[This corrects the article DOI: 10.3389/fnins.2023.1139086.].
Background Callosal Angle (CA) and Evans Index (EI) are considered as imaging biomarkers to diagnose normal-pressure hydrocephalus using traditional MR measurement methods. Objective The current study aimed to evaluate the differential diagnostic value of CA and EI in Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD). Methods Five-hundred and two subjects were selected from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database, which included 168 Normal Controls (NC), 233 MCI and 101 AD patients. The structural MR images were interactively applied with multiplanar reconstruction to measure the CA and EI. Results CA presented no significant difference among NC, MCI and AD groups (H value = 3.848, P value = 0.146), and EI demonstrated higher value in MCI and AD groups than that in NC groups (P = 0.000 and 0.001, respectively). MCI group had significant larger EI (0.29±0.04) than (0.27±0.03) NC group in 70-75 years old sub-groups. ROC showed that the area under the curve was 0.704±0.045 for NC-MCI in 70-75 years old groups. The correlation analysis indicated that EI was significantly negatively related to MMSE scores of MCI patients (r = -0.131, P = 0.046). Conclusion EI might serve as a screening imaging biomarker for MCI in 70-75 years old patients, and show limited differential value for the diagnosis of AD. CA could present no diagnostic value for MCI and AD in the current study.
背景 肩痛是脑卒中偏瘫患者最常见的症状之一,影响日常活动能力,降低生活质量.目的 分析脑卒中偏瘫肩痛患者肩关节损伤情况及发生肩关节挛缩的相关因素.方法 选取2013年10月-2019年12月解放军总医院第一医学中心康复科收治的偏瘫肩痛(hemiplegic shoulder pain,HSP)患者66例,男46例,女20例,平均年龄(57.28±12.08)岁.对患者患侧肩行MRI扫描,记录患侧肩关节磁共振结果和各项临床指标.根据是否存在关节挛缩,将患者分为关节挛缩组(35例)和非关节挛缩组(31例),比较两组各项指标差异.结果 66例中肩胛下滑囊炎/关节腔积液59例(89.39%),冈上肌肌腱损伤54例(81.82%),肱二头肌肌腱炎54例(81.82%),肩峰下-三角肌下滑囊炎50例(75.76%),喙突下滑囊炎57例(86.36%).关节挛缩组肩峰下-三角肌下滑囊炎、盂唇损伤率较非关节挛缩组高(85.71%vs 64.51%,P=0.050;62.86%vs 35.48%,P=0.026),两组其他指标差异无统计学意义.结论 肩胛下滑囊炎/关节腔积液、冈上肌肌腱损伤、肱二头肌肌腱炎是HSP患者最常见的MRI改变;肩关节挛缩患者更容易发生肩峰下-三角肌下滑囊炎及盂唇损伤.
Objectives To investigate the application value of the calcium-suppressed (CaSupp) images of dual-layer detector computed tomography (DLCT) in the evaluation of the temporomandibular joint (TMJ) discs. Methods Thirty-three healthy subjects underwent DLCT and magnetic resonance imaging (MRI) examinations. CaSupp images were reconstructed from the spectral-based images using a calcium suppression algorithm. The location, morphology, and thickness of the posterior band of the TMJ discs were evaluated on the oblique sagittal proton-density weighted images and CaSupp images. Results Of the 66 TMJ discs, anterior displacement was observed on 9 TMJ discs on MR images and 6 TMJ discs on CaSupp images, and posterior displacement was present on 3 TMJ discs on MR and CaSupp images. No significant difference was observed in TMJ disc displacement between MR images and CaSupp images ( P value = 0.730). The TMJ discs without displacement had no significant difference in the thickness of the posterior band between the MR and CaSupp images ( P value = 0.401). Conclusions The calcium-suppressed technique in DLCT may be a simple and preliminary way to evaluate the TMJ disc displacement and structure.
Objective: To evaluate the functional changes of lateral pterygoid muscle (LPM) in the patients with temporomandibular disorders (TMD) using histogram texture analysis. Methods: A total of 28 TMD patients, including 15 males and 13 females, aged (26.2±12.1) years (15-62 years), were enrolled in the outpatient clinic of Department of Radiology, Hainan Hospital of Chinese PLA General Hospital from May 2016 to April 2020. At the same time, 13 volunteers with normal temporomandibular joint [6 males and 7 females, aged (23.5±3.3) years (20-30) years] were recruited. All participants were performed with temporomandibular joint MRI scan, and the subjects were classified into 3 groups according to the disc displacement: TMD with disc without displacement (TMD-DwoD), TMD with disc displacement without reduction (TMD-DDwoR) and NC with disc displacement without reduction (NC-DwoD) for each temporomandibular joint. The area, signal intensity, coefficient of variation (CV) of mean signal intensity and histogram texture of the superior belly of LPM (SBLPM) and inferior belly of LPM (IBLPM) were measured using regions of interests. Results: The area of SILPM presented significantly smaller in TMD-DwoD [(67.36±30.23) mm2] compared with that in NC-DwoD [(91.42±45.01) mm2] (P<0.05) and in TMD-DDwoR group [(72.27±37.53) mm2] (P>0.05). The mean signal intensity of SBLPM was identified significantly higher in TMD-DwoD (304.20±29.90) and TMD-DDwoR (315.06±40.20) compared with that in NC-DwoD (269.79±25.54) (P<0.05). The CV of mean signal intensity of SBLPM presented significantly higher in TMD-DwoD (8.89±2.60) compared with that in NC-DwoD (6.76±1.82) and TMD-DDwoR (7.63±1.62) (P<0.05). The skew and kurtosis showed no significantly differences among three groups for SBLPM (P>0.05). The mean signal intensity and CV for IBLPM presented significantly higher in TMD-DwoD (286.69±23.48 and 9.96±2.24, respectively) and TMD-DDwoR (275.98±30.55 and 10.25±1.96, respectively) compared with that in NC-DwoD (243.56±17.04 and 8.49±1.94, respectively) (P<0.05). The skewness showed significantly lower in TMD-DwoD (0.90±0.94) and TMD-DDwoR (0.73±0.97) compared with that in NC-DwoD (1.40±1.03) (P<0.05). The area and kurtosis for IBLPM showed no significant differences among three groups (P>0.05). Conclusions: The MR histogram texture analysis could primarily be considered as a tool to evaluate the LPM function in TMD patients.
Background::Texture features were the intrinsic properties of the human tissues and could efficiently detect the subtle functional changes of involved tissue. The pathologic changes of the lateral pterygoid muscle (LPM) were significantly correlated with the temporomandibular disc displacement. However, the occult functional changes of LPM could not be detected by the naked eye on the medical images. The current study was aimed to evaluate the functional changes of the LPM in the patients with temporomandibular disorders (TMDs) using texture analysis.Methods::Twenty-nine patients with TMD were performed with magnetic resonance (MR) imaging on a 3.0T MR scanner, who were consecutively recruited from the TMD clinic of Hainan Hospital of Chinese People’s Liberation Army General Hospital from February 2019 to September 2019. The patients were classified into three groups according to the disc displacement: disc without displacement (DWoD), disc displacement with reduction (DDWR) and disc displacement without reduction (DDWoR). The gray-level co-occurrence matrix method was applied with the texture analysis of LPM on the axial T2-weighted imaging. The texture features included angular second moment, contrast, correlation, inverse different moment, and entropy. One-way analysis of variance was used for grouped comparisons and receiver operating characteristics (ROC) curve analysis was applied to evaluate the diagnostic efficacy of the texture parameters.Results::Texture contrast of LPM presented significantly lower in DDWoR (46.30 [35.03, 94.48]) than that in DWoD (123.85 [105.06, 143.23]; test statistic= 23.05; P < 0.001). Texture entropy of LPM showed significant differences among DWoD (7.62 ± 0.33), DDWR (6.76 ± 0.35), and DDWoR (6.46 ± 0.39) ( PDWoD-DDWR < 0.001, PDWoD-DDWoR < 0.001, and PDDWR-DDWoR = 0.014). Area under the ROC curve (AUC) demonstrated that texture entropy had an excellent diagnostic accuracy for DWoD-DDWR (AUC = 0.96) and DWoD-DDWoR (AUC = 0.98). Conclusion::The texture contrast and entropy could identify the altered functional status of LPM in patients with TMD and could be considered as the effective imaging biomarker to evaluate the functional changes of LPM in TMD.
Objective: To evaluate the altered brain volume of the patients with painful temporomandibular disorders (TMD) using voxel-based morphometry (VBM). Methods: One hundred forty-six TMD patients [age (36.8±15.8) years, male/female=44/102] and 193 normal controls (NC) [age (43.3±15.6) years, male/female = 92/101] were performed with 3 dimensional brain structural images at 3.0 T MR scanner from November 2011 to December 2019 in Department of Radiology, Hainan Hospital and General Hospital of Chinese PLA. The brain structural images were segmented into gray matter, white matter and cerebrospinal fluid, and the gray matter images were performed with two-samples t-test with total intracranial volume, age and gender as covariates. Results: The gray matter volume (GMV) presented significantly higher in TMD group [(632.4±65.4) ml] than that in NC group [(596.1±76.3) ml] (t=4.70, P<0.05). The brain regions with increased GMV for TMD located in left inferior temporal gyrus, bilateral fusiform gyrus, bilateral middle temporal gyrus and right lingual gyrus compared with NC. Conclusions: The temporal lobe was the targeting brain region for TMD patients with increased GMV, which should further be investigated to elucidate the neuromechanism.
Objective: To evaluate the application of calcium suppressed (CaSupp) spectral CT technique in evaluating disk position and measuring the thickness of the posterior band of temporomandibular joint (TMJ). Methods: The twenty-three temporomandibular disorder patients [mean age 23(12~62) years, male/female=14/9] were performed with oblique sagittal and coronal proton density weighted imaging (PDWI) and spectral CT scans from February to July, 2019 in Department of Radiology, Hainan Hospital of General Hospital of Chinese PLA, and 45 TMJ joints were evaluated. The subjects were classified into two groups according to the scanning modalities: MRI measurement group and CaSupp spectral-based CT group. The CaSupp technique were applied with the spectral-based CT images and CaSupp images were generated. The oblique sagittal and coronal CaSupp imaged were reformatted by perpendicular to the long axis of the condyle. The TMJ disk positions were evaluated on oblique sagittal and coronal images, and the maximal disk thickness were measured on the oblique sagittal images. Results: The joint position was basically consistent on MRI and CaSupp images for the 45 TMJ joints. The intra-class coefficient value was 0.843 (0.712, 0.914) for the measurement of the posterior band of the TMJ disk between MRI and CaSupp images. Bland-Altman presented that the [95.6% (43/45)] points with the difference located in the 95% agreement interval. Wilcoxon paired text demonstrated that there was no significant different for the thickness of the posterior band between MRI [2.57 (1.76, 3.65) mm] and CaSupp images [2.67 (1.74, 4.56) mm] (P=0.07). Conclusions: The CaSupp spectral-based CT could be used to evaluated the TMJ disk position and the thickness of the posterior band.
Fibrous meningioma is a common subtype of meningioma. Contrast-enhanced scan typically shows evident homogeneous enhancement,while ring enhancement has not been described. In this article,we report a case of fibrous meningioma with ring enhancement in cerebellopontine angle region.
OBJECTIVE To investigate the intra- and inter-scanner reproducibility of quantitative susceptibility mapping (QSM) of cerebral subcortical nuclei in healthy adults. METHODS QSM was performed in 21 healthy adults on two different 3.0T MR scanners, and the region of interest (ROI) method was used to measure the magnetic susceptibility value of the left subcortical nuclei (the head of the caudate, putamen, globus pallidus, thalamus, substantia nigra and red nucleus). The intraclass correlation coefficient (ICC) and Bland-Altman method were used to evaluate the inter-scanner and intra-scanner reliability. RESULTS The ICCs of the susceptibility value ranged from 0.90 to 0.99 for all the subcortical gray nuclei except for the head of the caudate nucleus measured on the same MR scanner by the same observer. Bland-Altman analysis revealed that the points with susceptibility differences for all the subcortical gray nuclei except for substantia nigra located in the 95% CI of limits of agreement for the same MR scanner. The ICCs of the susceptibility value for the inter-scanner was 0.49 (0.08-0.75) for the head of the caudate nuleus, 0.80 (0.57-0.91) for the putamen, 0.77 (0.51-0.90) for the globus pallidus, 0.78 (0.54-0.91) for the thalamus, 0.80 (0.56-0.91) for the substantia nigra and 0.93 (0.83-0.97) for the red nucleus. The points with susceptibility difference (95.2%, 20/21) located in the 95% CI of limits of agreement for the putamen and the thalamus measured on two different MR scanners. CONCLUSIONS The intra-scanner reproducibility of QSM of the subcortical gray nuclei is superior to the inter-scanner reproducibility in healthy adults.
Objective To investigate the difference in texture features on diffusion weighted imaging (DWI) images between breast benign and malignant tumors.Methods Patients including 56 with mass-like breast cancer, 16 with breast fibroadenoma, and 4 with intraductal papilloma of breast treated in the Hainan Hospital of Chinese PLA General Hospital were retrospectively enrolled in this study, and allocated to the benign group (20 patients) and the malignant group (56 patients) according to the post-surgically pathological results. Texture analysis was performed on axial DWI images, and five characteristic parameters including Angular Second Moment (ASM), Contrast, Correlation, Inverse Difference Moment (IDM), and Entropy were calculated. Independent sample t-test and Mann-Whitney U test were performed for intergroup comparison. Regression model was established by using Binary Logistic regression analysis, and receiver operating characteristic curve (ROC) analysis was carried out to evaluate the diagnostic efficiency.Results The texture features ASM, Contrast, Correlation and Entropy showed significant differences between the benign and malignant breast tumor groups (PASM=0.014, Pcontrast=0.019, Pcorrelation=0.010, Pentropy=0.007). The area under the ROC curve was 0.685, 0.681, 0.754, and 0.683 respectively for the positive texture variables mentioned above, and that for the combined variables (ASM, Contrast, and Entropy) was 0.802 in the model of Logistic regression. Binary Logistic regression analysis demonstrated that ASM, Contrast and Entropy were considered as the specific imaging variables for the differential diagnosis of breast benign and malignant tumors.Conclusions The texture analysis of DWI may be a simple and effective tool in the differential diagnosis between breast benign and malignant tumors.
目的 评估MRI脂肪抑制液体衰减反转恢复(FLAIR-FS)序列成像对膝关节滑膜炎的诊断价值.资料与方法 收集2017年6—10月解放军总医院海南医院49例(52个膝关节)临床诊断为膝关节滑膜炎患者的资料.患者均行膝关节FLAIR-FS序列及脂肪抑制质子密度加权(PDWI-FS)序列成像.采用4级视觉模拟评分法评价滑膜,并在FLAIR-FS图像上测量滑膜厚度.比较两种序列滑膜评分及FLAIR-FS不同滑膜分级间的滑膜厚度.结果 PDWI-FS序列图像的滑膜分级为1(0,3)分,FLAIR-FS图像为2(1,3)分.FLAIR-FS序列与PDWI-FS序列对滑膜分级的加权Kappa值为0.603±0.047,95%CI为0.510~0.696.两种序列滑膜分级差异有统计学意义(Z=4.023,P=0.000).1、2、3级滑膜厚度分别为(2.04±1.75)mm、(2.31±0.54)mm、(4.57±2.26)mm,1、2级滑膜厚度均低于3级滑膜厚度,差异有统计学意义(P=0.003、0.001),1级滑膜与2级滑膜厚度差异无统计学意义(P=0.936).结论 FLAIR-FS序列对膝关节滑膜炎的滑膜形态及信号评估具有一定的优势,可以作为膝关节滑膜炎诊断分期的评价工具.
目的 比较不同磁共振场强对脑部T1WI纹理特征的影响.资料与方法 对30例健康成年人分别在磁共振1.5T(MR-1.5T)及3.0T(MR-3.0T)上行脑部3D T1WI结构像扫描.对3D结构像进行脑部灰质及白质分割,并采用灰度共生矩阵方法进行全脑纹理分析,纹理特征参数包括角二阶矩、对比度、自相关、逆差距及熵.结果 MR-3.0T全脑灰质熵高于MR-1.5T(2.170±0.059比2.163±0.054,F=4.465,P=0.039).MR-3.0T全脑白质角二阶矩(0.734±0.008比0.736±0.007,F=11.368,P=0.001)及熵(1.392±0.051比1.397±0.042,F=10.612,P=0.002)低于MR-1.5T,MR-3.0T全脑白质逆差距高于MR-1.5T(0.875±0.005比0.873±0.004,F=10.776,P=0.002).结论 磁共振场强可影响脑部灰质及白质T1WI结构图像纹理特征.
患者男,25岁,反复发作性头痛6年余.患者有偏头痛病史6年,头痛呈搏动性,有紧缩感,以左额部疼痛为主,持续时间不等,活动后症状加重,伴轻度头晕.患者平素作息时间不规律,头痛难以忍受时服用布洛芬缓释片止痛;无家族史.查体未见异常.
BACKGROUND Quantitative susceptibility mapping (QSM) technique had been used to measure the magnetic susceptibility of brain tissue in clinical practice. However, QSM presented echo-time (TE) dependence, and an appropriate number of echo-times (nTEs) for QSM became more important to obtain the reliable susceptibility value. OBJECTIVE The aim of the study was to explore the optimal nTEs for quantitative susceptibility mapping (QSM) measurements of basal ganglia nuclei in the healthy brain. METHODS 3D multi-echo enhanced gradient recalled echo T2 star weighted angiography (ESWAN) sequence was acquired on a 3.0T MR scanner for QSM analysis. Regions of interests (ROIs) were drawn along the margin of the head of the caudate nucleus (HCN), putamen (Pu) and globus pallidus (GP). The mean susceptibility value and standard deviation of the ROIs were derived from the pixels within each region. RESULTS CV analysis demonstrated that TE6, TE8 and TE14 ESWAN sequences presented consistent lower CV value (< 1) for QSM measure of HCN, Pu and GP. ANOVA identified that susceptibility value showed no significant difference between TE6 and TE8 in HCN, Pu and GP (P > 0.05). ICC analysis demonstrated that the susceptibility value of TE6-TE8 had the highest ICC value as compared with TE6-TE14 and TE8-TE14 in HCN, Pu and GP. Combined with the timeefficiency of MRI scanning, TE6 sequence could not only provide the reliable QSM measurement but also short imaging time. CONCLUSION The current study identified that the optimal nTEs of ESWAN were 6 TEs (2.9ms ~ 80.9ms) for QSM measurement of basal ganglia nuclei in the healthy brain.
The magnetic resonance imaging findings of multicystic encephalomalacia are featured by bilateral frontal large cystic lesion with corpus callosum involvement,evident heterogeneous enhancement of the lesion margin,ring hyperintensity on diffusion weighted imaging,and high choline peak and low N-acetylaspartate peak of the enhanced lesion margin on magnetic resonance spectroscopy.This article reports a case of multicystic encephalomalacia.
Objective: To evaluate the mandibular condylar location and morphology in the temporomandibular joint disorders. Methods: One hundred thirty-seven TMD patients (age 37.5±16.1 years, male/female=39/98) were performed with MRI scan for temporomandibular joint (TMJ) from November, 2011 to April, 2019 in Department of Radiology,Hainan Hospital of General Hospital of Chinese PLA and General Hospital of Chinese PLA. The patients were classified into 3 groups according the disc displacement: disc without displacement (DWoD) (185 TMJ), disc displacement with reduction (DDWR) (17 TMJ) and disc displacement without reduction (DDWoR) (72 TMJ). The location (anterior position, central position and posterior position) and morphology (oval shape, flat shape and beaklike shape) of the condylar head were observed on the sagittal PDWI, and the long and short axes were measured on the axial T2WI. Another groups were classified into 3 subgroups according to the disc displacement of bilateral TMJ: bilateral normal disc location (biND) (74 cases), unilateral disc displacement (uniDD) (40 cases) and bilateral disc displacement (23 cases). The inter-condyle angle was measured on the axial T2WI. Results: There was no significant difference for the location of condylar head among DWoD, DDWR and DDwoR groups (χ(2)=7.435, P=0.115). The rate for flat condylar shape was significantly higher in DWoD group [83.9%(115/137)] than that in DDWoR group [50.7%(34/67)], and the rate for beaklike condylar shape was significantly lower in DWoD group [16.1%(22/137)] than that in DDWoR group [49.3%(33/67)] (χ(2)=23.521, P<0.001). The length of long axis presented significantly longer in DWoD group [(17.2±2.4) mm] than that in DDWR group [(15.4±2.0) mm] and that in DDWoR group [(14.7±2.7) mm] (P<0.05). The length of short axis presented significantly longer in DWoD group [(7.3±1.2) mm] than that in DDWR group [(6.5±1.3) mm] and that in DDWoR group [(6.1±1.4) mm] (P<0.05). The inter-condyle angle presented significantly larger in biND group (136°±13°) and uniDD group (132°±14°) than that inbiDD group (124°±17°) (P<0.05). Conclusions: The mandibular condylar morphology changes significantly presented in the patients with temporomandibular disc displacement for the temporomandibular disorders.
目的 探讨正常成人脑部皮层下灰质核团的磁共振T1WI纹理特征测量的可重复性及可信度.资料与方法 对16名成年健康志愿者行脑部磁共振T1WI扫描,并采用灰度共生矩阵法对脑部皮层下灰质核团(尾状核、壳核、丘脑)行纹理特征分析,纹理特征参数值包括能量、对比度、自相关、逆差矩、熵.采用组内相关系数(ICC)及Bland-Altman法分析观察者内的可重复性及观察者间的可信度.结果 观察者内皮层下灰质结构尾状核头、壳核及丘脑的纹理特征参数值ICC分别为0.970~0.990、0.815~0.996及0.677~0.996,其中丘脑自相关参数ICC为0.677,可重复性等级为良,其余皮层下核团纹理参数ICC均高于0.74,可重复性等级为优.观察者间皮层下灰质结构尾状核头、壳核及丘脑的纹理特征参数值ICC分别为0.960~0.982、0.833~0.994及0.829~0.989,均高于0.74,可信度等级为优.Bland-Altman法分析提示观察者内及观察者间皮层下灰质核团纹理参数差值绝大部分位于95%一致性界限内.结论 T1WI图像可以可靠地评估正常成人脑部皮层下灰质核团纹理特征(能量、对比度、自相关、逆差矩、熵).