精神分裂症白质损害与发病年龄的弥散张量成像研究

目的:应用弥散张量成像(DTI)比较精神分裂症患者脑白质与正常人群间的差异,并探究各向异性比值(FA)的改变与发病年龄之间的相关性。方法:纳入27例精神分裂症患者和29名性别、年龄及受教育程度相匹配的健康对照。两组研究对象均接受头颅磁共振检测。患者组按照发病年龄分为早发组(发病年龄18岁)和成年发病组(发病年龄≥18岁)。采用基于体素的分析方法,分别比较患者组和对照组、早发组和成年发病组之间FA值的差异,并在控制性别、病程和药物剂量影响的前提下,分析FA值与患者发病年龄的相关性。结果:与健康对照比较,患者组在右侧上纵束、右侧放射冠上部的FA值降低;患者组中早发组和成年发病组间FA值的差异无显著性。患者组FA值与发病年龄呈正相关的脑区包括右侧放射冠前部(r=0.70,P0.01)、右侧胼胝体膝部(r=0.65,P0.01);未发现呈负相关的脑区。结论:本研究提示精神分裂症患者右侧脑区上纵束及放射冠部位存在白质损害,发病年龄愈早,右侧放射冠及胼胝体膝部白质纤维的受损愈重。这对精神分裂症病理生理改变及脑结构异常的进一步研究具有提示作用。     

Diffusion tensor imaging of renal ischemia reperfusion injury in an experimental model

Renal ischemia reperfusion injury (IRI) is a major cause of acute renal failure. It occurs in various clinical settings such as renal transplantation, shock and vascular surgery. Serum creatinine level has been used as an index for estimating the degree of renal functional loss in renal IRI. However, it only evaluates the global renal function. In this study, diffusion tensor imaging (DTI) was used to characterize renal IRI in an experimental rat model. Spin‐echo echo‐planar DTI with b‐value of 300 s/mm² and 6 diffusion gradient directions was performed at 7 T in 8 Sprague‐Dawley (SD) with 60‐min unilateral renal IRI and 8 normal SD rats. Apparent diffusion coefficient (ADC), directional diffusivities and fractional anisotropy (FA) were measured at the acute stage of IRI. The IR‐injured animals were also examined by diffusion‐weighted imaging with 7 b‐values up to 1000 s/mm² to estimate true diffusion coefficient (D_true) and perfusion fraction (P_fraction) using a bi‐compartmental model. ADC of injured renal cortex (1.69 ± 0.24 × 10^?3 mm²/s) was significantly lower (p < 0.01) than that of contralateral intact cortex (2.03 ± 0.35 × 10^?3 mm²/s). Meanwhile, both ADC and FA of IR‐injured medulla (1.37 ± 0.27 × 10^?3 mm²/s and 0.28 ± 0.04, respectively) were significantly less (p < 0.01) than those of contralateral intact medulla (2.01 ± 0.38 × 10^?3 mm²/s and 0.36 ± 0.04, respectively). The bi‐compartmental model analysis revealed the decrease in D_true and P_fraction in the IR‐injured kidneys. Kidney histology showed widespread cell swelling and erythrocyte congestion in both cortex and medulla, and cell necrosis/apoptosis and cast formation in medulla. These experimental findings demonstrated that DTI can probe both structural and functional information of kidneys following renal IRI. Copyright © 2010 John Wiley & Sons, Ltd.     

Diffusion tensor imaging of diffuse axonal injury in a rat brain trauma model

Diffusion tensor imaging (DTI) was used to study traumatic brain injury. The impact-acceleration trauma model was used in rats. Here, in addition to diffusivities (mean, axial and radial), fractional anisotropy (FA) was used, in particular, as a parameter to characterize the cerebral tissue early after trauma. DTI was implemented at 7 T using fast spiral k-space sampling and the twice-refocused spin echo radiofrequency sequence for eddy current minimization. The method was carefully validated on different phantom measurements. DTI of a trauma group (n = 5), as well as a sham group (n = 5), was performed at different time points during 6 h following traumatic brain injury. Two cerebral regions, the cortex and corpus callosum, were analyzed carefully. A significant decrease in diffusivity in the trauma group versus the sham group was observed, suggesting the predominance of cellular edema in both cerebral regions. No significant FA change was detected in the cortex. In the corpus callosum of the trauma group, the FA indices were significantly lower. A net discontinuity in fiber reconstructions in the corpus callosum was observed by fiber tracking using DTI. Histological analysis using Hoechst, myelin basic protein and Bielschowsky staining showed fiber disorganization in the corpus callosum in the brains of the trauma group. On the basis of our histology results and the characteristics of the impact-acceleration model responsible for the presence of diffuse axonal injury, the detection of low FA caused by a drastic reduction in axial diffusivity and the presence of fiber disconnections of the DTI track in the corpus callosum were considered to be related to the presence of diffuse axonal injury.     

Fiber type characterization in skeletal muscle by diffusion tensor imaging

Fiber type distribution within a skeletal muscle, i.e. the quantification of the relative amount of type 1 (slow‐twitching) and type 2 (fast‐twitching) muscle fibers, is of great interest for the monitoring of the effects of training or the treatment of muscle diseases. The purpose of this study was to determine the feasibility of diffusion tensor imaging (DTI) as a tool for noninvasive fiber type quantification in human skeletal muscle. The right calves of 12 healthy volunteers were examined using DTI at 1.5 T. Standard DTI parameters, including fractional anisotropy (FA), and mean, radial and parallel diffusivity (MD, RD and PD, respectively), were determined in the soleus muscle. Fiber type proportion and mean fiber diameter within the soleus muscle were quantified from tissue specimens obtained via a fine needle biopsy. Linear regression analysis tested for associations between DTI and biopsy results. FA values were correlated significantly with fiber type proportion, such that higher FA values indicated a higher proportion of type 1 fibers (R² = 0.5, p = 0.01). This was based on lower diffusivity perpendicular to the main axis of the fiber in subjects with a higher type 1 fiber proportion (RD: R² = 0.52, p = 0.008). MD was also correlated with the proportion of type 1 fibers (R² = 0.37, p = 0.037), whereas PD showed no significant correlation. DTI is a promising method for the noninvasive estimation of fiber type proportion in skeletal muscle. This technique may be used to monitor training effects or may be further developed as a biomarker in certain muscle diseases. Copyright © 2013 John Wiley & Sons, Ltd.     

Diffusion tensor distribution imaging

Conventional diffusion MRI yields voxel‐averaged parameters that suffer from ambiguities for heterogeneous anisotropic materials such as brain tissue. Using principles from solid‐state NMR spectroscopy, we have previously introduced the shape of the diffusion encoding tensor as a separate acquisition dimension that disentangles isotropic and anisotropic contributions to the observed diffusivities, thereby allowing for unconstrained data inversion into diffusion tensor distributions with “size,” “shape,” and orientation dimensions. Here we combine our recent non‐parametric data inversion algorithm and data acquisition protocol with an imaging pulse sequence to demonstrate spatial mapping of diffusion tensor distributions using a previously developed composite phantom with multiple isotropic and anisotropic components. We propose a compact format for visualizing two‐dimensional arrays of the distributions, new scalar parameters quantifying intra‐voxel heterogeneity, and a binning procedure giving maps of all relevant parameters for each of the components resolved in the multidimensional distribution space.     

Considerations for measuring the fractional anisotropy of metabolites with diffusion tensor spectroscopy

Diffusion tensor spectroscopy of metabolites in brain is challenging because of their lower diffusivity (i.e. less signal attenuation for a given b value) and much poorer signal‐to‐noise ratio relative to water. Although diffusion tensor acquisition protocols have been studied in detail for water, they have not been evaluated systematically for the measurement of the fractional anisotropy of metabolites such as N‐acetylaspartate, creatine and choline in the white and gray matter of human brain. Diffusion tensor spectroscopy was performed in vivo with variable maximal b values (1815 or 5018 s/mm²). Experiments were also performed on simulated spectra and isotropic alcohol phantoms of various diffusivities, ranging from approximately 0.54 × 10^?3 to 0.13 × 10^?3 mm²/s, to assess the sensitivity of diffusion tensor spectroscopic parameters to low diffusivity, noise and b value. The low maximum b value of 1815 s/mm² yielded elevated fractional anisotropy (0.53–0.60) of N‐acetylaspartate in cortical gray matter relative to the more isotropic value (0.25–0.30) obtained with a higher b value of 5018 s/mm²; in contrast, the fractional anisotropy of white matter was consistently anisotropic with the different maximal b values (i.e. 0.43–0.54 for b = 1815 s/mm² and 0.47–0.51 for b = 5018 s/mm²). Simulations, phantoms and in vivo data indicate that greater signal attenuation, to a degree, is desirable for the accurate quantification of diffusion‐weighted spectra for slowly diffusing metabolites. Copyright © 2010 John Wiley & Sons, Ltd.     

Characterisation of brain microstructural alterations in children with obstructive sleep apnea syndrome using diffusion kurtosis imaging

Obstructive sleep apnea (OSA) is a common chronic sleep-related breathing disorder in children. Previous studies showed widespread alterations in white matter (WM) in children with OSA mainly by using diffusion tensor imaging (DTI), while diffusional kurtosis imaging (DKI) extended DTI and exhibited improved sensitivity in detecting developmental and pathological changes in neural tissues. Therefore, we conducted whole-brain DTI and DKI analyses and compared the differences in kurtosis and diffusion parameters within the skeleton between 41 children with OSA and 32 healthy children. Between-group differences were evaluated by tract-based spatial statistics (TBSS) analysis (p < 0.05, TFCE corrected), and partial correlations between DKI metrics and sleep parameters were assessed considering age and gender as covariates. Compared with the controls, children with OSA showed significantly decreased kurtosis fractional anisotropy (KFA) mainly in white matter regions with a complex fibre arrangement including the posterior corona radiate (PCR), superior longitudinal fasciculus (SLF), and inferior fronto-occipital fasciculus (IFOF), while decreased FA in white matter regions with a coherent fibre arrangement including the posterior limb of internal capsule (PLIC), anterior thalamic radiation (ATR), and corpus callosum (CC). Notably, the receiver operating characteristic (ROC) curve analysis demonstrated the KFA value in complex tissue regions significantly (p < 0.001) differentiated children with OSA from the controls. In addition, the KFA value in the left PCR, SLF, and IFOF showed significant partial correlations to the sleep parameters for children with OSA. Combining DKI derived kurtosis and diffusion parameters can provide complementary neuroimaging biomarkers for assessing white matter alterations, and reveal pathological changes and monitor disease progression in paediatric OSA.     

Diffusion tensor imaging of the abdominal organs: Influence of oriented intravoxel flow compartments

Water flow in partially oriented intravoxel compartments mimics an anisotropic fast‐diffusion regime, which contributes to the signal attenuation in diffusion‐weighted images. In the abdominal organs, this flow may reflect physiological fluid movements (eg, tubular urine flow in kidneys, or bile flow through the liver) and have a clinical relevance. This study investigated the influence of anisotropic intravoxel water flow on diffusion tensor imaging (DTI) of the abdominal organs. Diffusion‐weighted images were acquired in five healthy volunteers using an EPI sequence with diffusion preparation (TR/TE: 1000 ms/71 ms; b‐values: 0, 10, 20, 40, 70, 120, 250, 450, 700, 1000 s/mm²; 12 noncollinear diffusion‐encoding directions). DTI of liver and kidneys was performed assuming (i) monoexponential decay of the diffusion‐weighted signal, and (ii) accounting for potential anisotropy of the fast‐diffusion compartments using a tensorial generalization of the IVIM model. Additionally, potential dependency of the metrics of the tensors from the anatomical location was evaluated. Significant differences in the metrics of the diffusion tensor (DT) were found in both liver and kidneys when comparing the two models. In both organs, the trace and the fractional anisotropy of the DT were significantly higher in the monoexponential model than when accounting for perfusion. The comparison of areas of the liver proximal to the hilum with distal regions and of renal cortex with the medulla also proved a location dependency of the size of the fast‐diffusion compartments. Pseudo‐diffusion correction in DTI enables the assessment of the solid parenchyma regardless of the organ perfusion or other pseudo‐diffusive fluid movements. This may have a clinical relevance in the assessment of parenchymal pathologies (eg, liver fibrosis). The fast pseudo‐diffusion components present a detectable anisotropy, which may reflect the hepatic microcirculation or other sources of mesoscopic fluid movement in the abdominal organs.     

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。     

Diffusion tensor imaging in studying white matter complexity: A gap junction hypothesis

The role of the prefrontal cortex as an executive oversight of posterior brain regions raises the question of the extent to which the anterior regions of the brain interconnect with the posterior regions. The aim of this study is to test the complexity of rostral white matter tracts, which connect anterior and posterior brain regions, in comparison to caudal white matter tracts and the corpus callosum. Diffusion tensor imaging (DTI) is a modality that measures fractional anisotropy (FA). Higher white matter complexity could result in a decrease of FA, possibly through denser intersection of fiber tracts. DTI was used to determine regional FA in 9 healthy bonnet macaques (Macaca radiata). Four regions of interest were included: anterior and posterior limbs of the internal capsule, the occipital lobe white matter, and the corpus callosum. FA of the anterior limbs of the internal capsule was lowest compared to all other regions of interest (Newman–Keuls (N–K); p < 0.0001), whereas FA of the corpus callosum was highest (N–K; p < 0.0001). The posterior limbs of the internal capsule and the occipital white matter were not distinguishable but exhibited intermediate FA in comparison to the former (N–K; p < 0.0001) and the latter (N–K; p < 0.0001). The current study demonstrates that FA, a measure of white matter complexity, can vary markedly as a function of region of interest. Moreover, validation of these findings using neurohistological studies and replication in human samples appears warranted.     

The association between physical fitness parameters and white matter microstructure in older adults: A diffusion tensor imaging study

The present study was designed to examine whether different measures of physical fitness are differentially associated with white matter (WM) microstructure in older adults. Fifty-six healthy adults (mean age: 59.14 years) completed a standardized evaluation of physical fitness measurements (e.g., VO_2peak, push-ups, abdominal sit-ups, sit-and-reach, t test, and vertical jump). Fractional anisotropy (FA), an index of WM microstructure, was assessed using diffusion tensor imaging. The findings indicated that the cardiorespiratory fitness was positively associated with FA in the right cingulum hippocampus and the left cerebral peduncle. However, other physical fitness metrics were not significantly associated with FA in any region. These results suggest that cardiorespiratory fitness, but not other metrics of fitness, might be sensitive to WM microstructure.     

Diffusion tensor imaging of white matter in the superior temporal gyrus and temporal stem in autism

Recent MRI studies have indicated that regions of the temporal lobe including the superior temporal gyrus (STG) and the temporal stem (TS) appear to be abnormal in autism. In this study, diffusion tensor imaging (DTI) measurements of white matter in the STG and the TS were compared in 43 autism and 34 control subjects. DTI measures of mean diffusivity, fractional anisotropy, axial diffusivity, and radial diffusivity were compared between groups. In all regions, fractional anisotropy was significantly decreased and both mean diffusivity and radial diffusivity were significantly increased in the autism group. These results suggest that white matter microstructure in autism is abnormal in these temporal lobe regions, which is consistent with theories of aberrant brain connectivity in autism.     

The impact of myelination on axon sparing and locomotor function recovery in spinal cord injury assessed using diffusion tensor imaging

The dysmyelinated axons of shiverer mice exhibit impaired conduction characteristics, similar to early postnatal axons before myelination, whereas the patterns of neuronal activity and connectivity are relatively comparable with those of wild‐type myelinated axons. This unique dysmyelination pattern is exploited in the present study to determine the role of compact myelin in the loss and recovery of function following traumatic spinal cord injury (SCI). We applied in vivo diffusion tensor imaging (DTI) and post‐mortem immunohistochemistry analysis to examine changes in myelin and axonal integrity, and evaluated these changes in concert with the analysis of locomotor function from 1 to 4 weeks following a mid‐thoracic contusion injury in homozygous shiverer and heterozygous littermate mice. The DTI biomarkers, axial and radial diffusivities, are noninvasive indicators of axon and myelin integrity in response to SCI of both myelinated and dysmyelinated spinal cord. We show that myelin is critical for normal hind limb function in open field locomotion. However, when the functional outcome is limited during chronic SCI, the extent of recovery is associated with residual axonal integrity and independent of the extent of intact myelin at the lesion epicenter. Copyright © 2013 John Wiley & Sons, Ltd.     

基于扩散形状的DTI纤维跟踪算法研究

到目前为止，研究者们已经提出了许多种神经纤维束的三维可视化技术，其中，基于扩散跟踪的白质束成像技术在白质纤维束的可视化和分析中使用得最多。本文针对现有纤维跟踪算法存在的问题，提出了基于扩散形状的纤维跟踪算法，该算法结合了流线跟踪（streamline tracking，STT）法与张量弯曲（tensor deflection，TEND）法的优点，对不同的扩散形状采用不同的跟踪方向，尤其在平面扩散的情况提出了更接近纤维走行的跟踪方法，减少了跟踪方向与实际纤维走行的误差，能更完整、更准确地显示大脑白质的纤维走行。     

Fractional anisotropy and mean diffusivity: comparison between 3.0-T and 1.5-T diffusion tensor imaging with parallel imaging using histogram and region of interest analysis

We performed a comparison study focusing on differences in fractional anisotropy (FA) and mean diffusivity (MD) between 3-T and 1.5-T diffusion tensor imaging (DTI) with parallel imaging. Thirty healthy volunteers underwent DTI with an eight-channel phased-array coil at both 3 T and 1.5 T. Histogram and region of interest (ROI) analyses were performed. Paired t tests were applied for statistical analysis. Signal-to-noise ratios of these regions were also measured. For histogram analysis, peak location of FA was significantly lower at 3 T than at 1.5 T (P = 0.04). Mean FA was significantly higher at 3 T than at 1.5 T (P = 0.002). Peak location of MD was significantly lower at 3 T than at 1.5 T (P < 0.001). Mean MD was significantly lower at 3 T than at 1.5 T (P < 0.001). In ROI analysis, FA was significantly larger at 3 T than at 1.5 T in the centrum semiovale (P < 0.001), middle cerebellar peduncle (P < 0.001), cerebral peduncle (P = 0.006), posterior limb of the internal capsule (P = 0.007), genu (P < 0.001) and splenium (P < 0.001). FA was significantly lower at 3 T than at 1.5 T in the globus pallidus (P < 0.001). MD was significantly smaller at 3 T than at 1.5 T in the globus pallidus (P = 0.007), thalamus (P < 0.001), centrum semiovale (P < 0.001), middle cerebellar peduncle (P < 0.001), cerebral peduncle (P = 0.01), posterior limb of the internal capsule (P < 0.001), genu (P = 0.01) and splenium (P < 0.001). Significant differences in FA and MD exist between 3 T and 1.5 T for whole-brain histogram analysis and ROI analysis.     

磁共振扩散张量成像扩散椭球面积的简化计算方法

目的:提出一种可以精确计算磁共振扩散张量成像扩散椭球表面积的方法。方法:根据理想扩散椭球是旋转椭球及扩散张量矩阵均正定,可将三轴椭球校正为旋转椭球,进而由A.M.Legendre公式推出计算扩散椭球表面积的简化公式。分别利用A.M.Legendre、Knud Thomsen及本文提出的方法计算四种扩散椭球的表面积以评价本文方法的可行性。结果:对于旋转椭球,本文所提方法的计算结果与A.M.Legendre方法的结果一致。结论:本文所提方法计算量较小,可以精确地计算扩散椭球表面积。     

Longitudinal diffusion tensor imaging in a rat brain glioma model

In order to investigate the properties of water motion within and around brain tumors as a function of tumor growth, longitudinal diffusion tensor imaging (DTI) was carried out in a rat brain glioma (C6) model. As tumors grew in size, significant anisotropy of water diffusion was seen both within and around the tumor. The tissue water surrounding the tumor exhibited high planar anisotropy, as opposed to the linear anisotropy normally seen in white matter, indicating that cells were experiencing stress in a direction normal to the tumor border. When tumors were sufficiently large, significant anisotropy was also seen within the tumor because of longer-range organization of cancer cells within the tumor borders. These findings have important implications for diffusion-weighted MRI experiments examining tumor growth and response to therapy. Copyright (c) 2008 John Wiley & Sons, Ltd.     

Diffusion tensor imaging discriminates between glioblastoma and cerebral metastases in vivo

In a prospective study, patients with a radiologically proven brain tumour underwent diffusion tensor imaging (DTI) prior to definitive diagnosis and treatment. Twenty‐eight patients with a histologically proven glioblastoma or metastasis were included in the study. Following the definition of regions of interest, DTI metrics [mean diffusivity (MD) and fractional anisotropy (FA)] were calculated for the tumour volume and the surrounding region of peritumoral oedema. These metrics were then subjected to logistic regression to investigate their ability to discriminate between glioblastomas and cerebral metastases. A cross‐validation was performed to investigate the ability of the model to predict tumour. The logistic regression analysis correctly distinguished glioblastoma in 15 of 16 cases (93.8%) and metastasis in 11 of 12 cases (91.7%). Cross‐validation resulted in the model correctly predicting 14 of 16 (87.5%) glioblastomas and 10 of 12 (83.3%) metastases studied. MD was significantly higher (p = 0.02) and FA was significantly lower (p = 0.04) within the oedema surrounding metastases than within the oedema around glioblastomas. MD was significantly higher (p = 0.02) within the tumour volume of the glioblastomas. Our results demonstrate that, when DTI metrics from the tumour volume and surrounding peritumoral oedema are studied in combination, glioblastoma can be reliably discriminated from cerebral metastases. Copyright © 2010 John Wiley & Sons, Ltd.