Diffusion-weighted imaging predicts cognitive impairment in multiple sclerosis

2007 ◽  
Vol 13 (6) ◽  
pp. 722-730 ◽  
Author(s):  
Ralph H.B. Benedict ◽  
Jared Bruce ◽  
Michael G. Dwyer ◽  
Bianca Weinstock-Guttman ◽  
Chris Tjoa ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Processing Speed ◽  
Diffusion Weighted Imaging ◽  
Diffusion Tensor ◽  
Lesion Volume ◽  
Additive Variance ◽  
Whole Brain ◽  
Visual Spatial ◽  
Diffusion Weighted ◽  
And Performance

Following a previous study with diffusion tensor imaging, we investigated the correlation between diffusion-weighted imaging (DWI) and cognitive dysfunction in multiple sclerosis (MS). We studied 60 MS patients (mean age 45.8±9.0 years) using 1.5-T MRI. Disease course was RR=40 and SP = 20. Mean disease duration was 12.8±8.7 years. Mean EDSS was 3.4±1.7. Whole brain, gray and white matter normalized volumes were calculated on 3D SPGR T1-WI using a fully automated Hybrid SIENAX method. Parenchymal mean diffusivity (PMD) maps were created after automated segmentation of the brain parenchyma and cerebrospinal fluid using T2-WI and DW images. Histogram analysis was performed and DWI indices of peak position (PP), peak height (PH), mean parenchymal diffusivity (MPD) and entropy were obtained. Neuropsychological (NP) evaluation emphasized auditory/verbal and visual/spatial memory, as well as processing speed and executive function. We found significant correlations between DWI and performance in all cognitive domains. Overall, stronger correlations emerged for MPD and entropy than other DWI measures, although all correlations were in the expected direction. The strongest association was between DWI entropy and performance on the Symbol Digit Modalities Test, which assesses processing speed and working memory (r = -0.54). Fisher r to z transformations revealed that DWI, gray matter (GMF) and whole brain (BPF) atrophy, T1-lesion volume (LV) and T2-LV all accounted for similar amounts of variance in NP testing. Stepwise regression models determined whether multiple MRI measures predicted unique additive variance in test performance. GMF (R2 = 0.35, F =30.82, P <0.01) and entropy (ΔR2 =0.06, ΔF=5.47, P <0.05) both accounted for unique variance in processing speed. Our data make a stronger case for the clinical validity of DWI in MS than heretofore reported. DWI has very short acquisition times, and the segmentation method applied in the present study is reliable and fully automated. Given its overall simplicity and moderate correlation with cognition, DWI may offer several logistic advantages over more traditional MRI measures when predicting the presence of NP impairment. Multiple Sclerosis 2007; 13: 722-730. http://msj.sagepub.com

scholarly journals Detection of Active Plaques in Multiple Sclerosis Using 3 and 12 Directional Diffusion-weighted Imaging: Comparison with Gadolinium-enhanced MR Imaging

2018 ◽  
Author(s):  
S Rahimi ◽  
A Azari ◽  
P Ghaemmaghami ◽  
G H Meftahi ◽  
G Pirzad Jahromi
Keyword(s):  
Multiple Sclerosis ◽  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Diffusion Weighted Imaging ◽  
Diffusion Tensor ◽  
Intraclass Correlation ◽  
Neurological Dysfunction ◽  
Lower Sensitivity ◽  
Diffusion Weighted ◽  
Cost Effective Treatment

Background: Multiple sclerosis (MS) is a chronic disease of the central nervous system (CNS) characterized by exacerbations of neurological dysfunction due to inflammatory demyelination. MRI is the most sensitive method to make adiagnosis of multiple sclerosis. contrast-enhanced T1-weighted imaging (CE T1WI) is used as a gold standard to distinguish active and inactive MS lesions. However, Gadolinium based contrast agents (GBCAs) have some contraindications. Diffusion-weighted imaging (DWI) can detect diffusion alterations in active inflammatory lesions. The purpose of this study is to investigate whether common DWI (3 directional) and 12 directional DWI which is used in Diffusion tensor imaging can be an alternative to CE T1WI so as to demonstrat active (enhanced) MS lesions.Methods: In this cross sectional study, at two different hospitals, 138 patients who presented with CNS symptoms suggestive of demyelinating disease were examined. CE T1WI using 0.1 mmol/kg gadolinium as well as 3 & 12 directional DWI was done for all patients. To determine the reliability and accuracy of 3 & 12 directional DWI for delineating the enhancement of demyelinating lesions on CET1W, Intraclass correlation coefficient (ICC) and the plot of sensitivity versus specifity is called receiver operating characteristic (ROC) curve and the area under the curve (AUC) were calculated.Results: 114 patients (82.6%)revealed  contrast enhancement in CE T1WI, 117 (84.7%) and 107 (77.5%) patients demonstrated hyper intense lesions on DWI 12 & DWI 3 respectively. The intraclass correlation coefficient (ICC) for DWI 12 was higher than 0.92; however, for DWI 3 was less than 0.64. The DWI 12 data generated a sensitivity and specificity of 94.7% and 62.5%, combined with an AUC of 84%. Besides the sensitivity, specificity and AUC for DWI 3 CE were 86%, 62.5 and 79%, respectively.Conclusion: Among 2 different DWI sequences, 12 directional DWI images have higher reliability and accuracy. Therefore, despite lower sensitivity compared to CE T1WI, it can be a practical diagnostic sequence in discriminating enhancing lesions from non-enhancing lesions when performing CE-MRI is a concern for the patient. concerning the cons and pros of CE T1WI and DWI 12, these two sequences can be used in combination in order to reach higher sensitivities, leading to earlier diagnosis and more cost effective treatment.

scholarly journals Diffusion tensor imaging on 3-T MRI breast: diagnostic performance in comparison to diffusion-weighted imaging

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Dalia Abdelhady ◽  
Amany Abdelbary ◽  
Ahmed H. Afifi ◽  
Alaa-eldin Abdelhamid ◽  
Hebatallah H. M. Hassan
Keyword(s):  
Breast Cancer ◽  
Diffusion Tensor Imaging ◽  
Sensitivity And Specificity ◽  
Diffusion Weighted Imaging ◽  
Diffusion Tensor ◽  
Breast Mri ◽  
Breast Lesions ◽  
Dce Mri ◽  
Additional Tool ◽  
Diffusion Weighted

Abstract Background Breast cancer is the most prevalent cancer among females. Dynamic contrast-enhanced MRI (DCE-MRI) breast is highly sensitive (90%) in the detection of breast cancer. Despite its high sensitivity in detecting breast cancer, its specificity (72%) is moderate. Owing to 3-T breast MRI which has the advantage of a higher signal to noise ratio and shorter scanning time rather than the 1.5-T MRI, the adding of new techniques as diffusion tensor imaging (DTI) to breast MRI became more feasible. Diffusion-weighted imaging (DWI) which tracks the diffusion of the tissue water molecule as well as providing data about the integrity of the cell membrane has been used as a valuable additional tool of DCE-MRI to increase its specificity. Based on DWI, more details about the microstructure could be detected using diffusion tensor imaging. The DTI applies diffusion in many directions so apparent diffusion coefficient (ADC) will vary according to the measured direction raising its sensitivity to microstructure elements and cellular density. This study aimed to investigate the diagnostic accuracy of DTI in the assessment of breast lesions in comparison to DWI. Results By analyzing the data of the 50 cases (31 malignant cases and 19 benign cases), the sensitivity and specificity of DWI in differentiation between benign and malignant lesions were about 90% and 63% respectively with PPV 90% and NPV 62%, while the DTI showed lower sensitivity and specificity about 81% and 51.7%, respectively, with PPV 78.9% and NPV 54.8% (P-value ≤ 0.05). Conclusion While the DWI is still the most established diffusion parameter, DTI may be helpful in the further characterization of tumor microstructure and differentiation between benign and malignant breast lesions.

scholarly journals Prediction of secondary ischemic lesions with diffusion-weighted imaging after transient middle cerebral artery occlusion in rats

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 352-352
Author(s):  
Fuhai Li ◽  
Matthew D Silva ◽  
Xiangjun Meng ◽  
Christopher H Sotak ◽  
Marc Fisher
Keyword(s):  
Middle Cerebral Artery ◽  
Middle Cerebral Artery Occlusion ◽  
Cerebral Artery ◽  
Diffusion Weighted Imaging ◽  
Artery Occlusion ◽  
Lesion Volume ◽  
Diffusion Weighted ◽  
Adc Values ◽  
Cerebral Artery Occlusion ◽  
Initial Lesions

P75 Background and Purpose: Previous studies demonstrated that secondary ischemic lesions documented by diffusion-weighted imaging might be smaller than, larger than or similar to initial lesions that occur during ischemia. The purpose of this study was to investigate if the size of secondary lesions can be predicted. Methods: Twelve rats underwent 30 minutes of transient middle cerebral artery occlusion with the intraluminal suture method. Diffusion- and perfusion-weighted images were performed just before reperfusion, 90 minutes and 24 hours after reperfusion. The ischemic lesion size was calculated by tracing visual abnormalities on the apparent diffusion coefficient (ADC) maps. Cerebral blood flow index (CBF i ) ratio was calculated by dividing the ipsilateral CBF i by the contralateral CBF i . Based on difference between initial and secondary lesion volume, rats were assigned to reperfusion-benefit group (n=6) where secondary lesions were smaller than initial lesions (less than 85% of initial lesions) and reperfusion-nonbenefit group (n=6) where secondary lesions were similar to or larger than initial lesions (more than 85% of initial lesions). Results: At 90 minutes after reperfusion, the initial ischemic lesions almost disappeared in both groups. At 24 hours, secondary lesions were 54±11% (mean±SD) of the initial lesions in the reperfusion-benefit group and 100±14% of the initial lesions in the reperfusion-nonbenefit group (p<0.001). There was no difference in ADC values (47±2×10 -5 mm 2 /s vs 46±5×10 -5 mm 2 /s, p=0.7) and CBF i ratio (0.62±0.06 vs 0.67±0.04, p=0.2) between the two groups before reperfusion. However, the initial lesion volume was significantly smaller in the reperfusion-benefit group than in the reperfusion-nonbenefit group (125±54 mm 3 vs 195±36 mm 3 , p=0.037). Conclusions: Changes of ADC values and CBF before reperfusion are unable to predict if initial ischemic lesions will eventually shrink or not after reperfusion. Smaller size of initial lesions may suggest that secondary lesions will be smaller than initial lesions.

Diffusion-weighted imaging of the dentate nucleus after repeated application of gadolinium-based contrast agents in multiple sclerosis

2019 ◽  
Vol 58 ◽  
pp. 1-5 ◽  
Author(s):  
Philipp Eisele ◽  
Kristina Szabo ◽  
Anne Ebert ◽  
Alexander Radbruch ◽  
Michael Platten ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Contrast Agents ◽  
Diffusion Weighted Imaging ◽  
Dentate Nucleus ◽  
Repeated Application ◽  
Diffusion Weighted

scholarly journals e-ASPECTS derived acute ischemic volumes on non-contrast-enhanced computed tomography images

2019 ◽  
Vol 15 (9) ◽  
pp. 995-1001
Author(s):  
Simon Nagel ◽  
Olivier Joly ◽  
Johannes Pfaff ◽  
Panagiotis Papanagiotou ◽  
Klaus Fassbender ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Outcome ◽  
Diffusion Weighted Imaging ◽  
Clinical Severity ◽  
Stroke Severity ◽  
Lesion Volume ◽  
Computed Tomography Perfusion ◽  
Computed Tomography Images ◽  
Diffusion Weighted ◽  
Ischemic Core

Background and purpose Validation of automatically derived acute ischemic volumes (AAIV) from e-ASPECTS on non-contrast computed tomography (NCCT). Materials and methods Data from three studies were reanalyzed with e-ASPECTS Version 7. AAIV was calculated in milliliters (ml) in all scored ASPECTS regions of the hemisphere detected by e-ASPECTS. The National Institute of Health Stroke Scale (NIHSS) determined stroke severity at baseline and clinical outcome was measured with the modified Rankin Scale (mRS) between 45 and 120 days. Spearman ranked correlation coefficients (R) of AAIV and e-ASPECTS scores with NIHSS and mRS as well as Pearson correlation of AAIV with diffusion-weighted imaging and CT perfusion-estimated ischemic “core” volumes were calculated. Multivariate regression analysis (odds ratio, OR with 95% confidence intervals, CI) and Bland–Altman plots were performed. Results We included 388 patients. Mean AAIV was 11.6 ± 18.9 ml and e-ASPECTS was 9 (8–10: median and interquartile range). AAIV, respectively e-ASPECTS correlated with NIHSS at baseline (R = 0.35, p < 0.001; R = −0.36, p < 0.001) and follow-up mRS (R = 0.29, p < 0.001; R = −0.3, p < 0.001). In subsets of patients, AAIV correlated strongly with diffusion-weighted imaging ( n = 37, R = 0.68, p < 0.001) and computed tomography perfusion-derived ischemic “core” ( n = 41, R = 0.76, p < 0.001) lesion volume and Bland–Altman plots showed a bias close to zero (−2.65 ml for diffusion-weighted imaging and 0.45 ml forcomputed tomography perfusion “core”). Within the whole cohort, the AAIV (OR 0.98 per ml, 95% CI 0.96–0.99) and e-ASPECTS scores (OR 1.3, 95%CI 1.07–1.57) were independent predictors of good outcome Conclusion AAIV on NCCT correlated moderately with clinical severity but strongly with diffusion-weighted imaging lesion and computed tomography perfusion ischemic “core” volumes and predicted clinical outcome.

scholarly journals Diffusion weighted imaging and diffusion tensor imaging in the evaluation of transplanted kidneys

2015 ◽  
Vol 2 ◽  
pp. 71-80 ◽  
Author(s):  
Stefano Palmucci ◽  
Giuseppina Cappello ◽  
Giancarlo Attinà ◽  
Pietro Valerio Foti ◽  
Rita Olivia Anna Siverino ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
Diffusion Weighted Imaging ◽  
Diffusion Tensor ◽  
Diffusion Weighted ◽  
Transplanted Kidneys ◽  
And Diffusion

scholarly journals Exploratory MRI measures after intravenous autologous culture-expanded mesenchymal stem cell transplantation in multiple sclerosis

2019 ◽  
Vol 5 (2) ◽  
pp. 205521731985603 ◽  
Author(s):  
Jenny Feng ◽  
Erik Offerman ◽  
Jian Lin ◽  
Elizabeth Fisher ◽  
Sarah M Planchon ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Diffusion Tensor ◽  
Phase 1 ◽  
Lesion Volume ◽  
Open Label ◽  
Mesenchymal Stem Cell Transplantation ◽  
Post Transplant ◽  
Normal Appearing White Matter ◽  
Motor Tracts ◽  
Clinical Measures

Background Mesenchymal stem cells (MSC) have immunomodulatory and neuro-protective properties and are being studied for treatment of multiple sclerosis (MS). Tractography-based diffusion tensor imaging (DTI), cortical thickness (Cth) and T2 lesion volume (T2LV) can provide insight into treatment effects. Objective The objective of this study was to analyse the effects of MSC transplantation in MS on exploratory MRI measures. Methods MRIs were obtained from 24 MS patients from a phase 1 open-label study of autologous MSC transplantation. DTI metrics were obtained in lesions and normal-appearing white matter motor tracts (NAWM). T2LV and Cth were derived. Longitudinal evolution of MRI outcomes were modelled using linear mixed effects. Pearson’s correlation was calculated between MRI and clinical measures. Results Lesional radial diffusivity (RD) and axial diffusivity (AD) decreased pre-transplant and showed no changes post-transplant. There were mixed trends in NAWM RD and AD pre/post-transplant. Transplantation stabilized T2LV growth. NAWM RD and AD correlated with Cth, T2LV and with leg and arm function but not with cognition. Lesional DTI demonstrated similar but less robust correlations. Conclusions Microstructural tissue integrity is altered in MS. DTI changes pre-transplant may be influenced by concomitant lesion accrual. Contributor to DTI stabilization post-transplant is multifactorial. DTI of major motor tracts correlated well with clinical measures, highlighting its sensitivity to clinically meaningful changes.

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