Texture analysis of deep medullary veins on susceptibility-weighted imaging in infants: evaluating developmental and ischemic changes

Objective: Infarction is one of the most common postoperative complications after surgical revascularization for moyamoya disease (MMD). Increased conspicuity of deep medullary veins (DMVs) on susceptibility-weighted imaging (SWI), known as “brush sign,” could predict the severity of MMD. This study aimed to reveal the features of the “brush sign” in preoperative SWI and to verify its relationship to postoperative infarction. Methods: Consecutive patients with MMD who had undergone cerebral revascularization surgery were included. Routine preoperative SWI was performed. The “brush sign” was defined according to the number of the conspicuous DMVs > 5 detected on SWI. Postoperative infarctions were defined as the high-intensity signal on postoperative DWI images, with or without neurologic deficits. The modified Rankin scale (mRS) was applied to evaluate the prognosis of patients. Results: In the enrolled 100 hemispheres, 35 were presented with the “brush sign.” Patients with ischemic onset manifestation and previous infarction history tended to present with the “brush sign.” Multivariate analysis showed that the “brush sign” (OR 13.669; 95% CI, 1.747–106.967, p = 0.013) and decreased rCBF (OR 6.050; 95% CI, 1.052–34.799, p = 0.044) were independent risk factors of postoperative infarction. Besides, the “brush sign” showed a significant correlation with a higher mRS score at discharge (p = 0.047). Conclusion: The findings strongly suggest that the presence of the “brush sign” preoperatively can be a predictor of infarction after surgical revascularization for ischemic MMD. It may contribute to an improved surgical result through focused perioperative management based on appropriate surgical risk stratification.

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Relationship between deep medullary veins in susceptibility-weighted imaging and ipsilateral cerebrovascular reactivity of middle cerebral artery in patients with ischemic stroke

Experimental and Therapeutic Medicine ◽

10.3892/etm.2016.3198 ◽

2016 ◽

Vol 11 (6) ◽

pp. 2217-2220 ◽

Cited By ~ 5

Author(s):

XIANJUN HAN ◽

LINHUI OUYANG ◽

CHUNNING ZHANG ◽

HAILING MA ◽

JINGCUI QIN

Keyword(s):

Ischemic Stroke ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Cerebrovascular Reactivity ◽

Susceptibility Weighted Imaging ◽

Deep Medullary Veins

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MRI-visible perivascular spaces in basal ganglia but not centrum semiovale or hippocampus were related to deep medullary veins changes

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x211038138 ◽

2021 ◽

pp. 0271678X2110381

Author(s):

Kemeng Zhang ◽

Ying Zhou ◽

Wenhua Zhang ◽

Qingqing Li ◽

Jianzhong Sun ◽

...

Keyword(s):

Basal Ganglia ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Susceptibility Weighted Imaging ◽

Perivascular Spaces ◽

Centrum Semiovale ◽

Vessel Disease ◽

Phase Images ◽

Deep Medullary Veins

Our purpose is to assess the role of deep medullary veins (DMVs) in pathogenesis of MRI-visible perivascular spaces (PVS) in patients with cerebral small vessel disease (cSVD). Consecutive patients recruited in the CIRCLE study (ClinicalTrials.gov ID: NCT03542734) were included. Susceptibility Weighted Imaging-Phase images were used to evaluate DMVs based on a brain region-based visual score. T2 weighted images were used to evaluate PVS based on the five-point score, and PVS in basal ganglia (BG-PVS), centrum semiovale (CSO-PVS) and hippocampus (H-PVS) were evaluated separately. 270 patients were included. The severity of BG-PVS, CSO-PVS and H-PVS was positively related to the increment of age (all p < 0.05). The severity of BG-PVS and H-PVS was positively related to DMVs score (both p < 0.05). Patients with more severe BG-PVS had higher Fazekas scores in both periventricle and deep white matter (both p < 0.001) and higher frequency of hypertension ( p = 0.008). Patients with more severe H-PVS had higher frequency of diabetes ( p < 0.001). Besides, high DMVs score was an independent risk factor for more severe BG-PVS ( β = 0.204, p = 0.001). Our results suggested that DMVs disruption might be involved in the pathogenesis of BG-PVS.

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Intergrating conventional MRI, texture analysis of dynamic contrast-enhanced MRI, and susceptibility weighted imaging for glioma grading

Acta Radiologica ◽

10.1177/0284185118801127 ◽

2018 ◽

Vol 60 (6) ◽

pp. 777-787 ◽

Cited By ~ 3

Author(s):

Chun-Qiu Su ◽

Shan-Shan Lu ◽

Qiu-Yue Han ◽

Mao-Dong Zhou ◽

Xun-Ning Hong

Keyword(s):

Texture Analysis ◽

Susceptibility Weighted Imaging ◽

Dce Mri ◽

Dynamic Contrast Enhanced Mri ◽

Dynamic Contrast Enhanced ◽

Conventional Mri ◽

Enhanced Mri ◽

Glioma Grading ◽

Contrast Enhanced ◽

Contrast Enhanced Mri

Background The application of conventional magnetic resonance imaging (MRI) in glioma grading is limited and non-specific. Purpose To investigate the application values of MRI, texture analysis (TA) of dynamic contrast-enhanced MRI (DCE-MRI) and intratumoral susceptibility signal (ITSS) on susceptibility weighted imaging (SWI), alone and in combination, for glioma grading. Material and Methods Fifty-two patients with pathologically confirmed gliomas who underwent DCE-MRI and SWI were enrolled in this retrospective study. Conventional MRIs were evaluated by the VASARI scoring system. TA of DCE-MRI-derived parameters and the degree of ITSS were compared between low-grade gliomas (LGGs) and high-grade gliomas (HGGs). The diagnostic ability of each parameter and their combination for glioma grading were analyzed. Results Significant statistical differences in VASARI features were observed between LGGs and HGGs ( P < 0.05), of which the enhancement quality had the highest area under the curve (AUC) (0.873) with 93.3% sensitivity and 80% specificity. The TA of DCE-MRI derived parameters were significantly different between LGGs and HGGs ( P < 0.05), of which the uniformity of Ktrans had the highest AUC (0.917) with 93.3% sensitivity and 90% specificity. The degree of ITSS was significantly different between LGGs and HGGs ( P < 0.001). The AUC of the ITSS was 0.925 with 93.3% sensitivity and 90% specificity. The best discriminative power was obtained from a combination of enhancement quality, Ktrans- uniformity, and ITSS, resulting in 96.7% sensitivity, 100.0% specificity, and AUC of 0.993. Conclusion Combining conventional MRI, TA of DCE-MRI, and ITSS on SWI may help to improve the differentiation between LGGs and HGGs.

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