基于纤维束的空间统计方式的复发缓解型多发性硬化患者磁共振扩散张量成像与正常人对照

目的:利用基于纤维束的空间统计(TBSS)方式结合磁共振扩散张量成像技术(DTI)综合评价DTI对复发缓解型多发性硬化(RRMS)患者全脑白质微结构改变与正常人的对比,并探讨其应用价值。方法:实验组和对照组均进行全脑轴位常规扫描及DTI扫描,数据进行TBSS后处理,生成三维平均各向异性系数纤维骨架并进行非参数统计比较。结果:RRMS患者全脑双侧额叶、颞叶、顶叶及枕叶脑白质区域纤维素呈广泛性各向异性系数值减低、平均扩散率值升高,差异有统计学意义(P0.05)。结论:RRMS患者双侧额叶、颞叶、顶叶及枕叶脑白质区存在广泛的脑白质损伤,TBSS后处理方法能较为准确地定位和定量监测、评估及发现RRMS病灶。     

血压正常2型糖尿病患者大脑微结构改变的VBM及TBSS研究

目的:基于纤维束示踪空间统计分析(TBSS)研究大脑扩散张量成像(DTI)图像,观察血压正常2型糖尿病(T2DM)患者脑白质微结构的改变,并探讨双侧大脑半球间的脑白质改变方法:本研究纳入20名血压正常的T2DM患者及20名年龄、性别匹配的正常对照。采用3.0T磁共振扫描仪采集大脑结构像和DTI数据,应用基于体素的形态学分析(VBM)和TBSS方法比较两组受试者间的大脑体积,白质各向异性分数(FA)和平均扩散系数(MD)值的差异,以及两组受试者左右侧大脑半球DTI参数比值的差异。结果:与正常对照相比,血压正常的T2DM患者大脑体积未见显著减小(P0.05);大脑白质完整性广泛受损,尤以胼胝体膝部、左侧内囊前肢、辐射冠前上部、扣带束及上额-枕束为著;右侧上辐射冠、后辐射冠、扣带束及上纵束FA值和MD值均有改变(P0.05);双侧大脑半球上辐射冠MD值升高,以左侧升高更为显著(P0.05)。结论:血压正常的T2DM患者双侧大脑半球白质微结构广泛损伤,尤以左侧为著,TBSS分析有助于早期检出上述改变。     

基于DTI的胶质瘤患者手术前后脑网络特性分析

目的利用弥散张量成像(diffusion tensor imaging,DTI)技术构建胶质瘤患者手术前后全脑结构网络和半脑结构网络,基于图论知识对脑网络参数进行定量研究及对比分析,探究胶质瘤及肿瘤切除手术对患者脑网络拓扑特性的影响。方法构建健康对照组、胶质瘤患者组手术前后全脑和半脑结构网络,定量分析两组大脑结构网络拓扑特性及网络参数,比较分析手术对患者全脑及半脑网络特性的影响。结果从全脑角度看,患者术后各全局网络参数较正常人均有所降低,但是小世界特性却有所增强,患者各全局参数在术前术后均无显著差异,患者术后的全脑局部参数明显低于术前;在半脑结构网络中,手术前后半脑全局参数无明显差异,而术后半脑全局参数明显低于术前。结论手术使得脑结构网络的局部脑区发生损伤,但并未对患者全脑及半脑全局参数造成显著影响,研究证实了人类大脑的代偿机制以及功能重组。该研究方法可对胶质瘤患者术后的疾病发展状况以及手术治疗效果评价提供帮助。     

磁共振DTI技术和锰离子示踪方法活体定位鼠脑神经纤维

本文应用磁共振(MR)DTI的方法清晰准确描绘出鼠脑白质内主要神经纤维的位置、方向和形态,包括胼胝体、前联合、内囊、外囊、视束、大脑脚、锥体束等。皮质内注射MnCl2后MR成像,可见皮质脊髓束、皮质丘脑束、皮质纹状体束和纹状体黑质通路被示踪,可重复性地表现为特定部位的MR3D-FSPGR图像和T1W像高信号改变,相应区域T2WI为低信号。LFB染色各纤维束位置、形态与DTI-DEC张量图和MnCl2示踪MR图像结果相一致。因此,磁共振DTI技术和锰离子示踪的方法都能够对鼠脑主要神经纤维和投射通路进行定位,能够作为活体示踪脑内神经纤维束的手段。     

基于不同FA模板的全脑体素分析方法可靠性的研究

比较基于两种不同FA模板的全脑体素分析(VBA)方法的结果,了解该方法的可靠性,以期为脑白质的功能研究和相关疾病的诊治提供基础信息。选择27例健康成年志愿者,分为青年组(14例)和老年组(13例),行磁共振弥散张量成像扫描。首先使用DTIStudio软件对图像进行自动配准和张量计算,获取部分各向异性(FA)图,然后利用统计参数图(SPM8)软件对FA图进行配准、归一化、平滑等预处理,最后分别基于SPM8软件下产生的专用FA模板和本实验室自主开发的正常中国人FA模板,对两组间的脑白质FA值进行全脑体素分析比较。以纤维束示踪的空间统计学(TBSS)方法和相关文献结果为标准,对以上比较结果进行验证。在基于SPM8产生的专用FA模板下,与青年组对比,老年组的双侧内囊前、后肢,左外囊,左额上回,左枕叶,右放射冠,右大脑脚底,右额中、下回,右小脑中脚的FA值显著下降(P<0.05,簇错误率校正);在基于正常中国人FA模板下,老年组的左内囊后肢,左外囊,左额上回,左颞中回,左枕叶,右放射冠,右内囊前、后肢,右大脑脚底,右额中、下回和胼胝体膝部的FA值相对于青年组显著下降(P<0.05,簇错误率校正);两种模板结果的不一致区域共有4个,即:左内囊前肢、右小脑中脚和左颞中回、胼胝体膝部,前两个区域出现在第一个模板中,后两个区域出现在第二个模板中,根据TBSS方法的激活区结果可得出左内囊前肢、右小脑中脚是假阳性,TBSS方法和相关文献结果支持第二个模板的结论。在采用VBA方法对脑白质进行分析时,基于正常中国人FA模板有助于提高结果的客观性和可靠性。     

三维脑白质纤维束示踪成像

目的使用磁共振弥散张量成像数据三维示踪大脑白质纤维束。方法对18名健康自愿者使用弥散加权-回波平面成像(DW-EPI)序列进行头部DTI检查。输出DICOM格式的DTI图像数据并根据已知的脑白质纤维束的解剖学知识,选取起始区、目标区、回避区,使用Diffusion Tensor VisualizerⅡ软件进行脑白质纤维束示踪三维重建。结果大脑的连合系、联络系和投射系的各种脑白质纤维束的结构和其在三维空间的走行可在每例实验对象的三维示踪结果显示,与解剖学所描述相对比基本一致。结论使用三维脑白质纤维束示踪成像可以在活体立体直观地显示大脑的各种脑白质纤维束。不仅可以用于解剖学教学,还对临床神经系统疾病的辅助诊断和科学研究有潜在的应用价值。     

脑肿瘤患者手术前后脑结构网络拓扑属性研究

主要研究脑肿瘤的存在及手术对患者全脑及半脑结构网络拓扑属性的影响。结合弥散张量成像技术(DTI)和图论方法,对10例健康志愿者以及10例脑肿瘤患者进行术前术后全脑及半脑结构网络构建,获得两组受试者脑结构网络拓扑属性参数,以及反映脑认知功能的各项网络指标,并对其进行统计对比分析。结果显示,部分局部参数(包括K_i、L_i、E_nodal、C_i和E_ilocal)在手术前后具有明显差异,且术前组均优于术后组;全脑及半脑各全局网络参数显示,各项参数术前组均优于术后组;同时半脑结构网络分析显示,位于不同脑半球的脑肿瘤对患者脑结构网络所造成的损伤均无统计学差异(P>0.05)。肿瘤的存在以及手术均使得脑肿瘤患者脑结构网络发生改变,大脑的半脑优势化趋势明显降低;手术后结构网络拓扑特性的改变以及小世界属性的增强,验证大脑本身存在的代偿机制以及功能重组现象。     

弥散张量成像评价中老年患者全身麻醉后海马区纤维的完整性

目的:应用弥散张量成像技术(diffusion tensor imaging,DTI)比较中老年患者术前与接受全凭静脉麻醉术后海马旁回以及后扣带回白质纤维束的完整性.方法:对20例接受全凭静脉麻醉的老年患者进行术前简明精神状态量表(mini-mental state examination,MMSE)评分,并且进行术前1天及术后3天的功能磁共振扫描.分为术前组与术后组.术前组与术后组均为相同的患者.采用FSL软件对获取的磁共振图像数据进行处理,分别计算双侧海马旁回(hippocampal gyrus,PH),双侧后扣带回(posterior cingulate cortex,PCC)的各向异性分数(fractional anisotropy,FA)和表观弥散系数(apparent diffusion coefficient,ADC),利用SPSS软件进行统计学分析.结果:术后组双侧PH,双侧PCC的FA值较术前有所降低,ADC值较术前有所升高,差异有统计学意义(P＜0.05).结论:全凭静脉麻醉术后老年患者的海马体部白质纤维束的完整性较术前有所损害.     

腺苷负荷脑血流灌注显像的可行性研究

目的 数为参照,分别计算两侧大脑额叶、颞叶、顶叶、枕叶ROI放射性计数与其比值,比较同一组ROI在腺苷负荷状态下与静息状态下放射性计数比值.对视为异常部位的大脑ROI按其对腺苷负荷后脑血流灌注变化的反应进行分类.结果 所有患者进行腺苷负荷显像,没有因出现严重不良反应而终止,部分患者出现轻微不良反应并在腺苷注射结束后迅速消失.共获得视为正常的174组大脑ROI,静息显像的比值与负荷显像的比值比较显示,额叶、颞叶、顶叶差异有统计学意义(0.901±0.100比0.956±0.149,0.923±0.070比0.981±0.090,0.840±0.126比0.887±0.091,均P＜0.05),枕叶差异无统计学意义(1.102±0.146比1.010±0.124,P＞0.05).获得视为异常的49处ROI,其中静息状态局部脑血流量正常,腺苷负荷后局部脑血流量减低的有10处;静息状态局部脑血流量减低,腺苷负荷后局部脑血流量减低更加明显的有9处;静息状态局部脑血流量减低,腺苷负荷后局部脑血流量减低改善的有27处;静息状态局部脑血流量减低,腺苷负荷后局部脑血流量减低区无明显变化的有3处.结论 腺苷能用于负荷脑血流灌注显像,且不良反应少.     

基于DTI影像图论分析的正常老化认知表现预测模型

目的 以磁共振扩散张量影像（diffusion tensor imaging,DTI）为基础进行大脑结构网络拓扑属性分析,选择与认知表现分数相关性较大的结构网络特征,并基于这些特征建立认知表现分数预测模型,藉以客观地估测老年人的大脑认知能力.方法 对94例正常老化的DTI影像进行结构脑网络构建,采用图论法分析结构连接矩阵,提取结构网络的特征,并将所有特征与受试者的简单智能状态检查量表（mini-mental status examination,MMSE）分数进行相关性分析,选取出与大脑认知高度相关的网络特征,再基于这些特征建立5种分析模型,预测受试者的认知表现分数,以进一步分析模型的预测效能.结果 通过相关性分析,在相关系数大于0.22且P值小于0.05的条件下,选取出与大脑认知高度相关的30个特征,这些特征分布在AAL（automated anatomical labeling）图谱中的12个脑区.而在模型建立与效能分析部分,以高斯回归模型的效能最佳,其训练组相关系数达0.89,预测误差最小为2.01,对受试者的认知表现分数预测较准确.结论 利用结构脑网络度量指标作为生物标记指针可建立正常老化认知功能预测模型,且能有效预测正常老年人的认知表现分数.     

High-resolution diffusion tensor imaging of fixed brain in a mouse model of Pelizaeus-Merzbacher disease: comparison with quantitative measures of white matter pathology

Diffusion tensor imaging (DTI) is a powerful technique for the noninvasive assessment of the central nervous system. To facilitate the application of this technique to in vivo studies, we characterised a mouse model of the leukodystrophy, Pelizaeus-Merzbacher disease (PMD), comparing high-resolution ex vivo DTI findings with quantitative histological analysis of selected areas of the brain. The mice used in this study (Plp1-transgenic) carry transgenic copies of the Plp1 gene and are models for PMD as a result of gene duplication. Plp1 transgenic mice display a mild ataxia and experience frequent seizures around the time at which they were imaged. Axial (λ(1) ) and radial (RD) diffusivities and fractional anisotropy (FA) data were analysed using an exploratory whole-brain voxel-based method, a voxel-based approach using tract-based spatial statistics (TBSS), and by application of conventional region of interest (ROI) analyses to selected white matter tracts. Raw t value maps and TBSS analyses indicated widespread changes throughout the brain of Plp1-transgenic mice compared with the wild-type. ROI analyses of the corpus callosum, anterior commissure and hippocampal fimbria showed that FA was reduced significantly, whereas λ(1) and RD were increased significantly, in Plp1-transgenic mice compared with the wild-type. The DTI data derived from ROI analyses were subsequently compared with histological measures taken in the same regions. These revealed an almost complete absence of myelin, preservation of axons, marked astrocytosis and increased or unchanged cell densities. These data contribute to our growing understanding of the basis of anisotropic water diffusion in the normal and diseased nervous system.     

User‐independent diffusion tensor imaging analysis pipelines in a rat model presenting ventriculomegalia: A comparison study

Automated analysis of diffusion tensor imaging (DTI) data is an appealing way to process large datasets in an unbiased manner. However, automation can sometimes be linked to a lack of interpretability. Two whole‐brain, automated and voxelwise methods exist: voxel‐based analysis (VBA) and tract‐based spatial statistics (TBSS). In VBA, the amount of smoothing has been shown to influence the results. TBSS is free of this step, but a projection procedure is introduced to correct for residual misalignments. This projection assigns the local highest fractional anisotropy (FA) value to the mean FA skeleton, which represents white matter tract centers. For both methods, the normalization procedure has a major impact. These issues are well documented in humans but, to our knowledge, not in rodents. In this study, we assessed the quality of three different registration algorithms (ANTs SyN, DTI‐TK and FNIRT) using study‐specific templates and their impact on automated analysis methods (VBA and TBSS) in a rat pup model of diffuse white matter injury presenting large unilateral deformations. VBA and TBSS results were stable and anatomically coherent across the three pipelines. For VBA, in regions around the large deformations, interpretability was limited because of the increased partial volume effect. With TBSS, two of the three pipelines found a significant decrease in axial diffusivity (AD) at the known injury site. These results demonstrate that automated voxelwise analyses can be used in an animal model with large deformations.     

Diffusional kurtosis imaging and white matter microstructure modeling in a clinical study of major depressive disorder

Major depressive disorder (MDD) is a globally prevalent psychiatric disorder that results from disruption of multiple neural circuits involved in emotional regulation. Although previous studies using diffusion tensor imaging (DTI) found smaller values of fractional anisotropy (FA) in the white matter, predominantly in the frontal lobe, of patients with MDD, studies using diffusion kurtosis imaging (DKI) are scarce. Here, we used DKI whole‐brain analysis with tract‐based spatial statistics (TBSS) to investigate the brain microstructural abnormalities in MDD. Twenty‐six patients with MDD and 42 age‐ and sex‐matched control subjects were enrolled. To investigate the microstructural pathology underlying the observations in DKI, a compartment model analysis was conducted focusing on the corpus callosum. In TBSS, the patients with MDD showed significantly smaller values of FA in the genu and frontal portion of the body of the corpus callosum. The patients also had smaller values of mean kurtosis (MK) and radial kurtosis (RK), but MK and RK abnormalities were distributed more widely compared with FA, predominantly in the frontal lobe but also in the parietal, occipital, and temporal lobes. Within the callosum, the regions with smaller MK and RK were located more posteriorly than the region with smaller FA. Model analysis suggested significantly smaller values of intra‐neurite signal fraction in the body of the callosum and greater fiber dispersion in the genu, which were compatible with the existing literature of white matter pathology in MDD. Our results show that DKI is capable of demonstrating microstructural alterations in the brains of patients with MDD that cannot be fully depicted by conventional DTI. Though the issues of model validation and parameter estimation still remain, it is suggested that diffusion MRI combined with a biophysical model is a promising approach for investigation of the pathophysiology of MDD.     

Diffusion tensor imaging and Tract-Based Spatial Statistics in Alzheimer's disease and mild cognitive impairment

We aimed to explore the changes in fractional anisotropy (FA) in subjects with mild cognitive impairment (MCI) and Alzheimer's disease (AD) by analyzing diffusion tensor imaging (DTI) data using the Tract-Based Spatial Statistics (TBSS). DTI data were collected from 17 AD patients, 27 MCI subjects and 19 healthy controls. Voxel-based analysis with TBSS was used to compare FA among the three groups. Additionally, guided by TBSS findings, a region of interest (ROI)-based analysis along the TBSS skeleton was performed on group-level and the accuracy of the method was assessed by the back-projection of ROIs to the native space FA. Neurofiber tracts with decreased FA included: the parahippocampal white matter, cingulum, uncinate fasciculus, inferior and superior longitudinal fasciculus, corpus callosum, fornix, tracts in brain stem, and cerebellar tracts. Quantitative ROI-analysis further demonstrated the significant decrease on FA values in AD patients relative to controls whereas FA values of MCI patients were found in between the controls and AD patients. We conclude that TBSS is a promising method in examining the degeneration of neurofiber tracts in MCI and AD patients.     

Diffusion tensor MRI with tract-based spatial statistics and histology reveals undiscovered lesioned areas in kainate model of epilepsy in rat

In this study, we used tract-based spatial statistics (TBSS) to analyze diffusion tensor MR imaging (DTI) data acquired from the rat brain, ex vivo, for the first time. The aim was to highlight potential changes in the whole brain anatomy in the kainic acid model of epilepsy, and further characterize the changes with histology. Increased FA was observed in dorsal endopiriform nucleus, external capsule, corpus callosum, dentate gyrus, thalamus, and optic tract. A decrease in FA was seen in the horizontal limb of the diagonal band, stria medullaris, habenula, entorhinal cortex, and superior colliculus. Some of the areas have been described in kainic acid model before. However, we also found regions that to our knowledge have not been previously reported to undergo structural changes, in this model, including stria medullaris, nucleus of diagonal band, habenula, superior colliculus, external capsule, corpus callosum, and optic tract. Four of the areas highlighted in TBSS (dentate gyrus, entorhinal cortex, thalamus and stria medullaris) were analyzed in more detail with Nissl, Timm, and myelin-stained histological sections, and with polarized light microscopy. TBSS together with targeted histology confirmed that DTI changes were associated with altered myelination, neurodegeneration, and/or calcification of the tissue. Our data demonstrate that DTI in combination with TBSS has a great potential to facilitate the discovery of previously undetected anatomical changes in animal models of brain diseases.     

Right lateralized white matter abnormalities in first-episode,drug-naive paranoid schizophrenia

Numerous studies in first-episode schizophrenia suggest the involvement of white matter (WM) abnormalities in multiple regions underlying the pathogenesis of this condition. However, there has never been a neuroimaging study in patients with first-episode, drug-naive paranoid schizophrenia by using tract-based spatial statistics (TBSS) method. Here, we used diffusion tensor imaging (DTI) with TBSS method to investigate the brain WM integrity in patients with first-episode, drug-naive paranoid schizophrenia. Twenty patients with first-episode, drug-naive paranoid schizophrenia and 26 healthy subjects matched with age, gender, and education level were scanned with DTI. An automated TBSS approach was employed to analyze the data. Voxel-wise statistics revealed that patients with paranoid schizophrenia had decreased fractional anisotropy (FA) values in the right superior longitudinal fasciculus (SLF) II, the right fornix, the right internal capsule, and the right external capsule compared to healthy subjects. Patients did not have increased FA values in any brain regions compared to healthy subjects. There was no correlation between the FA values in any brain regions and patient demographics and the severity of illness. Our findings suggest right-sided alterations of WM integrity in the WM tracts of cortical and subcortical regions may play an important role in the pathogenesis of paranoid schizophrenia.     

Tract based spatial statistical analysis and voxel based morphometry of diffusion indices in temporal lobe epilepsy

White matter (WM) microstructure can be evaluated by diffusion tensor imaging (DTI). Tract-based spatial statistical (TBSS) analysis provides a means of assessing alterations in WM tracts. In this paper, both voxel-based morphometry (VBM) and TBSS are examined using DTI data of temporal lobe epilepsy (TLE) patients and nonepileptic subjects. In addition to fractional anisotropy (FA), ellipsoidal area ratio (EAR) is used in this study. Significant reductions of FA and EAR are identified by TBSS in the parahippocampal white matter. Because of methodological differences, TBSS detects more localized abnormalities than VBM, while the EAR is more sensitive to WM alteration than FA.     

基于DT-MRI的纤维跟踪及可视化研究

磁共振扩散张量成像(DT-MRI)是一种新的成像技术,比传统的扩散加权成像(DWI)能够更加准确地反映分子扩散的方向.在脑白质这样具有大量纤维束的组织中,水分子的扩散表现出显著的各向异性,从而有可能从张量信息的各向异性入手,跟踪得到白质纤维束的走行方向.本文介绍了DTI的原理、数据采集与处理方法,提出了一种可变步长的纤维跟踪方法,并以VC /ITK/VTK为开发工具实现了DTI分析和纤维跟踪与可视化.     

磁共振弥散张量成像的质量控制

磁共振弥散张量成像（DTI）是诊断和分析神经系统疾病的重要方法,但其目前发展受空间分辨率、信噪比及图像质量等限制。本文对近年来MRI系统基础质量保证方法、DTI参数定性测量方法、用于扩散成像的软件方法以及不同纤维跟踪方法等进行综述。     

Determination of three-dimensional muscle architectures: validation of the DTI-based fiber tractography method by manual digitization

In the last decade, diffusion tensor imaging (DTI) has been used increasingly to investigate three-dimensional (3D) muscle architectures. So far there is no study that has proved the validity of this method to determine fascicle lengths and pennation angles within a whole muscle. To verify the DTI method, fascicle lengths of m. soleus as well as their pennation angles have been measured using two different methods. First, the 3D muscle architecture was analyzed in vivo applying the DTI method with subsequent deterministic fiber tractography. In a second step, the muscle architecture of the same muscle was analyzed using a standard manual digitization system (MicroScribe MLX). Comparing both methods, we found differences for the median pennation angles (P < 0.001) but not for the median fascicle lengths (P = 0.216). Despite the statistical results, we conclude that the DTI method is appropriate to determine the global fiber orientation. The difference in median pennation angles determined with both methods is only about 1.2° (median pennation angle of MicroScribe: 9.7°; DTI: 8.5°) and probably has no practical relevance for muscle simulation studies. Determining fascicle lengths requires additional restriction and further development of the DTI method.