Value Of Diffusion Tensor Imaging Research Articles

The added value of diffusion tensor imaging with systematic bias correction for the assessment of liver morphology and physiology.

Diffusion-weighted images of the human liver are prone to artifacts from bulk motions, poor SNR, non-uniformity of magnetic field gradients, and non-optimal choice of diffusion weightings. These factors markedly affect diffusion tensor imaging (DTI) metrics such as mean diffusivity (MD) and fractional anisotropy (FA). This work presents a simple preprocessing pipeline for enhanced magnetic field gradient non-uniformity calibration and analysis of the systematic bias removal attained in each correction step. Liver DTI scans were conducted in two isotropic phantoms and one healthy volunteer. Diffusion tensor was calculated for the original data and after denoising, B1 correction, rigid body registration, and magnetic field gradient non-uniformity correction applying the B-matrix spatial distribution (BSD) method and then, compared with the standard approach (sDTI). MD and FA were determined in three segments of the right lobe from DTI using four different combinations of b-values from the set 0, 400, and 800 s/mm2. Results showed that the proposed preprocessing and BSD methods have a significant impact on MD and FA values in off- and iso-centered isotropic phantoms. The applied corrections applied to the human liver resulted in a 11% change in MD and a - 64% change in FA. By manipulating the b-values used in the diffusion tensor calculation, DTI metrics that reflect only morphology or additional information about liver tissue physiology can be obtained. Accurate quantification of the human liver by diffusion requires appropriate preprocessing and carefully chosen b-value. Noise, B1 inhomogeneity, mis-registration, and non-uniform magnetic field gradients significantly change distributions of DTI metrics in isotropic phantoms and the human liver. Basic preprocessing and the B-matrix spatial distribution (BSD) method perform differently for off-center and isocenter locations. In the human liver, they removed systematic bias of FA and MD by up to -63% and 11%, respectively. Visible variability of FA and MD among b-value sets indicates the possibility of DTI sensitization to different liver compartments.

Role of diffusion tensor imaging in the evaluation of white matter integrity in idiopathic intracranial hypertension.

To determine whether idiopathic intracranial hypertension (IIH) may affect white matter integrity and optic pathways by using diffusion tensor imaging (DTI) and to correlate the DTI metrics with intracranial pressure (ICP). This study is a retrospective case-control study. A total of 42 patients who underwent lumbar puncture and those with elevated ICP, meeting the diagnostic criteria for IIH, were included in the study. All patients had supportive magnetic resonance imaging findings for the diagnosis of IIH. The headache control group comprised 36 patients who presented to the Neurology Department with infrequent episodic tension-type headache, had a normal neurologic examination, and had clinical and radiological findings suggestive of normal ICP. For each patient with IIH, clinical findings and ophthalmological measurements were recorded. The apparent diffusion coefficient (ADC), fractional anisotropy (FA), axial diffusivity (AD), and radial diffusivity (RD) values were calculated using a region of interest-based method in different white matter tracts and optic pathways and compared. A total of 42 patients diagnosed with IIH (three males, 39 females), with a mean (standard deviation [SD] age of 38.1 (8.9) years), and 36 headache controls (10 males, 26 females, mean [SD] age; 38.1 [9.4] years) were included in the study. The mean (SD) body mass index (BMI) of the patients with IIH was 25.2 (1.9) kg/m2, and the mean (SD) BMI of the headache controls was 23.3 (1.5) kg/m2 (p < 0.001). Decreased FA values and increased RD values in the cingulum were detected in patients with IIH compared to the headache controls (p = 0.003, Cohen's d = 0.681; p = 0.002 Cohen's d = -0.710). Decreased AD values in the left and right superior cerebellar peduncle and increased ADC values in the middle cerebellar peduncle were detected in patients with IIH compared to the headache controls (p < 0.001, Cohen's d = 0.961; p = 0.009, Cohen's d = 0.607; p = 0.015, Cohen's d = -0.564). Increased ADC and RD values and decreased FA values in optic nerve were detected in patients with IIH (p = 0.010, Cohen's d = -0.603; p = 0.004, Cohen's d = -0.676; p = 0.015 Cohen's d = 0.568). Apositive correlation was found between the cerebrospinal fluid pressure and ADC values of the left and right superior and left inferior longitudinal fasciculus, genu of the corpus callosum, and right optic radiation (r = 0.43, p = 0.005; r = 0.31, p = 0.044; r = 0.39, p = 0.010; r = 0.35, p = 0.024; r = 0,41, p = 0.007). There was a positive correlation between the retinal nerve fiber layer thickness and the ADC values of the optic nerve (r = 0.32, p = 0.039). Intracranial hypertension can be associated with deteriorated DTI values, which might be interpreted as a sign of impaired white matter microstructural integrity in many brain regions beyond the periventricular white matter. Pressure-induced edema and axonal degeneration may be the potential underlying mechanisms of this microstructural damage.

Ex vivo diffusion tensor imaging of the plantar nerves is feasible in the horse.

The objective of this study was to optimize an MRI-based diffusion tensor imaging (DTI) protocol for imaging the plantar nerves at the level of the tarsus in normal equine limbs. 12 pelvic cadaver limbs from horses without evidence of proximal suspensory pathology were imaged with a 3T MRI system. For diffusion-weighted imaging, b values of 600, 800, and 1,000 s/mm2 were tested. Data were processed with DSI Studio. Cross-sectional areas of the medial and lateral plantar nerve along the plantar tarsus were recorded. The length and number of fiber tracts, signal-to-noise ratio, and DTI variables were recorded. At the level of interest, the mean cross-sectional areas of the plantar nerves ranged from 5.03 to 7.42 mm2. The DTI maps consistently generated tracts in the region of the lateral and medial plantar nerves with DTI values in the range of values reported for peripheral nerves in humans. Our findings demonstrate that DTI of the medial and lateral plantar nerves can be performed successfully and used to generate quantitative parameters including fractional anisotropy and mean, axial, and radial diffusivity. Quantitative data generated with this imaging technique can be used to noninvasively characterize the microstructural integrity of neural tissue with possible applications in the evaluation of pathologic changes to the plantar tarsal and metatarsal nerves of horses with proximal suspensory desmopathy.

Alterations in white matter integrity in Egyptian youth with smartphone dependence: does DTI have a role?

BackgroundSmartphones provide various functions that facilitate our communication, organization, and entertainment in different situations. Diffusion tensor imaging (DTI) is a method measuring tissue microstructure as well as white matter integrity of the brain and detecting early changes. Several research studies recently aim to utilize conventional MRI for assessing brain structural alterations among smartphone users, but our study was aimed at identifying the DTI value while assessing white matter alterations in Egyptian youth with smartphone dependence.ResultsOur prospective case–control study involved fifty-three individuals with smart phone dependence (SPD group) as well as twenty-five volunteers who represented the control group. SPD individuals and controls were right-handed. The SPD group mean age exhibited 20.54 ± 1.56 years, while controls exhibited 26.8 ± 15.1 years. When utilizing smart phone addiction scale-short version, SPD group median total score exhibited 33. The diagnostic performance of fornix (fractional anisotropy) FA and external capsule fractional anisotropy (EC FA) regarding area under curve (AUC) exhibited significant increase as opposed to all other tested regions, with a sensitivity of 90.6% as well as a specificity of 96%. While regarding the mean diffusivity (MD), the greatest (AUC) was for EC (0.927, p < 0.001), in which the MD value = 0.825 was the cutoff value and able to diagnose the smart phone dependency with a sensitivity of 92.5% as well as a specificity of 76%.ConclusionsQuantitative DTI parameters (FA, MD) in different white matter regions can diagnose and detect white matter changes in excessive smartphone users even when conventional MRI data are normal. This study demonstrates the recent noninvasive MRI technique value while revealing covered brain white matter alterations in Egyptian youth due to smartphone overuse.

Differences of white matter structure for diffusion kurtosis imaging using voxel-based morphometry and connectivity analysis.

In a clinical study, diffusion kurtosis imaging (DKI) has been used to visualize and distinguish white matter (WM) structures' details. The purpose of our study is to evaluate and compare the diffusion tensor imaging (DTI) and DKI parameter values to obtain WM structure differences of healthy subjects. Thirteen healthy volunteers (mean age, 25.2 years) were examined in this study. On a 3-T MRI system, diffusion dataset for DKI was acquired using an echo-planner imaging sequence, and T1-weghted (T1w) images were acquired. Imaging analysis was performed using Functional MRI of the brain Software Library (FSL). First, registration analysis was performed using the T1w of each subject to MNI152. Second, DTI (eg, fractional anisotropy [FA] and each diffusivity) and DKI (eg, mean kurtosis [MK], radial kurtosis [RK], and axial kurtosis [AK]) datasets were applied to above computed spline coefficients and affine matrices. Each DTI and DKI parameter value for WM areas was compared. Finally, tract-based spatial statistics (TBSS) analysis was performed using each parameter. The relationship between FA and kurtosis parameters (MK, RK, and AK) for WM areas had a strong positive correlation (FA-MK, R2 = 0.93; FA-RK, R2 = 0.89) and a strong negative correlation (FA-AK, R2 = 0.92). When comparing a TBSS connection, we found that this could be observed more clearly in MK than in RK and FA. WM analysis with DKI enable us to obtain more detailed information for connectivity between nerve structures. Quantitative indices of neurological diseases were determined using segmenting WM regions using voxel-based morphometry processing of DKI images.

Evaluation of white matter microstructural alterations in premature infants with necrotizing enterocolitis.

Preterm infants with necrotizing enterocolitis (NEC) are at high risk of adverse neurodevelopmental outcomes. The aim of this study was to explore the value of diffusion tensor imaging (DTI) combined with serum C-reactive protein (CRP) and procalcitonin (PCT) in evaluating alterations of white matter (WM) microstructure in preterm infants with NEC. A retrospective cross-sectional study was conducted in which all participants were consecutively enrolled at The Third Affiliated Hospital of Zhengzhou University from June 2017 and October 2021. Data from 30 preterm infants with NEC [mean gestational age at birth 31.41±1.15 weeks; mean age at magnetic resonance imaging (MRI) 37.53±3.08 weeks] and 40 healthy preterm infants with no NEC were recorded (mean gestational age at birth 32.27±2.09 weeks; mean age at MRI 37.15±3.23 weeks). WM was used to obtain the fractional anisotropy (FA) and mean diffusivity (MD) values of the regions of interest (ROIs). Additionally, serum levels of CRP and PCT were determined. Spearman correlation analysis was performed between the WM-derived parameters, CRP level, and the PCT serum index. Preterm infants with NEC had reduced FA values and elevated MD values in WM regions [posterior limbs of the internal capsule (PLIC), lentiform nucleus (LN), frontal white matter (FWM)] compared to the control group (P<0.05). Additionally, the FA of the PLIC was negatively correlated with serum CRP (r=-0.846; P<0.05) and PCT (r=-0.843; P<0.05). Meanwhile, the MD of PLIC was positively correlated with serum CRP (r=0.743; P<0.05) and PCT (r=0.743; P<0.05, respectively). The area under the curve (AUC) of FA and MD combined with CRP and PCT in the diagnosis of WM microstructure alterations with NEC was 0.968, representing a considerable improvement in predicted efficacy over single indicators, including FA [AUC: 0.938; 95% confidence interval (CI): 0.840-0.950], MD (AUC: 0.807; 95% CI: 0.722-0.838), CRP (AUC: 0.867; 95% CI: 0.822-0.889), and PCT (AUC: 0.706; 95% CI: 0.701-0.758). WM can noninvasively and quantitatively assess the WM microstructure alterations in preterm infants with NEC. WM combined with serum CRP and PCT demonstrated superior performance in detecting and evaluating WM microstructure alterations in preterm infants with NEC.

Diffusion tensor imaging of the physis: the ABC's.

The physis, or growth plate, is the primary structure responsible for longitudinal growth of the long bones. Diffusion tensor imaging (DTI) is a technique that depicts the anisotropic motion of water molecules, or diffusion. When diffusion is limited by cellular membranes, information on tissue microstructure can be acquired. Tractography, the visual display of the direction and magnitude of water diffusion, provides qualitative visualization of complex cellular architecture as well as quantitative diffusion metrics that appear to indirectly reflect physeal activity. In the growing bones, DTI depicts the columns of cartilage and new bone in the physeal-metaphyseal complex. In this "How I do It", we will highlight the value of DTI as a clinical tool by presenting DTI tractography of the physeal-metaphyseal complex of children and adolescents during normal growth, illustrating variation in qualitative and quantitative tractography metrics with age and skeletal location. In addition, we will present tractography from patients with physeal dysfunction caused by growth hormone deficiency and physeal injury due to trauma, chemotherapy, and radiation therapy. Furthermore, we will delineate our process, or "DTI pipeline," from image acquisition to data interpretation.

Multimodal magnetic resonance imaging after experimental moderate and severe traumatic brain injury: A longitudinal correlative assessment of structural and cerebral blood flow changes.

Traumatic brain injury (TBI) is a worldwide problem that results in death or disability for millions of people every year. Progressive neurological complications and long-term impairment can significantly disrupt quality of life. We demonstrated the feasibility of multiple magnetic resonance imaging (MRI) modalities to investigate and predict aberrant changes and progressive atrophy of gray and white matter tissue at several acute and chronic time points after moderate and severe parasagittal fluid percussion TBI. T2-weighted imaging, diffusion tensor imaging (DTI), and perfusion weighted imaging (PWI) were performed. Adult Sprague-Dawley rats were imaged sequentially on days 3, 14, and 1, 4, 6, 8, and 12 months following surgery. TBI caused dynamic white and gray matter alterations with significant differences in DTI values and injury-induced alterations in cerebral blood flow (CBF) as measured by PWI. Regional abnormalities after TBI were observed in T2-weighted images that showed hyperintense cortical lesions and significant cerebral atrophy in these hyperintense areas 1 year after TBI. Temporal DTI values indicated significant injury-induced changes in anisotropy in major white matter tracts, the corpus callosum and external capsule, and in gray matter, the hippocampus and cortex, at both early and chronic time points. These alterations were primarily injury-severity dependent with severe TBI exhibiting a greater degree of change relative to uninjured controls. PWI evaluating CBF revealed sustained global reductions in the cortex and in the hippocampus at most time points in an injury-independent manner. We next sought to investigate prognostic correlations across MRI metrics, timepoints, and cerebral pathology, and found that diffusion abnormalities and reductions in CBF significantly correlated with specific vulnerable structures at multiple time points, as well as with the degree of cerebral atrophy observed 1 year after TBI. This study further supports using DTI and PWI as a means of prognostic imaging for progressive structural changes after TBI and emphasizes the progressive nature of TBI damage.

Diffusion tensor imaging and auditory tractography to evaluate cochlear implant candidacy: a pilot study

Background Conventional radiological evaluation does not evaluate the functional status of the auditory pathway in patients scheduled for cochlear implantation (CI). Objectives Determine the value of diffusion tensor imaging [DTI] in the preoperative evaluation of some patients scheduled for CI. Material and Methods Patients with profound SNHL and inner ear and/or cochlear nerve anomalies or long standing SNHL were selected. They underwent conventional MRI images of the brain in three orthogonal planes, MR arterial spin labelling (ASL), perfusion, and DTI auditory tractography to determine functional status of the auditory pathways. Results Ten patients were included. Seven with bilateral SNHL, one with fluctuating hearing loss and one with long standing single sided deafness. In 8 patients the auditory pathway could be traced and functional maps could determine the side of possible better function. In the patient with progressive hearing loss DTI revealed major central pathway problems and CI was discouraged. In the patient with SSD, DTI revealed a robust intact pathway and CI was advised. Conclusions DTI and auditory tractography can help in outlining the functional integrity of the 33auditory pathway and assist in decision making before CI.

Diffusion tensor and kurtosis imaging reveal microstructural changes in the trigeminal nerves of patients with trigeminal neuralgia.

To evaluate the use of diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) for detection of microstructural changes in the trigeminal nerves of trigeminal neuralgia (TN) patients. Forty TN patients and 40 healthy controls were examined using 3T magnetic resonance imaging (MRI) to evaluate DTI and DKI parameters in trigeminal nerves. One-way ANOVA was used to test the differences in age, sex, and DTI and DKI parameters between the TN-affected sides, TN-unaffected sides, and controls. For parameters with inter-group differences, pairwise comparisons were performed. Then, the difference ratios (DRs) of the parameters with statistical differences were calculated and used for the receiver operating characteristic (ROC) analysis to assess their diagnostic performance. In addition, for the DTI and DKI parameter values with differences, we used pure DTI and DKI values to perform the ROC analysis. Compared to the unaffected sides and controls, the FA, MK, and Kr of the affected sides of TN patients were significantly reduced, while ADC was significantly increased (p < 0.05). The diagnostic efficiency of the FA DRs (AUC: 0.974; cutoff value: 0.038; sensitivity: 100%; specificity: 95.0%) was the highest among all DTI and DKI parameters. The DRs of FA and MK more efficiently diagnosed TN than pure FA and MK values. DTI and DKI allowed detection of microstructural changes in TN-affected trigeminal nerves. FA DR was the best independent predictor of microstructural changes in TN. Both DTI and DKI can be used for noninvasive quantitative evaluation of the changes in the microstructure of the cisternal segment of the cranial nerves in clinical practice. • Diffusion tensor imaging (DTI) can be used to evaluate the in vivo integrity of white matter and nerve fiber pathway. • Diffusion kurtosis imaging (DKI) has been shown to be considerable sensitive to microstructural changes. • DTI combined with DKI can comprehensively evaluate the status of the TN-affected trigeminal nerve.

A Prospective Study to Evaluate the Clinical and Diffusion Tensor Imaging (DTI) Correlation in Patients with Lumbar Disc Herniation with Radiculopathy.

Conventional magnetic resonance imaging findings frequently do not correlate with the symptoms of lumbar disc herniation (LDH). Diffusion-weighted imaging can reveal important details about the microstructure of tissues. This study assessed the role of diffusion-weighted imaging (DTI) in LDH with radiculopathy and explored the relationship between DTI values and clinical scores. Forty-five patients with LDH with radiculopathy were evaluated via DTI at the intraspinal (IS), intraforaminal (IF), and extraforaminal (EF) levels. A visual analog scale (VAS) was used for low back and leg pain. The Japanese Orthopaedic Association (JOA) scoring system, Oswestry Disability Index (ODI), and Roland-Morris Disability Questionnaire (RMDQ) were used for functional evaluation. There was a statistically significantly (p<0.05) difference between the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values on the affected side compared with those on contralateral normal side. The VAS score had a weak positive correlation with RMDQ score (r=0.279, P=0.050). The JOA score had a moderate negative correlation with RMDQ score (r=-0.428, P=0.002), whereas the ODI score had a moderate positive correlation with RMDQ score (r=0.554, P<0.001). There was a moderate positive correlation between ADC values at the IF level and the RMDQ score on the affected side (r=0.310, P=0.029). There was no correlation between FA values and JOA score. ODI had a significantly positive correlation with the contralateral normal side FA values at the IF (r=0.399, P=0.015), EF (r=0.368, P=0.008) and IS (r=0.343, P=0.015) levels. RMDQ had a weak positive correlation with the contralateral normal side FA values at the IF (r=0.311, P=0.028), IS (r=0.297, P=0.036) and EF (r=0.297, P=0.036) levels. The decrease in FA values and the increase in ADC values are useful markers of compression. ADC correlates well with the patient's neurological symptoms and functional status. Conversely, FA correlates well with the patient's neurological symptoms, but is not correlated well with the functional status.

The additive value of diffusion tensor imaging in the determination of perianal fistula activity

BackgroundAlthough the activity of the perianal fistula has been evaluated before by MRI in the literature, limited diffusion tensor magnetic resonance imaging (DT-MRI) studies are reported to date. Our study aimed to elucidate the role of DT-MRI in evaluating the activity state of the perianal fistula and the prediction of postoperative complications. We reviewed the data of 30 patients diagnosed with perianal fistula and referred them for an MRI diffusion study before the surgical intervention. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were calculated for the fistulous area and the normal surrounding puborectalis as a control area.ResultsAccording to the presence of pus intraoperatively, patients were allocated into two groups: the active group (10 patients) and the inactive group (20 patients). FA and ADC measurements showed a significant decrease in association with the active disease when measured at the fistula site, and this was not observed in the normal surrounding tissues. The area under the curve (AUC) was 0.985 and 0.730 for the ADC and FA, respectively, when cutoff values of 1 × 10–3 mm2/s and 0.621 were applied, respectively. Adding the FA to the ADC increased the DT-MRI specificity to 95% in the determination of the active fistula. The combination between both FA and ADC increased the AUC to 0.785 with a sensitivity of 73.7% and specificity of 63.6% in the detection of postoperative complications.ConclusionsDT-MRI could be used as a reliable diagnostic tool to differentiate patients with active perianal fistula disease from inactive ones and to predict the postoperative outcome.

Diffusion Tensor Imaging as a Tool to Evaluate the Cognitive Function of Patients With Vascular Dementia: A Meta-Analysis.

Vascular dementia (VaD) is the most common type of dementia secondary to Alzheimer's disease. The pathologic mechanism of VaD is complex, and VaD still lacks a more objective diagnosis and evaluation method. Diffusion tensor imaging (DTI) can better detect the organizational structure and functional characteristics compared with any other diagnosis methods. Therefore, DTI has broad application in evaluating the severity and prognosis of VaD. This study aimed to assess the value of DTI in evaluating the cognitive function of patients with VaD. Authors searched Pubmed, Embase, and Cochrane Library, using the search terms, such as "diffusion tensor imaging," "DTI," "Vascular Dementia," "Arteriosclerotic Dementia," "Cognition," and "Cognitive." A voxel-based meta-analysis combined with quality statistics was performed, using the anisotropic effect-size version of the signed differential mapping method. A total of 8 case-control studies were included in this meta-analysis. The sample size of patients ranged from 35 to 60, including 166 patients in the VaD group and 177 healthy individuals. The DTI imaging of the brain tissue of VaD patients was significantly different from that of healthy individuals. DTI imaging of the brain tissue of VaD patients was clearly different from that of healthy controls. Therefore it may be feasible to use DTI imaging as a diagnostic method for VaD.

Docetaxel-induced cognitive impairment in rats can be ameliorated by edaravone dexborneol: Evidence from the indicators of biological behavior and anisotropic fraction.

This study aimed to investigate the effect of Edaravone Dexborneol (ED) on impaired learning and memory in docetaxel (DTX)-treated rats using cognitive behavior assessments and magnetic resonance diffusion tensor imaging (DTI). In total, 24 male Sprague-Dawley rats were divided into control, low-dose DTX (L-DTX) model, and high-dose DTX(H-DTX) model groups, with eight rats in each group, numbered 1-8. The rats were intraperitoneally injected with 1.5 mL of either normal saline (control group), or 3 mg/kg and 6 mg/kg DTX (L-DTX and H-DTX groups, respectively), once a week for 4 weeks. The learning and memory abilities of each group were tested using a water maze. At the end of the water maze test, rats 1-4 in each group were treated with ED (3 mg/kg, 1 mL), and rats 5-8 were injected with an equal volume of normal saline once a day for 2 weeks. The learning and memory abilities of each group were evaluated again using the water maze test, and the image differences in the hippocampus of each group were analyzed using DTI. (1) H-DTX group (32.33 ± 7.83) had the longest escape latency, followed by the L-DTX group (27.49 ± 7.32), and the Control group (24.52 ± 8.11) having the shortest, with the difference being statistically significant (p < 0.05). (2) Following ED treatment, compared to rats treated with normal saline, the escape latency of the L-DTX (12.00 ± 2.79 vs. 10.77 ± 3.97, p < 0.05), and the H-DTX (12.52 ± 3.69 vs. 9.11 ± 2.88, p < 0.05) rats were significantly shortened. The residence time in the target quadrant of H-DTX rats was significantly prolonged (40.49 ± 5.82 vs. 55.25 ± 6.78, p < 0.05). The CNS damage in the L-DTX rats was repaired to a certain extent during the interval between the two water maze tests (28.89 ± 7.92 vs. 12.00 ± 2.79, p < 0.05). (3) The fractional anisotropy (FA) value of DTI in the hippocampus of rats in the different groups showed variable trends. After treatment with ED, though the FA values of most areas in the hippocampus of rats in L-DTX and H-DTX groups were higher than before, they did not reach the normal level. ED can ameliorate the cognitive dysfunctions caused by DTX in rats by improving the learning and memory impairment, which is reflected in the recovery of biological behavior and DTI indicators of the hippocampus.

Diffusion tensor imaging (DTI) studies of cerebral white matter integrity in normal to moderate cardiovascular risk patients

Background &amp; Objectives: The cerebral small vessel disease (CSVD) manifest as white matter lesion (WML) in magnetic resonance imaging (MRI). The diffusion tensor imaging (DTI) study shows a lower white matter integrity in white matter lesion (WML) and its penumbra region, suggesting cerebral white matter damage. The aim of this study is to establish correlation between the DTI values of white matter with the age related white matter changes (ARWMC) visual rating score and identify predictors of ARWMC score. Methods: 63 brain MRI images of subjects were selected. Relevant clinical information of the subjects which satisfied QRISK2 risk factors were retrieved from the patients’ folder. DTI parameters were obtained via postprocessing at OsiriX DTImap workstation. Results: FA frontal (r = -0.36; p = 0.003) and AD frontal (r = -0.26; p = 0.040) had a substantial and negative correlation with the ARWMC score. There was a significant positive correlation shown between the ARWMC score and RD frontal (r = 0.30; p = 0.018). There were positive significant association between the ARWMC score and age (b(95%CI): 0.106 (0.061, 0.151); p&lt;0.001) and QRISK2 score (b(95%CI): 0.235 (0.036, 0.433)). Conclusion: DTI is a good method to study the cerebral white matter integrity. It was found that frontal lobe is the first region affected in relation to ageing, in particular the myelin integrity. Increasing age and higher QRISK2 cardiovascular risk factors were shown to increase the ARWMC score.

Porcine Model of the Growing Spinal Cord—Changes in Diffusion Tensor Imaging Parameters

Diffusion tensor imaging (DTI) is an advanced magnetic resonance imaging (MRI) technique that has promising applications for the objective assessment of the microstructure of the spinal cord. This study aimed to verify the parameters obtained using DTI change during the growth process. We also wanted to identify if the DTI values change on the course of the spinal cord. The model organism was a healthy growing porcine spinal cord (19 pigs, Polish White, weight 24-120 kg, mean 48 kg, median 48 kg, age 2.5-11 months, mean 5 months, median 5.5 months). DTI parameters were measured in three weight groups: up to 29 kg (five pigs), 30-59 kg (six pigs), and from 60 kg up (eight pigs). DTI was performed with a 1.5 Tesla magnetic resonance scanner (Philips, Ingenia). Image post-processing was done using the Fiber Track package (Philips Ingenia workstation) by manually drawing the regions of interest (nine ROIs). The measurements were recorded for three sections: the cervical, thoracolumbar and lumbar segments of the spinal cord at the C4/C5, Th13/L1, and L4/L5 vertebrae levels. In each case, one segment was measured cranially and one caudally from the above-mentioned places. The values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were obtained for each ROIs and compared. It is shown that there is a correlation between age, weight gain, and change in FA and ADC parameters. Moreover, it is noted that, with increasing weight and age, the FA parameter increases and ADC decreases, whereas the FA and ADC measurement values did not significantly change between the three sections of the spinal cord. These findings could be useful in determining the reference values for the undamaged spinal cords of animals and growing humans.

Magnetic resonance imaging assessment of the therapeutic effect of combined electroacupuncture and stem cells in acute peripheral nerve injury.

Objectives: This study aimed to evaluate the therapeutic effect of a combination of Bone Mesenchymal stem cells (BMSCs) transplantation and Electroacupuncture (EA) for acute sciatic nerve injury in rats using magnetic resonance. Methods: Ninety-two male adult healthy Sprague-Dawley rats were randomly divided into the EA+BMSCs group, EA group, MSCs group, and PBS group (control). Electroacupuncture was performed on a rat receiving EA treatment at Huantiao (GB30) and Zusanli (ST36). T2 values and diffusion tensor imaging (DTI) derived from multiparametric magnetic resonance imaging (MRI), histological assessments, and immunohistochemistry was used to monitor nerve regeneration. Walking track analysis was used to assess nerve functional recovery. Repeated-measures one-way analysis of variance was used to evaluate the significance of T2, DTI, and SFI values among the four groups. One-way analysis of variance was used for comparing the histological characteristics. Bonferroni test was used for multiple pairwise comparisons at each time point. Results: In terms of FA, the EA+BMSCs and EA groups had faster recovery than PBS (control) in all time points after surgery, and the EA+BMSCs group recovered better than the BMSCs group at 3 weeks (P ≤ 0.008). FA values were higher in the EA group than in the BMSCs group at 4 weeks (P ≤ 0.008). In terms of RD, the EA+BMSCs group recovered better than the BMSCs group at 2 and 4 weeks (P ≤ 0.008). Immunofluorescence staining for axon guidance molecule netrin-1 revealed that it was significantly higher in the EA+BMSCs subgroup and EA subgroup than it was in the control (PBS) subgroup at 1-3 weeks (P < 0.001). Immunofluorescence staining for S100 showed the continuity of nerve fibers recovered more quickly in the EA+BMSCs subgroup than in the BMSCs subgroup. Conclusion: Our research revealed that a combination of MSCs and EA can provide both topological and biomolecular guidance to promote axonal extension, myelin regeneration, and functional recovery after PNI. EA not only promotes nerve repair on its own, but also enhanced the beneficial effects of stem cell treatment and the secretion of netrin 1, a guidance regeneration factor, and promotes the orderly growth of nerve fibers. These PNI repairs could be monitored non-invasively and in situ by MRI. The FA and RD values derived from MRI could be sensitive biomarkers to reflect the PNI repair process.

Discriminating glioblastoma from solitary brain metastases on 3 Tesla magnetic resonance imaging: the roles of fractional anisotropy and mean diffusivity.

This study determined the diagnostic value of diffusion tensor imaging (DTI) sequences using fractional anisotropy (FA) and mean diffusivity (MD) for discriminating glioblastoma (GBM) from solitary brain metastases (SBM) using 3 Tesla magnetic resonance imaging (MRI). A retrospective study was conducted, including 40 patients who underwent biopsy or surgery and received a histological diagnosis of GBM or SBM between August 2020 and December 2021. All preoperative examinations were performed on 3 Tesla MRI using conventional and DTI sequences. Three regions of interest (ROIs) were placed to measure a solid tumor component, peritumoral edema, and the opposite normal white matter to evaluate FA and MD values. Parametric and nonparametric statistical tests were used to determine differences between GBM and SBM. The diagnostic value of significantly different parameters between the two tumor entities was analyzed using the receiver operating characteristic (ROC) curve. The FA value for peritumoral edema (eFA) in GBM cases was significantly larger than that in SBM cases (p < 0.05), with no significant difference in MD values. The FA and MD values for the solid tumor component (sFA and sMD, respectively) and the ratio of the sFA value to the FA value of the opposite normal white matter (rFAs/n) in GBM cases were significantly larger than those in SBM cases (p < 0.05). Combining the sFA and sMD values provided the highest area under the ROC curve (AUC) value of 0.96, with a sensitivity, specificity, positive predictive value, and negative predictive value of 85.2%, 100%, 85.2%, and 87.1%, respectively, for distinguishing GBM from SBM. MRI parameters, including sFA, sMD, eFA, and rFAs/n, are useful for differentiating between GBM and SBM. The combination of sFA and sMD may increase the diagnostic performance of MRI for these two tumor entities.

To Investigate the Effect of Magnetic Resonance Imaging (MRI) and Diffusion Tensor Imaging (DTI) in the Diagnosis of Mild Craniocerebral Injury

In order to assess the value of magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) in microscopic brain scans. Diffusion tensor imaging (DTI) and magnetic resonance spectroscopy (MRI) changes over time in patients with traumatic brain injury (TBI) show a relationship between recovery from coma and overall Glasgow prognostic parameters. The value of DTI combined with MRI in evaluating TBI has been investigated. 10 patients with TBI received 10 evaluations of magnetic resonance imaging, DTI and MRI scans. Thalamic plate nucleus, reticular nucleus, and retinal developmental activity were measured in normal controls and TBI coma (2-3 weeks) and mild (>4 weeks) patients. Anisotropy, mean diffusion coefficient, axial diffusion coefficient, and radial diffusion coefficient were measured using MRI together with acetylaspartic acid, choline, creatinine, and lactic acid. Independent control t-tests were conducted between controls and TBI patients, and 1-test paired between moderate and severe injuries, and regression and correlation were evaluated. Evaluated for all measures and treatments. DTI and MRI scores in TBI patients differed from normal controls. DTI and MRI can predict the prognosis of TBI patients better. The limitations of the thalamus-retinal activation system are gradually restored. axial diffusion coefficient and radial diffusion coefficient can be used to evaluate the reliability of comatose patients with TBI. DTI and MRI scans of the patient's brain can predict recovery and guide treatment in TBI coma patients.

Diagnostic value of diffusion tensor imaging in patients with clinical signs of cervical spondylotic myelopathy.

The aim of this study was to assess the diagnostic value of diffusion tensor imaging (DTI) in patients with symptoms of cervical myelopathy. Detailed goals included determining the diagnostic effectiveness of quantitative parameters, i.e. fractional anisotropy (FA) and apparent diffusion coefficient (ADC), in the diagnosis of cervical myelopathy, and the correlation between these parameters and clinical symptoms. The demonstration of an ischaemic focus in the spinal cord by standard magnetic resonance imaging (MRI) methods is associated with already accomplished spinal cord damage, and of course limited treatment options. Therefore, finding a new examination protocol that allows early diagnosis of myelopathic focus, before the onset of full neurological symptoms, has become a priority in the diagnosis and treatment of spine diseases. Such an examination increases the chances of correctly qualifying the patient for conservative vs. surgical treatment. Between 2013 and 2017, 128 adults with clinical signs of cervical myelopathy were examined, and were divided into four symptomatic subgroups. A control group consisted of 37 healthy volunteers. DTI values were measured at the level of C2/C3, and at the most severe stenosis of the spine. In patients with cervical spondylotic myelopathy (CSM), the ADC values were significantly higher (p < 0.001), and FA values were significantly lower (p < 0.001), than in healthy volunteers at the stenotic level. There were significant differences in DTI parameters between the clinical subgroups (p < 0.001). Changes in DTI parameters indicate a microstructural disorder of the core which is not visible in a structural MRI. FA and ADC values measured at the level of the most severe stenosis of the spinal canal allow the differentiation of patients with myelopathy of varying degrees of clinical severity. Extending standard MRI to include assessment of FA and ADC may be helpful in deciding treatment modalities (conservative vs. surgical) for patients with visible canal stenosis without full neurological symptoms. This may be useful in selecting patients for urgent rehabilitative treatment. This study is a starting point for further research, i.e. an evaluation of the extent of FA and ADC lesion withdrawal after surgical treatment.