磁共振扩散张量成像在显示正常人脑白质纤维中的应用

目的应用DTI技术显示正常人脑白质纤维,探讨其与解剖学描述的一致性。方法20名健康志愿者行颅脑MRI与颅脑单次激发回波平面扩散张量成像扫描(b值=0,500s/mm2),在SiemensLeonardo工作站应用纤维束跟踪软件(SiemensStandar12dirs)进行后处理重建出白质纤维束。结果对主要白质纤维如皮质脊髓束、皮质核束、胼胝体、扣带、上纵束、下纵束、上枕额束、下枕额束、钩束进行模拟显示,不同纤维需要选择适合的感兴趣区、各向异性阈值、角度阈值、步长和体素内采样数目等参数,显示结果与解剖学描述具有较好的一致性。结论利用扩散张量成像技术可模拟显示正常人脑白质纤维,与解剖学描述具有较好的一致性,是在活体中研究人脑白质纤维的一种较可靠的方法。     

正常成人近段坐骨神经的弥散张量成像

背景：弥散张量成像及神经纤维束示踪的出现为外周神经细微结构的显示及定量分析提供了新的方法。目的：前瞻性分析健康成人大腿近段坐骨神经纤维束示踪、弥散张量成像的可行性及最佳成像参数。方法：采用单次激发自旋回波-平面回波技术对28名健康志愿者双侧坐骨神经进行弥散张量成像及神经纤维束示踪,b值分别为1200,1400,1600s/mm2。结果与结论：弥散张量成像及神经纤维束示踪成功者26名,成功率93%,神经纤维束示踪图上能清晰显示近段坐骨神经,与T1WI上解剖图像融合较好。两侧坐骨神经具有相同的弥散特征：随着b值增加,信噪比逐渐减少,b值为1200s/mm2,信噪比值最大为142.72±32.25,神经纤维束长度最长,所占体素最大,但不同b值的弥散张量参数无差异（P〉0.05）,且两侧坐骨神经弥散张量参数无差异。说明正常成人大腿近段坐骨神经的弥散张量成像及经纤维束示踪是可行的,可清晰显示坐骨神经走行及弥散特征;最佳b值为1200s/mm2。     

高阶弥散张量纤维束成像评估胶质瘤研究进展北大核心CSCD

胶质瘤为中枢神经系统常见恶性肿瘤,手术切除为治疗最有效治疗手段,而术前评估极为重要。基于弥散张量成像(DTI)的弥散张量纤维束成像(DTT)可无创显示活体内脑白质纤维束走行,定量评估胶质瘤病理分级、与白质纤维的解剖关系及瘤周白质纤维损伤程度。本文就高阶DTT评估胶质瘤研究进展进行综述。     

扩散张量纤维束成像对非脑回性皮层发育不良脑内主要纤维结构分析

目的用扩散张量纤维束成像技术对左侧非脑回性皮层发育不良患者脑内主要白质纤维进行研究，旨在揭示该病脑内重要纤维结构改变特征，为临床预后评估提供功能解剖学依据。方法用SIEMENS Trio2003T对患者行全脑常规检查和扩散张量成像，然后进行数据收集和后处理。结果常规MRI左侧大脑半球体积增大，顶叶脑回增宽，左侧半卵圆中心大片块样异常信号影。扩散张量纤维束成像显示左侧弓状纤维束、下纵行纤维束、扣带束、海马等重要的联络、连合纤维明显比对侧增大，左侧内囊后肢及外囊较右侧纤维束少，左侧内囊后肢交叉到对侧小脑的纤维明显减少。结论扩散张量成像技术可精确、直观显示先天性发育畸形的脑内主要纤维结构特征，可提供脑白质的先天性畸形与后天性白质结构异常鉴别的依据，同时对预后的评估有参考价值。     

磁共振弥散张量成像技术及其在中枢神经系统临床应用进展

1994年,Basser等首次提出磁共振弥散张量成像（diffusiontensorimaging,DTI）的概念,它可研究脑白质纤维的微观结构及形态结构,探测白质纤维束的生理或病理状态下的变化,并利用多参数进行定量分析。弥散张量纤维束成像（diffusiontensor tracyography,DTT）是基于DTI上的一种新的可视化成像技术,是目前唯一可在活体上显示脑白质纤维束的无创性成像方法。DTI及DTT可清晰显示神经纤维束生理和病理的各向异性和构象特征,对疾病的诊断与鉴别诊断、肿瘤定性与分级、预后评估、制订治疗方案以及疗效评价等方面具有重要意义,近几年也成为国内外研究的热点,并取得很大成就。     

弥散张量纤维束示踪成像在涉及锥体束脑肿瘤中的应用

目的探讨磁共振弥散张量纤维束示踪成像在涉及锥体束的脑肿瘤的术前计划和预测临床预后中的应用价值.方法对36例涉及锥体束的脑胶质瘤患者,术前在常规成像基础上,行弥散张量成像(DTI)序列检查采集全脑DTI原始数据,经工作站生成二维的部分各向异性伪彩图(FA color)和三维的锥体束白质纤维束示踪图,提供锥体束与脑内肿瘤的位置关系信息,优化手术方案,保护皮层下重要功能的白质纤维束,并预测患者预后.术前、术后行KPS评分,评价患者的生活状态.结果所有病人术前DTI图像采集经后处理均生成二维FA color图和三维锥体束白质纤维束示踪图.术前成功地显示出锥体束与脑内肿瘤的位置关系以及肿瘤对锥体束的影响,优化手术方案.36例病人中,20例DTI清楚显示肿瘤未累及锥体束,低级别16例、高级别4例,术前、后KPS评分平均为86和93;12例DTI显示肿瘤紧邻锥体束并推移,低级别6例、高级别6例,术前、后KPS评分平均为80和94;4例DTI显示肿瘤在大体上已浸润及/或破坏锥体束,低级别2例、高级别2例,术前、后KPS评分为67和80.结论在常规的MR成像后行弥散张量纤维束示踪成像研究,优化涉及重要白质纤维束如锥体束的脑肿瘤切除术的手术方案,保护皮质下重要功能的白质纤维,并可预测患者临床功能预后.     

弥散张量纤维束成像在高血压性脑出血患者神经功能恢复评估中的应用研究

目的:应用弥散张量纤维束成像(DTT)技术观察基底核区高血压性脑出血(HICH)皮质脊髓束(CST)的受损情况,探讨弥散张量纤维束成像技术在HICH预后评估的临床应用价值。方法:对18例基底核区HICH患者进行磁共振弥散张量成像检查,所有患者分别于入院时、发病后第3个月、第6个月进行肌力测定、NIHSS评分,对CST损伤程度和各个时期肌力、NIHSS评分的关系进行分析。结果:健侧CST解剖形态与正常人大致相吻合,患侧CST则受血肿的侵犯,表现为受压、移位、不同程度的破坏;CST完整患者的肌力、NIHSS评分恢复情况在各个时期均较CST中断的患者好,发病后3个月是恢复最快的阶段。结论:通过弥散张量纤维束成像可以了解基底核区HICH患者CST的损伤情况,有助于早期预测神经功能的恢复情况,指导治疗方案的制定。     

弥散频谱成像的研究进展

研究表明人类大脑中的很多区域内存在着多方向的纤维束,这类区域的体素内水分子的平均弥散并不符合高斯分布。因此,基于单方向纤维束模型的弥散张量成像在揭示组织微观结构中存在先天缺陷。弥散频谱成像使用多b值多方向的扫描序列,采集水分子在整个q空间的弥散信息,通过一个具有高角分辨率的概率密度函数来描述水分子的弥散运动,能够可靠地观测单体素内多方向的纤维束,并据此进行纤维束追踪重建出真实而复杂的组织结构。作者全面介绍了近年来弥散频谱成像在基本原理、方法学和应用方面的研究进展,为推动国内弥散成像技术在科研和临床上的发展提供帮助。     

弥散张量成像纤维跟踪技术的研究进展

纤维跟踪技术(fiber tracking或 tractography )是近年来MR技术的一项重大进展,它是利用弥散张量数据,能在活体上三维显示脑白质纤维束的一种无创性成像方法.由于该技术具有显示神经纤维束的能力,将有助于理解正常脑功能和多种影响脑功能的病理过程.本文就该技术的研究进展进行综述.     

磁共振弥散张量成像及纤维束成像对脑胶质瘤分级的诊断价值

目的 联合应用弥散张量成像(diffusion tensor imaging,DTI)与弥散张量纤维束成像(diffusion tensor tractography,DTT),探讨其在胶质瘤分级诊断中的应用价值.方法 25例脑胶质瘤患者进行常规MR及弥散张量成像,经组织病理学证实其中9例低级别(Ⅰ～Ⅱ级)胶质瘤,16...     

Resolving fiber crossing using advanced fast marching tractography based on diffusion tensor imaging

Magnetic resonance diffusion tensor tractography is a powerful tool for the non-invasive depiction of the white matter architecture in the human brain. However, due to limitations in the underlying tensor model, the technique is often unable to reconstruct correct trajectories in heterogeneous fiber arrangements, such as axonal crossings. A novel tractography method based on fast marching (FM) is proposed which is capable of resolving fiber crossings and also permits trajectories to branch. It detects heterogeneous fiber arrangements by incorporating information from the entire diffusion tensor. The FM speed function is adapted to the local tensor characteristics, allowing in particular to maintain the front evolution direction in crossing situations. In addition, the FM's discretization error is reduced by increasing the number of considered possible front evolution directions. The performance of the technique is demonstrated in artificial data and in the healthy human brain. Comparisons with standard FM tractography and conventional line propagation algorithms show that, in the presence of interfering structures, the proposed method is more accurate in reconstructing trajectories. The in vivo results illustrate that the elucidated major white matter pathways are consistent with known anatomy and that multiple crossings and tract branching are handled correctly.     

Resolving crossings in the corticospinal tract by two-tensor streamline tractography: Method and clinical assessment using fMRI

An inherent drawback of the traditional diffusion tensor model is its limited ability to provide detailed information about multidirectional fiber architecture within a voxel. This leads to erroneous fiber tractography results in locations where fiber bundles cross each other. This may lead to the inability to visualize clinically important tracts such as the lateral projections of the corticospinal tract. In this report, we present a deterministic two-tensor eXtended Streamline Tractography (XST) technique, which successfully traces through regions of crossing fibers. We evaluated the method on simulated and in vivo human brain data, comparing the results with the traditional single-tensor and with a probabilistic tractography technique. By tracing the corticospinal tract and correlating with fMRI-determined motor cortex in both healthy subjects and patients with brain tumors, we demonstrate that two-tensor deterministic streamline tractography can accurately identify fiber bundles consistent with anatomy and previously not detected by conventional single-tensor tractography. When compared to the dense connectivity maps generated by probabilistic tractography, the method is computationally efficient and generates discrete geometric pathways that are simple to visualize and clinically useful. Detection of crossing white matter pathways can improve neurosurgical visualization of functionally relevant white matter areas.     

Initial demonstration of in vivo tracing of axonal projections in the macaque brain and comparison with the human brain using diffusion tensor imaging and fast marching tractography

Diffusion tensor imaging (DTI), a magnetic resonance imaging technique, is used to infer major axonal projections in the macaque and human brain. This study investigates the feasibility of using known macaque anatomical connectivity as a "gold-standard" for the evaluation of DTI tractography methods. Connectivity information is determined from the DTI data using fast marching tractography (FMT), a novel tract-tracing (tractography) method. We show for the first time that it is possible to determine, in an entirely noninvasive manner, anatomical connection pathways and maps of an anatomical connectivity metric in the macaque brain using a standard clinical scanner and that these pathways are consistent with known anatomy. Analogous human anatomical connectivity is also presented for the first time using the FMT method, and the results are compared. The current limitations of the methodology and possibilities available for further studies are discussed.     

White and gray matter development in human fetal, newborn and pediatric brains

Brain anatomy is characterized by dramatic growth from the end of the second trimester through the neonatal stage. The characterization of normal axonal growth of the white matter tracts has not been well-documented to date and could provide important clues to understanding the extensive inhomogeneity of white matter injuries in cerebral palsy (CP) patients. However, anatomical studies of human brain development during this period are surprisingly scarce and histology-based atlases have become available only recently. Diffusion tensor magnetic resonance imaging (DTMRI) can reveal detailed anatomy of white matter. We acquired diffusion tensor images (DTI) of postmortem fetal brain samples and in vivo neonates and children. Neural structures were annotated in two-dimensional (2D) slices, segmented, measured, and reconstructed three-dimensionally (3D). The growth status of various white matter tracts was evaluated on cross-sections at 19-20 gestational weeks, and compared with 0-month-old neonates and 5- to 6-year-old children. Limbic, commissural, association, and projection white matter tracts and gray matter structures were illustrated in 3D and quantitatively characterized to assess their dynamic changes. The overall pattern of the time courses for the development of different white matter is that limbic fibers develop first and association fibers last and commissural and projection fibers are forming from anterior to posterior part of the brain. The resultant DTMRI-based 3D human brain data will be a valuable resource for human brain developmental study and will provide reference standards for diagnostic radiology of premature newborns.     

Comparison of fiber tracts derived from in-vivo DTI tractography with 3D histological neural tract tracer reconstruction on a macaque brain

Since the introduction of diffusion weighted imaging (DWI) as a method for examining neural connectivity, its accuracy has not been formally evaluated. In this study, we directly compared connections that were visualized using injected neural tract tracers (WGA-HRP) with those obtained using in-vivo diffusion tensor imaging (DTI) tractography. First, we injected the tracer at multiple sites in the brain of a macaque monkey; second, we reconstructed the histological sections of the labeled fiber tracts in 3D; third, we segmented and registered the fibers (somatosensory and motor tracts) with the anatomical in-vivo MRI from the same animal; and last, we conducted fiber tracing along the same pathways on the DTI data using a classical diffusion tracing technique with the injection sites as seeds. To evaluate the performance of DTI fiber tracing, we compared the fibers derived from the DTI tractography with those segmented from the histology. We also studied the influence of the parameters controlling the tractography by comparing Dice superimposition coefficients between histology and DTI segmentations. While there was generally good visual agreement between the two methods, our quantitative comparisons reveal certain limitations of DTI tractography, particularly for regions at remote locations from seeds. We have thus demonstrated the importance of appropriate settings for realistic tractography results.     

High-resolution diffusion tensor imaging and tractography of the human optic chiasm at 9.4 T

The optic chiasm with its complex fiber micro-structure is a challenge for diffusion tensor models and tractography methods. Likewise, it is an ideal candidate for evaluation of diffusion tensor imaging tractography approaches in resolving inter-regional connectivity because the macroscopic connectivity of the optic chiasm is well known. Here, high-resolution (156 microm in-plane) diffusion tensor imaging of the human optic chiasm was performed ex vivo at ultra-high field (9.4 T). Estimated diffusion tensors at this high resolution were able to capture complex fiber configurations such as sharp curves, and convergence and divergence of tracts, but were unable to resolve directions at sites of crossing fibers. Despite the complex microstructure of the fiber paths through the optic chiasm, all known connections could be tracked by a line propagation algorithm. However, fibers crossing from the optic nerve to the contralateral tract were heavily underrepresented, whereas ipsilateral nerve-to-tract connections, as well as tract-to-tract connections, were overrepresented, and erroneous nerve-to-nerve connections were tracked. The effects of spatial resolution and the varying degrees of partial volume averaging of complex fiber architecture on the performance of these methods could be investigated. Errors made by the tractography algorithm at high resolution were shown to increase at lower resolutions closer to those used in vivo. This study shows that increases in resolution, made possible by higher field strengths, improve the accuracy of DTI-based tractography. More generally, post-mortem investigation of fixed tissue samples with diffusion imaging at high field strengths is important in the evaluation of MR-based diffusion models and tractography algorithms.     

Bootstrap white matter tractography (BOOT-TRAC)

White matter tractography is a noninvasive method for estimating and visualizing the white matter connectivity patterns in the human brain using diffusion tensor imaging (DTI) data. Sources of experimental noise may induce errors in the measured fiber directions, which will reduce the accuracy of the estimated white matter trajectories. In this study, a statistical nonparametric bootstrap method is described for estimating the dispersion and other errors in white matter tractography results. Prior studies have derived models of tractography error using the signal-to-noise ratio (SNR) and diffusion anisotropy of the DTI data. Tractography errors measured using bootstrap methods were generally consistent with an analytic model of tractography error except in areas where branching was evident. White matter tractography with bootstrap resampling is also applied to estimate the probabilities of connection between brain regions. The approach was used to generate probabilistic connectivity maps between the cerebral peduncles and specific cortical regions.     

From diffusion tractography to quantitative white matter tract measures: a reproducibility study

The aim of this study is to propose methods for assessing the reproducibility of diffusion tractography algorithms in future clinical studies and to show their application to the tractography algorithm developed in our unit, fast marching tractography (FMT). FMT estimates anatomical connectivity between brain regions using the information provided by diffusion tensor imaging. Three major white-matter pathways were investigated in 11 normal subjects--anterior callosal fibers, optic radiations, and pyramidal tracts. FMT was used to generate maps of connectivity metric, and regions of voxels with highest connectivity metric to an anatomically defined starting point were identified for each tract under investigation. The reproducibilities of tract-"normalized" volume (NV) and fractional anisotropy (FA) measurements were assessed over such regions. The values of tract volumes are consistent with the postmortem data. Coefficients of variation (CVs) for FA and NV ranged from 1.7 to 7.1% and from 2.2 to 18.6%, respectively. CVs were lowest in the anterior callosal fibers (range: 1.7- 7.8%), followed by the optic radiations (range: 1.2-18.6%) and pyramidal tracts (range: 2.6-15.5%), suggesting that fiber organization plays a role in determining the level of FMT reproducibility. In conclusion, these findings underline the importance of assessing the reliability of diffusion tractography before investigating white matter pathology.     

精神分裂症患者脑白质纤维扩散张量成像测量方法研究

目的探讨用MR扩散张量成像(DTI)对精神分裂症患者脑白质纤维测量方法研究和意义。材料与方法对10~50岁精神分裂症住院患者(研究组)和50名健康人群(对照组)扩散张量成像脑白质纤维形态和量的分析。结果 (1)比较研究组与对照组年龄和性别无显著统计学意义;(2)比较对照组和研究组各部位对应左右差值分布差异有显著统计学意义(P0.05),发现研究组双侧颞上回、双侧外囊中部及双侧海马钩回左右FA差值明显低于对照组,差值越大,越有统计学意义。结论用扩散张量成像对精神分裂症患者脑白质测量FA值时,取连续相邻两个层面最清晰部位进行对称性测量,发现脑白质某部位扩散张量成像FA值异常,进行左右FA值(胼胝体除外)比较分析时,用左减右FA差值的方法进一步分析脑白质细微结构变化具有临床意义,可用于临床分析。