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Multiparametric MRI (multiparametric + mri)
Selected AbstractsCombination of T2*W and FLAIR Abnormalities for the Prediction of Parenchymal Hematoma Following Thrombolytic Therapy in 100 Stroke PatientsJOURNAL OF NEUROIMAGING, Issue 4 2009Jens Fiehler MD ABSTRACT INTRODUCTION The objective of our study was to determine whether the combination of hypointense spots ("cerebral microbleeds," CMBs) with a leukoaraiosis is associated with the risk of parenchymal hematoma (PH) after thrombolytic therapy. PATIENTS AND METHODS We analyzed magnetic resonance imaging (MRI) scans acquired within 6 hours after symptom onset from 100 ischemic stroke patients. Multiparametric MRI including a T2*-weighted (T2*w) MRI and fluid attenuated inversion recovery (FLAIR) was performed before thrombolysis in all patients. Initial T2*w imaging was rated by two independent observers for the presence of CMBs smaller than 5 mm. White matter changes were evaluated using an adapted scale of Fazekas and Schmidt. PH was defined in follow-up imaging. FINDINGS A PH was observed in seven per 100 patients. CMBs were detected by observer 1 in 22 and observer 2 in 20 patients. We found a very low sensitivity (0.14) for prediction of PH by the presence of CMBs. We found a concordant increase in the rate of PH when the periventricular hyperintensity in FLAIR was larger than a thin lining. Sensitivity was good-to-perfect (0.86 and 1.00, observers 1 and 2) and specificity was substantial (0.65 and 0.66). Using the combination of a periventricular matter lesion (PVML)>1 and the presence of CMBs did not improve the prediction of PH. DISCUSSION A marked periventricular hyperintensity in FLAIR imaging seems to be associated with a substantially increased risk of PH. A combination of CMBs with leukoaraiosis scores did not appear to be beneficial for prognosis. [source] Computer-aided detection of brain tumor invasion using multiparametric MRIJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 3 2009Todd R. Jensen PhD Abstract Purpose To determine the potential of using a computer-aided detection method to intelligently distinguish peritumoral edema alone from peritumor edema consisting of tumor using a combination of high-resolution morphological and physiological magnetic resonance imaging (MRI) techniques available on most clinical MRI scanners. Materials and Methods This retrospective study consisted of patients with two types of primary brain tumors: meningiomas (n = 7) and glioblastomas (n = 11). Meningiomas are typically benign and have a clear delineation of tumor and edema. Glioblastomas are known to invade outside the contrast-enhancing area. Four classifiers of differing designs were trained using morphological, diffusion-weighted, and perfusion-weighted features derived from MRI to discriminate tumor and edema, tested on edematous regions surrounding tumors, and assessed for their ability to detect nonenhancing tumor invasion. Results The four classifiers provided similar measures of accuracy when applied to the training and testing data. Each classifier was able to identify areas of nonenhancing tumor invasion supported with adjunct images or follow-up studies. Conclusion The combination of features derived from morphological and physiological imaging techniques contains the information necessary for computer-aided detection of tumor invasion and allows for the identification of tumor invasion not previously visualized on morphological, diffusion-weighted, and perfusion-weighted images and maps. Further validation of this approach requires obtaining spatially coregistered tissue samples in a study with a larger sample size. J. Magn. Reson. Imaging 2009;30:481,489. © 2009 Wiley-Liss, Inc. [source] MRI of late microstructural and metabolic alterations in radiation-induced brain injuriesJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 5 2009Kevin C. Chan BEng Abstract Purpose To evaluate the late effects of radiation-induced damages in the rat brain by means of in vivo multiparametric MRI. Materials and Methods The right hemibrains of seven Sprague-Dawley rats were irradiated with a highly collimated 6 MV photon beam at a single dose of approximately 28 Gy. Diffusion tensor imaging (DTI), proton MR spectroscopy (1H-MRS), T2-weighted imaging, and T1-weighted imaging were performed to the same animals 12 months after radiation treatment. Results Compared with the contralateral side, a significantly higher percentage decrease in fractional anisotropy was observed in the ipsilateral fimbria of hippocampus (29%) than the external capsule (8%) in DTI, indicating the selective vulnerability of fimbria to radiation treatment. Furthermore, in 1H-MRS, significantly higher choline, glutamate, lactate, and taurine peaks by 24%, 25%, 87%, and 58%, respectively, were observed relative to creatine in the ipsilateral brain. Postmortem histology confirmed these white matter degradations as well as glial fibrillary acidic protein and glutamine synthetase immunoreactivity increase in the ipsilateral brain. Conclusion The microstructural and metabolic changes in late radiation-induced brain injuries were documented in vivo. These multiparametric MRI measurements may help understand the white matter changes and neurotoxicity upon radiation treatment in a single setting. J. Magn. Reson. Imaging 2009;29:1013,1020. © 2009 Wiley-Liss, Inc. [source] Bilateral Internal Carotid Artery Dissection Mimicking Inflammatory Demyelinating DiseaseJOURNAL OF NEUROIMAGING, Issue 4 2003C. Lie MD ABSTRACT Background and Purpose. Internal carotid artery (ICA) dissection (ICAD) may be extremely difficult to diagnose only on the basis of historical information and clinical signs, and even standard brain imaging (computed tomography [CT], T2-weighted magnetic resonance imaging [MRI]) may not be sufficient to delineate the underlying pathology clearly, as shown in this case. Methods. The clinical presentation and parenchymal lesion pattern on CT were suggestive of inflammatory demyelinating disease, and additional multiparametric MRI was per-formed. Results. Diffusion-weighted MRI, magnetic resonance angiography, and perfusion-weighted MRI revealed acute ischemic lesions, bilateral ICA obstruction, and bilateral hypoperfusion in the middle cerebral artery territories. Bilateral ICAD was confirmed by Doppler and duplex ultrasound, and anticoagulation therapy was initiated. A follow-up examination showed recanalization of the obstructed ICAs and the normalization of cerebral perfusion. Conclusion. This case illustrates the importance of demonstrating the pathology and the value of multiparametric MRI techniques for the diagnosis and monitoring of ICAD and its hemodynamic consequences. [source] | ||||||||||