HCs) underwent MRI scans and scale questionnaires. A dynamic amplitude of low-frequency fluctuation (dALFF) evaluation was performed to examine the time-varying nature of OSA-MCI and OSA-nMCI. Compared with OSA-MCI, OSA-nMCI had increased dALFF in the posterior cerebellar and right superior frontal gyrus; compared with HCs, OSA-nMCI patients showed increased dALFF in the right posterior cerebellum. A positive correlation between the bilateral posterior cerebellar lobes and right superior frontal gyrus was observed in OSA-MCI patients; however, in OSA-nMCI patients, a positive correlation was observed only between the bilateral posterior cerebellar lobes. The dALFF value of the left posterior cerebellar lobe was positively correlated with the apnea-hypopnea index (AHI), epworth sleepiness scale (ESS) score, and arousal index in OSA-nMCIs, while the dALFF value of the right posterior cerebellum was positively correlated with the AHI and negatively correlated with the lowest oxygen saturation (SaO2). This study argues that OSA-nMCIs and OSA-MCIs exhibit different temporal variabilities in dynamic brain functions, OSA-nMCIs may have variable intermediate states. We concluded that the functional abnormalities of the cerebellar-prefrontal cortex pathway in OSA-MCIs may cause cognitive impairment with OSA.

Cyclic changes in T2* relaxometry of human uterus during the menstrual cycle using BOLD MR imaging

PurposeTo evaluate dynamic changes of T2* values within the endometrium, junctional zone and myometrium during the menstrual cycle using blood oxygen level-dependent (BOLD) magnetic resonance imaging. MethodVolunteers underwent MRI scans on menstrual phase, ovulatory phase and luteal phase, including T2-weighted imaging and BOLD MR imaging. Multi-gradient-recalled echo (MGRE) sequence was used to obtain BOLD MR images. T2* values of different uterine layers, including endometrium, junctional zone and myometrium, on sagittal images were analyzed quantitatively. ResultsTwenty-four subjects calculated T2* values successfully. The T2* values of each zonal structure during menstruation were significantly lower than those during ovulatory phase (P < 0.05) and luteal phase (P < 0.001). The T2* value of junctional zone was significantly lower than that of the myometrium over all three menstrual phases (P = 0.000, menstrual; P = 0.000, ovulatory; P = 0.001, luteal). The mean T2* value in endometrium during the ovulatory phase was the highest of the uterine zones over menstrual cycle. During menstrual phase, there was no statistical difference between endometrium and junctional zone (P > 0.05). Conversely, the comparison of the T2* values between endometrium and myometrium, junctional zone and myometrium both showed significant difference (P = 0.000). The mean T2* values within endometrium during ovulatory phase and luteal phase were significantly higher than those within junctional zone and myometrium (P < 0.05). ConclusionsCyclic changes of T2* values in each zonal structure of the uterus were revealed during the menstrual cycle by means of BOLD technique, which may be potentially beneficial in investigating dysmenorrhea, guiding assisted reproductive technologies and monitoring hypoxia in gynecological tumors.

Study of female pelvic floor muscle in overactive bladder based on MRI 3D reconstruction

BackgroundThis study examined the three-dimensional (3D) morphological changes of the urination and urinary continence anatomical structures in overactive bladder (OAB) patients, to offer a morphological data for OAB diagnosis and treatment.MethodsEleven OAB patients, 9 healthy females and 22 pelvic organ prolapse (POP) patients were enrolled and underwent MRI scans. The anatomical components of urination (bladder detrusor) and the urinary continence (main part of the urethral sphincter, compressor urethrae, and levator ani muscle (LAM) were 3D reconstructed and measured with Amira software. We also analyze the relativity between pelvic floor muscle’s morphological parameters among the volunteers, OAB and POP group.ResultsThrough 3D reconstruction, increased thickness and volume of the bladder detrusor were found in the OAB patients compared with volunteers (3.1 ± 0.7 mm vs. 1.9 ± 0.3 mm; P = 0.000 and 50,632.0 ± 19,724.7 mm3 vs. 23,386.6 ± 7826.3 mm3; P = 0.001). The volume of LAM showed no significant difference between the OAB patients and volunteers (27,089.4 ± 5015.0 mm3 vs. 27,294.4 ± 4461.4 mm3; P = 0.924); whereas, LAM’s volume of the POP patients was significantly larger than that of the volunteers (34,130.6 ± 7968.3 mm3 vs. 27,294.4 ± 4461.4 mm3; P = 0.023). The thickness and volume of the main part of urethral sphincter were significantly lower in the OAB patients compared with volunteers (2.2 ± 0.5 mm vs. 2.7 ± 0.3 mm; P = 0.018 and 2558.6 ± 703.2 mm3 vs. 23,267.3 ± 681.9 mm3; P = 0.035). The volume of the compressor urethrae was significantly lower in the OAB patients than that in the volunteers (630.3 ± 301.2 mm3 vs. 866.1 ± 514.2 mm3; P = 0.247).ConclusionsIn OAB patients, the bladder detrusor has long-term tension and contraction, which thickened muscle and increased volume, and aggravate urination. The compressor urethral and main part of urethral sphincter are weaker and the anterior part of LAM hiatus is relaxed, easily resulting in leakage of urine and ultimately incontinence. The MRI 3D reconstruction and measurement can help to evaluate pelvic floor urination and continence function, and accurately diagnose.

The Dorsolateral Prefrontal Cortex Presents Structural Variations Associated with Empathy and Emotion Regulation in Psychotherapists.

Empathic abilities have been shown to be linked with brain structural variations. Since psychotherapists constitute a population that tends to display greater empathic abilities, as shown in psychometric differences in cognitive empathy and emotional regulation, we aimed to identify cortical thickness (CT) differences between a group of professional psychotherapists and a control group. In line with the recently emphasized urge to employ more than a single workflow in cortical analyses, we utilized two cortical surface extraction and thickness estimation pipelines-CIVET and FreeSurfer. Eighteen psychotherapists and eighteen controls underwent MRI scanning and completed empathy-related psychometric assessments. We evaluated how CT measures differed between groups and if there was an association with individual empathy-related scores in a series of regions of interest (ROIs). Our analysis with CIVET shows that psychotherapists display a significantly greater CT at a ROI in the left dorsolateral prefrontal cortex (dlPFC; p < 0.05, FDR corrected). With FreeSurfer, a whole-brain vertex-wise analysis identified a statistically significant cluster in the left PFC that partially overlaps with the previous ROI. These results were reinforced by a structural covariance analysis revealing that, in psychotherapists, the left dlPFC ROI seemed to vary independently from the rest of the cortex. These findings are relevant because the dlPFC region importantly participates in the cognitive components of the empathic response, such as emotion regulation and perspective taking. Thus, our findings support the idea that empathic capacity is reflected by brain structural variations while also studying for the first time a sample of subjects for whom empathic responding is crucial in their profession.

Evaluation of Spatial Attentive Deep Learning for Automatic Placental Segmentation on Longitudinal MRI.

Automated segmentation of the placenta by MRI in early pregnancy may help predict normal and aberrant placenta function, which could improve the efficiency of placental assessment and the prediction of pregnancy outcomes. An automated segmentation method that works at one gestational age may not transfer effectively to other gestational ages. To evaluate a spatial attentive deep learning method (SADL) for automated placental segmentation on longitudinal placental MRI scans. Prospective, single-center. A total of 154 pregnant women who underwent MRI scans at both 14-18 weeks of gestation and at 19-24 weeks of gestation, divided into training (N=108), validation (N=15), and independent testing datasets (N=31). A 3 T, T2-weighted half Fourier single-shot turbo spin-echo (T2-HASTE) sequence. The reference standard of placental segmentation was manual delineation on T2-HASTE by a third-year neonatology clinical fellow (B.L.) under the supervision of an experienced maternal-fetal medicine specialist (C.J. with 20 years of experience) and an MRI scientist (K.S. with 19 years of experience). The three-dimensional Dice similarity coefficient (DSC) was used to measure the automated segmentation performance compared to the manual placental segmentation. A paired t-test was used to compare the DSCs between SADL and U-Net methods. A Bland-Altman plot was used to analyze the agreement between manual and automated placental volume measurements. A P value < 0.05 was considered statistically significant. In the testing dataset, SADL achieved average DSCs of 0.83 ± 0.06 and 0.84 ± 0.05 in the first and second MRI, which were significantly higher than those achieved by U-Net (0.77 ± 0.08 and 0.76 ± 0.10, respectively). A total of 6 out of 62 MRI scans (9.6%) had volume measurement differences between the SADL-based automated and manual volume measurements that were out of 95% limits of agreement. SADL can automatically detect and segment the placenta with high performance in MRI at two different gestational ages. 4 TECHNICAL EFFICACY STAGE: 2.

Remote cortical atrophy and language outcomes after chronic left subcortical stroke with aphasia.

ObjectiveSubcortical stroke can cause a variety of language deficits. However, the neural mechanisms underlying subcortical aphasia after stroke remain incompletely elucidated. We aimed to determine the effects of distant cortical structures on aphasia outcomes and examine the correlation of cortical thickness measures with connecting tracts integrity after chronic left subcortical stroke.MethodsThirty-two patients and 30 healthy control subjects underwent MRI scanning and language assessment with the Western Aphasia Battery-Revised (WAB-R) subtests. Among patients, the cortical thickness in brain regions that related to language performance were assessed by the FreeSurfer software. Fiber tracts connecting the identified cortical regions to stroke lesions were reconstructed to determine its correlations with the cortical thickness measures across individual patient.ResultsCortical thickness in different parts of the left fronto-temporo-parietal (FTP) regions were positively related to auditory-verbal comprehension, spontaneous speech and naming/word finding abilities when controlling for key demographic variables and lesion size. Cortical thickness decline in the identified cortical regions was positively correlated with integrity loss of fiber tracts connected to stroke lesions. Additionally, no significant difference in cortical thickness was found across the left hemisphere between the subgroup of patients with hypoperfusion (HP) and those without HP at stroke onset.ConclusionsThese findings suggest that remote cortical atrophy independently predicts language outcomes in patients with chronic left subcortical stroke and aphasia and that cortical thinning in these regions might relate to integrity loss of fiber tracts connected to stroke lesions.

A study on longitudinal changes in white matter microstructure of parents who have lost their only child based on diffusion tensor imaging and its relationship with symptoms of posttraumatic stress disorder

Objective: To investigate the longitudinal changes of white matter microstructural based on diffusion tensor imaging in parents who lost their only child without psychiatric disorders and its relationship with symptoms of posttraumatic stress disorder (PTSD). Methods: Parents who had who lost their only child and without psychiatric disorders in Jiangsu Province, from September 2016 to March 2017, were retrospectively collected (TENP group, 32). MRI scans were performed at baseline and at the end of 5-year follow-up, and the Clinician Administered PTSD Scales (CAPS) were used for assessing the severity of symptoms. Additionally, sex, age and education level matched healthy subjects were recruited as healthy controls (control group, 27) and underwent MRI scanning using the same protocol. The differences of fractional anisotropy (FA) values between TENP group and control group at baseline were analyzed by using Tract-based spatial statistics method, and the brain areas of lateral differences were used as the regions of interest for longitudinal follow-up analysis of TENP group. Partial correlation analysis was used to evaluate the relationship between FA values changes in longitudinal differences in brain regions and CAPS scores. Results: Compared with the control group, FA values of the right cingulate gyrus, Uncinate fasciculus, superior longitudinal fasciculus, corticospinal tract, Inferior fronto-occipital fasciculus, Inferior longitudinal fasciculus and forceps major in TENP group were decreased at baseline ((0.613±0.032) vs (0.631±0.034), (0.539±0.048) vs (0.563±0.045), (0.534±0.033) vs (0.558±0.039), (0.560±0.038) vs (0.580±0.030), (0.519±0.023) vs(0.549±0.024), (0.489±0.038) vs (0.518±0.027), (0.499±0.027) vs (0.533±0.032); all P<0.05). From baseline to follow-up, scores of trauma reexperience symptoms and avoidance/numbness symptoms were decreased ((5.2±2.8) vs (8.1±4.9), (4.0±3.2) vs (6.6±5.4); all P<0.05); FA values of the right corticospinal tract, Inferior fronto-occipital fasciculus, Inferior longitudinal fasciculus and forceps major were decreased ((0.523±0.049) vs (0.537±0.049), (0.568±0.052) vs (0.590±0.050), (0.540±0.063) vs (0.559±0.059), (0.520±0.059) vs (0.547±0.059); all P<0.05); The decrease of FA values of the right Inferior fronto-occipital fasciculus and right Inferior longitudinal fasciculus was negatively correlated with the decrease of avoidance/numbness symptoms scores (r=-0.458, -0.374, respectively, all P<0.05). Conclusions: The trauma of parents who lost their only child can result in impaired microstructural integrity of white matter. As the post-traumatic time goes by, parents who have lost their only child do not develop to PTSD and other psychiatric disorders, and the clinical symptoms are alleviated, the damage of the white matter microstructure continued to progress.

Moyamoya Disease With Initial Ischemic or Hemorrhagic Attack Shows Different Brain Structural and Functional Features: A Pilot Study.

ObjectiveCerebral ischemia and intracranial hemorrhage are the two main phenotypes of moyamoya disease (MMD). However, the pathophysiological processes of these two MMD phenotypes are still largely unknown. Here, we aimed to use multimodal neuroimaging techniques to explore the brain structural and functional differences between the two MMD subtypes.MethodsWe included 12 patients with ischemic MMD, 10 patients with hemorrhagic MMD, and 10 healthy controls (HCs). Each patient underwent MRI scans and cognitive assessment. The cortical thickness of two MMD subtypes and HC group were compared. Arterial spin labeling (ASL) and diffusion tensor imaging (DTI) were used to inspect the cerebral blood flow (CBF) of cortical regions and the integrity of related white matter fibers, respectively. Correlation analyses were then performed among the MRI metrics and cognitive function scores.ResultsWe found that only the cortical thickness in the right middle temporal gyrus (MTG) of hemorrhagic MMD was significantly greater than both ischemic MMD and HC (p < 0.05). In addition, the right MTG showed higher ASL-CBF, and its associated fiber tract (arcuate fasciculus, AF) exhibited higher fractional anisotropy (FA) values in hemorrhagic MMD. Furthermore, the cortical thickness of the right MTG was positively correlated with its ASL-CBF values (r = 0.37, p = 0.046) and the FA values of right AF (r = 0.67, p < 0.001). At last, the FA values of right AF were found to be significantly correlated with cognitive performances within patients with MMD.ConclusionsHemorrhagic MMD shows increased cortical thickness on the right MTG in comparison with ischemic MMD and HCs. The increased cortical thickness is associated with the higher CBF values and the increased integrity of the right AF. These findings are important to understand the clinical symptoms and pathophysiology of MMD and further applied to clinical practice.

Assessing left atrial function in patients with atrial fibrillation and valvular heart disease using cardiovascular magnetic resonance imaging

BackgroundAtrial fibrillation (AF) is common arrhythmia in valvular heart disease (VHD) and is associated with adverse outcomes.HypothesisTo evaluate the left atrial (LA) function in patients with AF‐VHD by cardiovascular magnetic resonance imaging feature tracking (CMR‐FT) using LA strain (ε s/ε e/ε a) and their corresponding strain rate (SRs/SRe/SRa).MethodsThis was a retrospective cross‐sectional inter‐reader and intra‐reader reproducibility conducted from July 1, 2020, to January 31, 2021. A total of 39 patients with AF‐VHD (rheumatic heart valvular disease [RHVD] [n = 22], degenerative heart valvular disease [DHVD] [n = 17]) underwent MRI scans performed with drug‐controlled heart rate before correcting the rhythm and valves through maze procedure. Fifteen participants with normal cardiac MRI were included as healthy control. ε s/SRs, ε e/SRe, and ε a/SRa, corresponding to LA reservoir, conduit, and booster‐pump function, were assessed using Feature Tracking software (CVI42 v5.12.1).ResultsCompared with healthy controls, LA global strain parameters (ε s/ε e/ε a/SRs/SRe/SRa) were significantly decreased (all p < 0.001), while LA size and volume were increased in AF‐VHD group (all p < 0.001). In the subgroup, RHVD group showed lower LA total ejection fraction (LATEF) and strain data than DHVD group (12.6% ± 3.3% vs. 19.4 ± 8.6, p = 0.001). Decreased LATEF was significantly related to altered LA strain and strain rate, especially in ε s, ε e, and SRs (Pearson/Spearman r/ρ = 0.856/0.837/0.562, respectively; all p < 0.001). Interstudy and intrastudy reproducibility were consistent for LA volumetry and strain parameters (intraclass correlation coefficient: 0.88–0.99).ConclusionsCMR‐FT can be used to assess the LA strain parameters, and identify LA dysfunction and deformation noninvasively, which could be a helpful functional imaging biomarker in the clinical treatment of AF‐VHD.

Verbal production dynamics and plasticity: functional contributions of language and executive control systems.

Bilingual language production requires both language knowledge and language control in order to communicate in a target language. Learning or improving a language in adulthood is an increasingly common undertaking, and this has complex effects on the cognitive and neural processes underlying language production. The current functional magnetic resonance imaging (fMRI) experiment investigated the functional plasticity of verbal production in adult language learners, and examined the dynamics of word retrieval in order to dissociate the contributions of language knowledge and executive control. Thirty four adults who were either intermediate or advanced language learners, underwent MRI scanning while performing verbal fluency tasks in their native and new languages. A multipronged analytical approach revealed (i) time-varying contributions of language knowledge and executive control to verbal fluency performance, (ii) learning-related changes in the functional correlates of verbal fluency in both the native and new languages, (iii) no effect of learning on lateralization, and (iv) greater functional coupling between language and language control regions with greater second language experience. Collectively, our results point to significant functional plasticity in adult language learners that impacts the neural correlates of production in both the native and new languages, and provide new insight into the widely used verbal fluency task.