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OBJECTIVE@#To investigate iron accumulation level over the whole brain and explore the possible neuromechanism of medication-overuse headache (MOH) using quantitative susceptibility mapping (QSM).@*METHODS@#Thirty-seven MOH patients and 27 normal control subjects were enrolled in the study for examinations with both a multiecho gradient echo magnetic resonance (MR) sequence and brain high resolution structural imaging. A voxel-based analysis was performed to detect the brain regions with altered iron deposition, and the quantitative susceptibility mapping values of the positive brain regions were extracted. Correlation analysis was performed between the susceptibility values and the clinical variables of the patients.@*RESULTS@#In patients with MOH, increased susceptibility values were found mainly in the bilateral substantia nigra (SN) (MNI coordinate: 8, -18, -14; -6, -16, -14) as compared with the normal control subjects (P < 0.001), but these alterations in iron deposition were not significantly correlated with the clinical variables of the patients (P > 0.05). The susceptibility value in the left SN had an area under curve (AUC) of 0.734, and at the cut-off value of 0.077, its diagnostic sensitivity was 72.97% and its specificity was 70.37% for distinguishing MOH from normal controls; The susceptibility value in the right SN had an AUC of 0.699 with a diagnostic sensitivity of 72.97% and a specificity of 62.96% at the cut-off value of 0.084.@*CONCLUSION@#Increased iron deposition occurs in the bilateral SN of MOH patients, which provides a new insight into the mechanism of mesocorticolimbic dopamine system dysfunction in MOH. QSM technique can be used as a non-invasive means for quantitative analysis of brain iron deposition in migraine neuroimaging.
Subject(s)
Humans , Brain , Substantia Nigra , Magnetic Resonance Imaging/methods , Headache Disorders, Secondary , Headache , Iron , Brain Mapping/methodsABSTRACT
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.
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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.
Subject(s)
Adult , Humans , Brain/diagnostic imaging , Gray Matter , Iron , Magnetic Resonance Imaging , Reproducibility of Results , Substantia Nigra/diagnostic imagingABSTRACT
We reported a case of supratentorial primary central nervous system lymphoma with hyperperfusion.Computed tomography revealed hyperdense lesions on the bilateral centrum semiovale with obvious edema.Magnetic resonance imaging demonstrated that the lesion presented slightly long and iso-T1 signal and slightly long and long T2 signals;hyperintensity was found on diffusion-weighted imaging,with relatively high apparent diffusion coefficient value compared with the adjacent normal white matter.Contrast-enhanced imaging revealed bilateral evenly enhanced lesions,along with patchy non-enhanced shadows in right-sided lesion.The perfusion-weighted imaging revealed hyperperfusion in bilateral lesions.
Subject(s)
Humans , Central Nervous System Neoplasms , Diffusion Magnetic Resonance Imaging , Lymphoma , Magnetic Resonance ImagingABSTRACT
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.
Subject(s)
Humans , Corpus Callosum , Encephalomalacia , Magnetic Resonance Imaging , Magnetic Resonance SpectroscopyABSTRACT
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 (χ2=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)] (χ2=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.
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OBJECTIVE: The periaqueductal gray matter (PAG), a small midbrain structure, presents dysfunction in migraine. However, the precise neurological mechanism is still not well understood. Herein, the aim of this study was to investigate the texture characteristics of altered PAG in episodic migraine (EM) patients based on high resolution brain structural magnetic resonance (MR) images. MATERIALS AND METHODS: The brain structural MR images were obtained from 18 normal controls (NC), 18 EM patients and 16 chronic migraine (CM) patients using a 3T MR system. A PAG template was created using the International Consortium Brain Mapping 152 gray matter model, and the individual PAG segment was developed by applying the deformation field from the structural image segment to the PAG template. A grey level co-occurrence matrix was used to calculate the texture parameters including the angular second moment (ASM), contrast, correlation, inverse difference moment (IDM) and entropy. RESULTS: There was a significant difference for ASM, IDM and entropy in the EM group (998.629 ± 0.162 × 10−3, 999.311 ± 0.073 × 10−3, 916.354 ± 0.947 × 10−5) compared to that found in the NC group (998.760 ± 0.110 × 10−3, 999.358 ± 0.037 × 10−3 and 841.198 ± 0.575 × 10−5) (p < 0.05). The entropy was significantly lower among the patients with CM (864.116 ± 0.571 × 10−5) than that found among patients with EM (p < 0.05). The area under the receiver operating characteristic curve was 0.776 and 0.750 for ASM and entropy in the distinction of the EM from NC groups, respectively. ASM was negatively related to disease duration (DD) and the Migraine Disability Assessment Scale (MIDAS) scores in the EM group, and entropy was positively related to DD and MIDAS in the EM group (p < 0.05). CONCLUSION: The present study identified altered MR image texture characteristics of the PAG in EM. The identified texture characteristics could be considered as imaging biomarkers for EM.
Subject(s)
Humans , Biomarkers , Brain , Brain Mapping , Entropy , Gray Matter , Magnetic Resonance Imaging , Mesencephalon , Migraine Disorders , Periaqueductal Gray , ROC CurveABSTRACT
Objective The aim of this study is to investigate the cerebral cortical thickness changes in type 2 diabetes mellitus (T2DM) using a whole brain cortical thickness mapping system based on brain magnetic resonance imaging (MRI).Methods High resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MR images were obtained from 16 patients with T2DM, as well as from 16 normal controls. The whole brain cortical thickness maps were generated, and the cortical thickness of each brain region was calculated according to gyral based regions of interest (ROI) using an automated labeling system by the Freesurfer software. We compared mean cortical thickness at each brain region by the analysis of covariance with age and sex as covariates. The regional difference of the cortical thickness over the whole brain was compared by the analysis of surface-based cortical thickness.Results Mean cortical thicknesses analysis showed bilateral cerebrum in the patients with T2DM (left: 2.52±0.07 mm; right: 2.51±0.08 mm) were significant thinner than those in the normal controls (left: 2.56±0.09 mm; right: 2.56±0.09 mm) (both P<0.05). Regional cortical thinning in T2DM was demonstrated in the paracentral lobule, postcentral gyrus, lateral occipital gyrus, lingual gyrus, precuneus, superior temporal gyrus, middle temporal gyrus, inferior temporal gyrus and posterior cingulate gyrus, compared to the normal controls. The cortical thickness of left middle cingulate and right inferior temporal gyrus were negatively correlated with the disease course.Conclusion A widespread cortical thinning was revealed in patients with T2DM by the analysis of brain cortical thickness on MR. Our finding supports the idea that T2DM could lead to subtle diabetic brain structural changes.
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Cerebral Cortex , Pathology , Diabetes Mellitus, Type 2 , Diagnostic Imaging , Pathology , Magnetic Resonance Imaging , Methods , Pilot ProjectsABSTRACT
ObjectiveHigh resolution structural MR imaging can reveal structural characteristics of cerebral cortex and provide an insight into normal brain development and neuropsychological diseases. The aim of this study was to compare cortical structural characteristics of normal human brain between 3T and 7T MRI systems using surface-based morphometry based on high resolution structural MR imaging. Methods Twelve healthy volunteers were scanned by both 3T with 3D T1-weighted fast spoiled gradient recalled echo (3D T1-FSPGR) sequence and 7T with 3D T1-weighted magnetization-prepared rapid gradient echo (3D T1-MPRAGE) sequence. MRI data were processed with FreeSurfer. The cortical thickness, white and gray matter surface area, convexity, and curvature from data of 3T and 7T were measured and compared by paired t-test. Results Measurements of mean cortical thickness, total white matter surface area and gray matter surface area of 3T were larger than those of 7T (left hemisphere: P=0.000, 0.006, 0.020 respectively; right hemisphere: P=0.000, 0.000, 0.000 respectively). Surface-based morphometry over the whole brain demonstrated both reduced and increased measurements of cortical thickness, white and gray surface area, convexity, and curvature at 7T compared to 3T. Conclusions Inconsistency of brain structural attribute between 3T and 7T was confirmed, and researchers should be cautious about data when using ultrahigh field MR system to investigate brain structural changes.
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Objective To investigate the difference of texture on conventional T2-weighted image (T2WI) between hepatic cyst and hepatic hemangioma. Methods All the subjects included 156 patients with hepatic cyst [A group:100 cases with equi or low signal on diffusion weighted imaging (DWI);B group:56 cases with high signal on DWI] and 100 patients with hemangioma (C group). Conventional magnetic resonance imaging T2WI,DWI and dynamic contrast enhancement were performed on all the patients,and the texture analysis was applied with the images of T2WI,and the texture parameters included angular second moment,contrast,correlation,inverse difference moment,and entropy. Independent sample t-test and Aspin-Welch test were performed for the comparisons among groups. Results All the texture parameters showed significant difference among groups [(A+B) group vs. C group:P=0.000,P=0.000,P=0.000,<inline-formula><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="Mml1-1000-503X-39-2-169"><mml:mtable frame="none" columnlines="none" rowlines="none"><mml:mtr><mml:mtd><mml:maligngroup/><mml:mrow><mml:msub><mml:mrow><mml:msub><mml:mrow><mml:mi>P</mml:mi></mml:mrow><mml:mrow><mml:mi mathvariant="italic">inverse difference moment</mml:mi></mml:mrow></mml:msub></mml:mrow><mml:mrow/></mml:msub></mml:mrow></mml:mtd></mml:mtr></mml:mtable></mml:math></inline-formula>=0.822,P=0.000;A group vs. C group:P=0.000,P=0.000,P=0.000,P=0.092,P=0.000;B group vs. C group:P=0.000,P=0.000,P=0.000,P=0.046,P=0.009],and receiver operating characteristic curve analysis demonstrated that contrast and correlation had high differential diagnostic values between hepatic cyst and hemangioma. Conclusion Hepatic cyst and hemangioma present evident different texture characteristics,and the texture analysis may be considered as a simple and effective tool in the differential diagnosis between hepatic cyst and hemangioma based on the images of T2WI.
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Purpose At present,morphological observation and CT value measurement were mainly used to evaluate ground-glass nodule (GGN),and there was no effective image feature-quantization evaluation method.Therefore,in this study,a follow-up quantization analysis was conducted on GGN within 2 years using texture feature analysis method to confirm reasonable GGN follow-up time.Materials and Methods Baseline and highresolution CT images of 100 GGN follow-up patients were retrospectively analyzed.They were assigned into three groups,3 months follow-up (group A),6 to 12 months follow-up (group B) and 2 years follow-up (group C).For each group,using firstly founded GGN image as baseline,GGN texture features (including energy,contrast,autocorrelation,inverse difference moment and entropy) were analyzed.Results There were 1 case of narrowed nodules in group A,1 case of increased nodules and 1 case of narrowed nodules in group B,and 4 cases of increased nodules in group C,2 of which showed density differences.There was no significant change in shape,density and size of the remaining nodules.There were no significant differences in texture features (energy,contrast,autocorrelation,deficit,entropy) among group A,group B and group C (P＞0.05).Conclusion Texture feature analysis can quantitatively evaluate the change of GGN attribute characteristics,and as a GGN follow-up quantitative tool,it can guide patients to choose reasonable follow-up mode.
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Purpose To evaluate the diagnostic value of diffusion weighted imaging with high b value in acute cerebral microinfarcts.Materials and Methods Conventional MRI and diffusion weighted imaging with standard b value (b=1000 s/mm2) and high b value (b=3000 s/mm2) were performed in the 7 patients with acute cerebral infarction,and all the images were evaluated.The signal to noise ration (SNR) and contrast to noise ration (CNR) were measured.Results Five patients were detected much more microinfarcts in high b value as HB group than that in standard b value as SB group.The SNR and CNR were significantly higher in high b value group than that in standard b value group (P＜0.05),but the apparent diffusion coefficient value showed no significant difference between the two groups (P＞0.05).Conclusion DWI with high b value could sensitively detect acute cerebral microinfarcts with high clinical value.
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Objective To investigate the effect of integrated traditional Chinese ( TCM ) and western medicine fast-track surgery ( FTS) in the perioperative management of laparoscopic cholecystectomy ( LC) .Methods One hundred and fifty patients with acute cholecysititis undergoing LC from June 2012 to January 2015, were recruited and divided randomly into 3 groups.Patients in group A (n=30) were treated with routine method in perioperative period, patients in group B ( n=60) were treated with western medicine FTS, and patients in group C (n=60) were treated with integrated TCM and western medicine FTS.The first exhaust time after operation, length of stay, times of clinic visit, symptoms, levels of IL-6, CRP and ALB, postoperative complications, readmission rate, reoperation rate, and patient satisfaction were evaluated in three groups.Results The first exhaust time after operation of group B and group C was earlier than that of group A [(25.16 ±8.36)h and (21.61 ±6.52)h vs.(36.06 ±10.88)h, P0.05).Conclusion Integrated traditional Chinese and western medicine FTS in the perioperative period of LC can promote recovery, reduce symptoms and operation stress and maintain albumin level.
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PurposeTo optimize the imaging parameters of clinical MRI scanner in rat pancreas imaging to improve the image quality and to provide better MRI image quality and more economical research method for imaging study of rat pancreas. Materials and Methods Twenty-four healthy male Wistar rats were randomly divided into the conventional sequence (CS) group, the adjustment sequence (AS) group and the optimization sequence (OS) group, with 8 rats in each group. The rats in the CS group were scanned with conventional parameters using a clinical MRI scanner. The principle of parameter adjustment was: parameters associated with T1WI or T2WI imaging quality (TR, TE, slice thickness, NEX, FOV and matrix) was set with four changes, and only one of the six parameters was changed in each scan, image quality was evaluated by two senior radiologists, the parameter corresponded the best image quality evaluated consistently by two radiologists were selected as the optimal imaging parameter, all the optimized parameters were set up step by step in this way which formed the imaging parameters in OS group. The pancreatic signal intensity and signal to noise ratio was compared between CS group and OS group after imaging.Results The optimized sequence parameters in clinical MRI scanner were listed below: T1WI sequence (M3D/FSPGR/15): TR 6 ms, TE 2.5 ms, slice thickness 2.0 mm, NEX 8, FOV 7 cm×7 cm, Matrix 120×120; T2WI sequence (FSE-XL/90): TR 4000 ms, TE 71 ms, slice thickness 2.0 mm, NEX 1, FOV 8 cm×8 cm, Matrix 192×160. The pancreatic SI in T1WI and T2WI sequence of the OS group were significantly higher than those in the CS group (t=5.16 and 3.80,P<0.01), while the pancreatic SNR in T1WI and T2WI sequence of the OS group were significantly higher than those in the CS group (t=5.65 and 3.26,P<0.01).Conclusion The optimized parameters can improve the imaging quality of rat pancreas MRI significantly, thus provide a reference for the related experimental study.
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<p><b>OBJECTIVE</b>To evaluate early occult brain functional damage in patients with type 2 diabetes mellitus using resting-state functional magnetic resonance imaging (MRI).</p><p><b>METHODS</b>High-resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MRI and resting-state functional MRI images were obtained from 18 patients with type 2 diabetes mellitus and 18 normal control subjects. Regional homogeneity (ReHo) map, amplitude of low-frequency fluctuation (ALFF) map, and functional connectivity map of the bilateral hippocampus and posterior cingulate gyrus were calculated and voxel-based analysis was performed using two-sample t-test.</p><p><b>RESULTS</b>In type 2 diabetic patients, decreased ReHo was deteted in the right thalamus, hippocampus, olfactory cortex and left putamen as compared with the normal controls. The decreased ALFF was found mainly in the left middle frontal gyrus, right supramarginal gyrus and middle occipital gyrus in the diabetic patients. The patients showed reduced functional connectivity between the bilateral hippocampus but not between the bilateral posterior gyrus and the other brain regions.</p><p><b>CONCLUSION</b>The occult brain damage is featured by decreased ReHo and ALFF in multiple brain regions and reduced functional connectivity between the bilateral hippocampus in type 2 diabetic patients.</p>
Subject(s)
Humans , Brain , Pathology , Brain Injuries , Brain Mapping , Case-Control Studies , Diabetes Mellitus, Type 2 , Pathology , Frontal Lobe , Gyrus Cinguli , Hippocampus , Imaging, Three-Dimensional , Magnetic Resonance ImagingABSTRACT
<p><b>OBJECTIVE</b>To investigate the age-related changes in resting functional connectivity of the marginal division (MrD) of the neostriatum in healthy adults detected using resting-state functional magnetic resonance imaging (rs-fMRI).</p><p><b>METHODS</b>Forty-four healthy volunteers aged between 22 and 44 years (mean 30.36∓6.31 years) and 20 elderly volunteers aged between 48-83 years (mean 61.4∓10.25 years) underwent conventional MRI, 3D structural MRI and rs-fMRI. MrD was defined manually on the structural images for computation of the functional connectivity maps. The single group data were analyzed with independent sample t test, and the data of the two-group were examined by analysis of covariance with gender as the covariance.</p><p><b>RESULTS</b>In the young volunteers, the brain regions of functional connectivity related with the MrD were located in bilateral middle cingulate gyri, putamen, thalamus and amygdala, as compared with the brain regions of the bilateral putamen, thalamus, amygdala, insular cortex, rolandic operculum and right supramarginal gyrus in the elderly volunteers. Compared with the young volunteers, the elderly volunteers showed decreased functional connectivity related with the MrD in the bilateral middle cingulate gyri, parahippocampal gyri and left hippocampus.</p><p><b>CONCLUSION</b>An increased age is associated with alterations in the functional connectivity related with the MrD in healthy adults.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Young Adult , Age Factors , Limbic System , Physiology , Magnetic Resonance Imaging , Methods , Neural Pathways , RestABSTRACT
<p><b>OBJECTIVE</b>To investigate the structural connectivity between visual cortex and auditory cortex in healthy adults.</p><p><b>METHODS</b>Diffusion tensor imaging was performed to examine the brain of 21 healthy adult subjects. The structural connectivity was calculated based on fractional anisotropy (FA) value of the visual and auditory cortices, and fiber tracking was performed between the visual cortex and auditory cortex.</p><p><b>RESULTS</b>Positive structural connectivity was demonstrated between the bilateral visual cortices, and between the bilateral auditory cortices. Ipsilateral primary auditory cortex presented a negative structural connectivity with the ipsilateral visual cortex, and a positive structural connectivity with the contralateral visual cortex. A positive connectivity was demonstrated between the secondary auditory cortex and visual cortex. Tracking analysis showed fiber connectivity between the bilateral visual cortices, and between the ipsilateral auditory and visual cortices.</p><p><b>CONCLUSION</b>Intrinsic structural connectivity is present between the visual cortex and auditory cortex in the brain of healthy adults.</p>
Subject(s)
Adult , Female , Humans , Male , Young Adult , Auditory Cortex , Diffusion Tensor Imaging , Visual CortexABSTRACT
Objective To evaluate early occult brain damage by diffusion tensor imaging in patients with type Ⅱ diabetes mellitus.Methods High resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MRI images and diffusion tensor imaging were obtained from 16 patients with type Ⅱ diabetes mellitus (T2DM) and 16 normal controls (NC).Average apparent diffusion coefficient (ADC) map and fractional anisotropy (FA) map were calculated and analyzed with voxel-based analysis.Analysis of covariance was performed to compare ADC and FA between T2DM and NC.Results Increased ADC values of gray matter were demonstrated in right superior temporal gyrus,middle frontal gyrus,anterior cingulate gyrus,middle cingulate gyrus,inferior occipital gyrus,and left lingual gyrus,operculum orbitale,fusiform gyrus and parahippocampal gyrus in T2DM (voxel numbers in clusters were 176-3125,P ＜ 0.01).And increased ADC values of white matter were demonstrated in the regions of right middle temporal lobe,linual lobe,middle frontal lobe,calcarine gyrus,superior parietal lobe,and left operculum orbitale in T2DM patients compared with NC (voxel numbers in clusters were 200-781,P ＜ 0.01).Decreased FA values of gray natter were mainly located in left thalamus,bilateral caudate nuclei and right cuneus in T2DM(voxel numbers in clusters were 210-1402,P ＜0.01).Decreased FA values of white matter were demonstrated in the regions of right cuneus and the body of corpus callosum in T2DM (voxel numbers in clusters were 206,253,P ＜ 0.01).Conclusions The occult brain damage is demonstrated as increased ADC values and decreased FA values in regional brain parenchyma in type Ⅱ diabetes mellitus.Voxel-based analysis of diffusion tensor indices may be a simple and effective tool for the evaluation of occult brain damage in type]][diabetes mellitus.
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<p><b>OBJECTIVE</b>To evaluate the alternations of degree centrality (DC) in the brain of a patient with alternating Horner's syndrome (AHS).</p><p><b>METHODS</b>Conventional magnetic resonance imaging (MRI), 3D structure reconstruction and resting-state functional MRI were performed in a patient with AHS and 8 healthy adults. The DC of brain functional connectivity was calculated and statistically analyzed to evaluate the changes in the nodes in the brain default network of the patient.</p><p><b>RESULTS</b>In the AHS patient, the DC at onset of left eye involvement was located mainly in the bilateral anterior middle frontal gyri, frontal operculum and opercula insulae; the brain regions with a DC greater than the mean DC of the whole brain were found mainly in the bilateral occipital lobes, temporal lobes and cingulate gyri, and the brain regions with a significantly decreased DC included mainly the left inferior temporal gyrus, postcentral gyrus, right superior temporal gyrus, lateral occipital gyri and bilateral paracentral lobules (P<0.05). At the onset of right eye involvement, the DC was mainly located in the anterior part of the bilateral superior and middle frontal gyri, parietal lobes, middle cingulate gyri and medial occipital gyri; the brain regions with a DC greater than the mean DC of the whole brain included the bilateral occipital lobers, temporal lobes, cingulate, orbital gyri and gyrus rectus, and the brain regions with a significantly decreased DC included the left supramarginal gyrus, right lateral occipital gyrus, paracentral lobule and bilateral superior temporal gyrus.</p><p><b>CONCLUSION</b>The AHS patient exhibited a decreased DC of functional connectivity in multiple brain regions.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Brain , Case-Control Studies , Horner Syndrome , Magnetic Resonance ImagingABSTRACT
<p><b>OBJECTIVE</b>To elucidate the volume changes of cortical and subcortical reward circuitry in patients with type 2 diabetes mellitus.</p><p><b>METHODS</b>High-resolution three-dimensional T1-weighted fast spoiled gradient recalled echo MRI images were obtained from 16 patients with type 2 diabetes mellitus and 16 normal controls, and 11 type 2 diabetic patients also received the same MRI scans after insulin therapy for 1 year. Volumetric analysis was performed and analysis of covariance and paired t test were applied.</p><p><b>RESULTS</b>A decreased volume was found in the left insular lobe, left nucleus accumbens area, right hippocampus, putamen and amygdala in type 2 diabetic patients compared with normal controls (P<0.05). After insulin therapy for 1 year, an increased volume of bilateral cortical reward structures was observed (left, 33.65∓3.66 ml; right, 33.35∓4.25 ml) compared the baseline level (left, 31.45∓2.90 ml; right, 31.12∓2.97 ml) in diabetic patients (P<0.05). No significant volume change in the bilateral basal ganglia structures was found after insulin therapy for 1 year (P>0.05), and bilateral ventral diencephalon area showed an increased volume after the treatment (left, 3.26∓0.68 ml; right, 3.20∓0.78 ml) compared with the baseline (left, 2.96∓0.76 ml; right, 2.82∓0.90 ml)(P<0.05).</p><p><b>CONCLUSION</b>Type 2 diabetic patients have a decreased volume of the cortical and subcortical reward circuitry, and insulin therapy can reverse such changes and improve the damage of reward circuitry.</p>