Tuberculoma – a great mimicker: can diffusion tensor imaging and tractography help?

Background Central nervous system (CNS) tuberculomas often mimic tumors on conventional imaging, differentiation of which may not be possible without invasive tissue sampling. Diffusion tensor imaging (DTI), owing to its unrivalled property of characterizing molecular diffusion, may help in better lesion characterization and tractography may help understand the pattern of white matter involvement by tuberculomas. Purpose To estimate qualitative and quantitative diffusion tensor changes in brain tuberculomas and to evaluate patterns of white matter involvement using 3D tractography. Material and Methods Thirty patients with brain tuberculomas were evaluated on a 3-T magnetic resonance scanner. Diffusion tensor images were acquired along 20 non-colinear encoding directions with two b-values (b = 0, b = 1000). Regions of interest (ROIs) were drawn on quantitative fractional anisotropy (FA) and apparent diffusion coefficient (ADC) maps in the center of the tuberculoma and perilesional area. Similar ROIs were placed in contralateral hemispheres for comparison. Tractography maps were also generated. Results Mean FA in the center and perilesional area of tuberculomas were 0.098 ± 0.041 and 0.311 ± 0.135, respectively. ADC values in corresponding regions were 0.920 ± 0.272 ×10−3 mm2/s and 1.157 ± 0.277 ×10−3 mm2/s. These values were significantly different compared to contralateral similar brain parenchyma. Tractography revealed interruption of white fibers in the center with deviation of fibers at the periphery in the majority of tuberculomas with none showing infiltration of white matter described in tumors. Conclusion Significant qualitative as well as quantitative DTI changes were seen in tuberculoma and perilesional areas compared to contralateral hemisphere with tractography showing a pattern different from that described in tumors. These findings may help to differentiate tuberculomas from infiltrating tumors.

Differences in Brain Functional Networks of Executive Function Between Cantonese-Mandarin Bilinguals and Mandarin Monolinguals

It remains controversial whether long-term logographic-logographic bilingual experience shapes the special brain functional subnetworks underlying different components of executive function (EF). To address this question, this study explored the differences in the functional connections underlying EF between the Cantonese-Mandarin bilinguals and Mandarin monolinguals. 31 Cantonese-Mandarin bilinguals and 31 Mandarin monolinguals were scanned in a 3-T magnetic resonance scanner at rest. 4 kinds of behavioral tasks of EF were tested. Network-based statistics (NBS) was performed to compare the connectomes of fronto-parietal (FP) and cingulo-opercular (CO) network between groups. The results showed that the bilinguals had stronger connectivity than monolinguals in a subnetwork located in the CO network rather than the FP network. The identified differential subnetwork referred to as the CO subnetwork contained 9 nodes and 10 edges, in which the center node was the left mid-insula with a degree centrality of 5. The functional connectivity of the CO subnetwork was significantly negatively correlated with interference effect in bilinguals. The results suggested that long-term Cantonese-Mandarin bilingual experience was associated with stronger functional connectivity underlying inhibitory control in the CO subnetwork.

Secondary Iron Overload in Pediatric Hematology: the Priority of Free-Breathing Liver Study at 3.0 T Magnetic Resonance Scanner in Children with Severe Iron Overload

The aim of the study was to compare the effectiveness and scanning features of iron detection in the liver based on 3T MR scanner data using a breath holding and free breathing sequences in children with iron overload. 108 patients aged of 3 to 17 years with secondary iron overload associated with the regular blood transfusions underwent an MRI study on a 3.0 T MR scanner using specialized sequences for obtaining relaxometric maps: 3T-mGRE and 3T-uTE. The quality of the images received by the 3T-mGRE and 3T-uTE sequences was assessed by determining the signal-to-noise ratio (SNR). The SNR of 3T-uTE was found to be 8 times higher than the SNR of 3T-mGRE. In addition, it was found that for patients with an iron overload less than 25 mg/g the 3T-mGRE and 3T-uTE sequences showed the same efficacy in iron detection in the liver (r = 0.99, p = 0.54). The concentration of iron in the liver in patients with extremely severe iron overload could be calculated only using 3T-uTE relaxometric maps due to the high approximation error of the results obtaining by 3T-mGRE maps. These data demonstrate the possibility of using the 3T-mGRE sequence to determine the concentration of iron in the liver below 25 mg/g. However, with extremely severe iron overload, it is better to use the 3T-uTE sequence.

A study of the correlations between IVIM-DWI parameters and the histologic differentiation of hepatocellular carcinoma

The present study aimed to investigate the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in the preoperative prediction of the histologic differentiation of hepatocellular carcinoma (HCC). Seventy HCC patients were scanned with a 3.0 T magnetic resonance scanner. The values of apparent diffusion coefficient (ADC), slow apparent diffusion coefficient (D), fast apparent diffusion coefficient (D*), and the fraction of the fast apparent diffusion coefficient (f) were measured. Analysis of variance was used to compare the differences in parameters between groups with different degrees of histologic differentiation. p < 0.05 was considered statistically significant. Receiver operating characteristic (ROC) curves were used to analyse the efficacy of IVIM-DWI parameters for predicting the histologic differentiation of HCC. The ADC and D values for well, moderately and poorly differentiated HCC were 1.35 ± 0.17 × 10−3 mm2/s, 1.16 ± 0.17 × 10−3 mm2/s, 0.98 ± 0.21 × 10−3 mm2/s, and 1.06 ± 0.15 × 10−3 mm2/s, 0.88 ± 0.16 × 10−3 mm2/s, 0.76 ± 0.18 × 10−3 mm2/s, respectively, and all differences were significant. The D* and f values of the three groups were 32.87 ± 14.70 × 10−3 mm2/s, 41.68 ± 17.90 × 10−3 mm2/s, 34.54 ± 18.60 × 10−3 mm2/s and 0.22 ± 0.07, 0.23 ± 0.08, 0.18 ± 0.07, respectively, with no significant difference. When the cut-off values of ADC and D were 1.25 × 10−3 mm2/s and 0.97 × 10−3 mm2/s, respectively, their diagnostic sensitivities and specificities for distinguishing well differentiated HCC from moderately differentiated and poorly differentiated HCC were 73.3%, 85.5%, 86.7%, and 78.2%, and their areas under the ROC curve were 0.821 and 0.841, respectively. ADC and D values can be used preoperatively to predict the degree of histologic differentiation in HCC, and the D value has better diagnostic value.

Multiple sclerosis: prevalence of the ‘central vein’ sign in white matter lesions on gadolinium-enhanced susceptibility-weighted images

Aims To evaluate prospectively whether an intravenous gadolinium injection could improve the detection of the central vein sign on susceptibility-weighted imaging sequences obtained with a 1.5 T magnetic resonance scanner in patients with multiple sclerosis compared to unenhanced susceptibility-weighted images. Materials and methods This prospective, institution review board-approved study included 19 patients affected by multiple sclerosis (six men; 13 women; mean age 40.8 years, range 20–74 years). Patients had the relapsing–remitting clinical subtype in 95% of cases, and only one (5%) patient had the primary progressive clinical subtype of multiple sclerosis. T2-weighted images, fluid-attenuated inversion recovery images, unenhanced and contrast-enhanced susceptibility-weighted images were evaluated in consensus by two neuroradiologists for the presence of the central vein sign. The readers were blinded to magnetic resonance imaging reports, clinical information, the presence and the localisation of focal hyperintense white matter lesions. Any discordance between readers was resolved through a joint review of the recorded images with an additional neuroradiologist. Results A total of 317 multiple sclerosis lesions were analysed. The central vein sign had a higher prevalence detection rate on gadolinium-enhanced susceptibility-weighted images (272 of 317 lesions, 86%) compared to unenhanced susceptibility-weighted images (172 of 317 lesions, 54%). Conclusion Gadolinium-enhanced susceptibility-weighted imaging improves the detection rate of the central vein sign in multiple sclerosis lesions.

Serotonin transporter genotype modulates resting state and predator stress-induced amygdala perfusion in mice in a sex-dependent manner

The serotonin transporter (5-HTT) is a key molecule of serotoninergic neurotransmission and target of many anxiolytics and antidepressants. In humans, 5-HTT gene variants resulting in lower expression levels are associated with behavioral traits of anxiety. Furthermore, functional magnetic resonance imaging (fMRI) studies reported increased cerebral blood flow (CBF) during resting state (RS) and amygdala hyperreactivity. 5-HTT deficient mice as an established animal model for anxiety disorders seem to be well suited for investigating amygdala (re-)activity in an fMRI study. We investigated wildtype (5-HTT+/+), heterozygous (5-HTT+/-), and homozygous 5-HTT-knockout mice (5-HTT-/-) of both sexes in an ultra-high-field 17.6 Tesla magnetic resonance scanner. CBF was measured with continuous arterial spin labeling during RS, stimulation state (SS; with odor of rats as aversive stimulus), and post-stimulation state (PS). Subsequently, post mortem c-Fos immunohistochemistry elucidated neural activation on cellular level. The results showed that in reaction to the aversive odor CBF in total brain and amygdala of all mice significantly increased. In male 5-HTT+/+ mice amygdala RS CBF levels were found to be significantly lower than in 5-HTT+/- mice. From RS to SS 5-HTT+/+ amygdala perfusion significantly increased compared to both 5-HTT+/- and 5-HTT-/- mice. Perfusion level changes of male mice correlated with the density of c-Fos-immunoreactive cells in the amygdaloid nuclei. In female mice the perfusion was not modulated by the 5-Htt-genotype, but by estrous cycle stages. We conclude that amygdala reactivity is modulated by the 5-Htt genotype in males. In females, gonadal hormones have an impact which might have obscured genotype effects. Furthermore, our results demonstrate experimental support for the tonic model of 5-HTTLPR function.

Tibiofemoral Contact Measures During Standing in Toe-In and Toe-Out Postures

Knee osteoarthritis is thought to result, in part, from excessive and unbalanced joint loading. Toe-in and toe-out gait modifications produce alterations in external knee joint moments, and some improvements in pain over the short- and long-term. The aim of this study was to probe mechanisms of altered joint loading through the assessment of tibiofemoral contact in standing with toe-in and toe-out positions using an open magnetic resonance scanner. In this study, 15 young, healthy participants underwent standing magnetic resonance imaging of one of their knees in 3 foot positions. Images were analyzed to determine contact in the tibiofemoral joint, with primary outcomes including centroid of contact and contact area for each compartment and overall. The centroid of contact shifted laterally in the lateral compartment with both toe-in and toe-out postures, compared with the neutral position (P < .01), while contact area in the medial and lateral compartments showed no statistical differences. Findings from this study indicate that changes in the loading anatomy are present in the tibiofemoral joint with toe-in and toe-out and that a small amount of lateralization of contact, especially in the lateral compartment, does occur with these altered lower limb orientations.

Repeatability of soma and neurite metrics in cortical and subcortical grey matter

Diffusion magnetic resonance imaging is a technique which has long been used to study white matter microstructure in vivo. Recent advancements in hardware and modelling techniques have opened up interest in disentangling tissue compartments in the grey matter. In this study, we evaluate the repeatability of soma and neurite density imaging in a sample of six healthy adults scanned five times on an ultra-strong gradient magnetic resonance scanner (300 mT/m). Repeatability was expressed as an intraclass correlation coefficient (ICC). Our findings reveal that measures of soma density (mean ICC=.976), neurite density (mean ICC=.959) and apparent soma size (mean ICC=.923) are highly reliable across multiple cortical and subcortical networks. Overall, we demonstrate the promise of moving advanced grey matter microstructural imaging towards applications of development, ageing, and disease.