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Acute carbon monoxide poisoning and its delayed encephalopathy have obvious damage to the central nervous system. There are different neuroimaging changes in different stages of the disease, and they are relatively specific. This article reviews the clinical research progress on the imaging changes of carbon monoxide poisoning and delayed encephalopathy, including computed tomography (CT) , conventional magnetic resonance imaging (MRI) , diffusion weighted imaging (DWI) , diffusion tensor imaging (DTI) , diffusion kurtosis imaging (DKI) , magnetic resonance spectroscopy (MRS) and other imaging changes reflecting the function and metabolic state of the brain tissue.
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Humans , Brain Diseases/etiology , Carbon Monoxide Poisoning/diagnostic imaging , Diffusion Magnetic Resonance Imaging , Diffusion Tensor Imaging , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Magnetic Resonance SpectroscopyABSTRACT
Objective To study imaging findings of primary angiitis of the central nervous system (PACNS) on MR new techniques,and to explore the diagnostic value of MR new techniques in this disease.Methods Seventeen cases who had been clinically diagnosed as PACNS were enrolled.All the cases underwent MR regular scans [T1 WI,T2 WI,diffusion weighted imaging(DWI),enhanced-enhanced T1 WI] and 3D-posudo-continuous arterial spin labeling (3D-PCASL).Some cases were scanned by using magnetic resonance angiography (MRA),susceptibility weighted imaging (SWI) and magnetic resonance spectrum (MRS) techniques.The regional cerebral blood flow (CBF) values were achieved based on ASL.The inter-group difference of the CBF values were analyzed by independent sample t test.Results Compared to the normal site,the CBF values in the lesion site were significant lower on PACNS (P=0.000).Of 13 patients scanned by SWI,10 cases showed low signal in the lesion.Of 14 patients scanned by MRS,10 cases showed N-acetylaspartic acid (NAA) peak decrease and Cho peak increase and 2 cases showed lactic acid(Lac) peak.Conclusion 3D PCASL can detect the hemodynamic abnormalities of PACNS.SWI can improve the ability of sensibility to observe the microbleed inside the lesion.MRS can explicit the extent of destruction and repairment of neurons in the lesion.Combining with the convention MR images can improve the understanding of the disease and the diagnostic accuracy.
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Objective To investigate metabolic levels of the splenium and genu of corpus callosum(CC)in subacute diffuse axonal injury (DAI)patients,and their longitudinal change in a short time.Methods 12 patients with subacute DAI and 12 gender and age matched healthy controls were enrolled successively in this study.All subjects were scanned with single volume magnetic resonance spectrum(MRS)in two regions of interest(the splenium and genu of CC),and they were reexamined with MRS a month later(31.5 d±6.2 d, 28-43 d).Some metabolite concentrations were calculated quantitatively by using LC-model software and the differences were analyzed.Results The concentrations of NAA in the splenium and genu of CC in subacute DAI patients were decreased significantly compared with those of controls (the genu:t=4.474,P=0.001;the splenium:t=4.231,P=0.001),meanwhile the Cho concentrations were increased significantly (the genu:t=2.509,P=0.031;the splenium:t=2.195,P=0.018).The concentrations of NAA and Cho in the splenium and genu of CC in patients with the follow-up were slightly elevated when compared with those of subacute DAI patients,but the difference had no statistical significance.The concentrations of Cr in the splenium and genu of CC in all subjects had no statistic difference.Conclusion The single volume MRS is sensitive to reflect the metabolic levels of CC in subacute DAI patients.The metabolic levels of CC has no significant change in the short term (about 1 month).
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Objective To explore the value of cMRI and MRS in diagnosis and differential diagnosis of single brain metastases and localized high grade gliomas.Methods The cMRI (T1WI,T2WI and contrast-enhanced MRI)and MRS data of 23 cases with single brain metastases and in 28 cases with high grade gliomas confirmed by pathology were collected and analyzed retrospectively.Results cMRI:①There were no significant differences of T1WI,T2WI and constrast-enhanced MRI between single brain metastases and high-grade gliomas.②Enhanced images of single brain metastases and localized high-grade gliomas showed that there was a significant difference in the peritumoral edema area:the nodular or ring enhancement were found in single brain metastases,the outer outline of ring enhancement was smooth,and there was no enhancement at the peripheral edema area;Irregular patchy or ring enhancement were found in localized high-grade glioma tumor,both of the outer and inner edges of the ring enhancement rough,a little patchy enhancement at the peripheral edema area were found in 1 6 patients,and there was no enhancement of the edema area in the other 1 2 patients.MRS:①There were no significant differences of the tumor parenchyma in the peaks of NAA,Cr,Cho and central Lac between single brain metastases and localized high grade gliomas.②A significant difference of the peripheral edema area were observed between them.The peaks of NAA,Cr,Cho at the edema area in all single brain metastases patients were normal.But in all high-grade glioma patients,the NAA and Cr peaks were decreased,while the Cho peaks were increased.Conclusion The morphological manifestations of single brain metastases are similar to localized high grade gliomas.An obvious difference of cMRI and MRS lines exists in the peritumoral edema area between them,which could be used for differential diagnosis.
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Objective To investigate the association of serum ghrelin level with cognition, hippocampal volume, and proton magnetic resonance spectrum ( [ 1 H ]-MRS ) in patients with type 2 diabetes mellitus ( T2DM) . Methods The T2DM patients cared at the Wuhan Fourth Hospital were recruited. Data on demographic characteristics and clinical parameters were collected. Ghrelin was measured by ELISA assay. Cognitive performance was assessed by the Montreal Cognitive Assessment ( MoCA ) and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The changes of metabolites in hippocampus were detected by [1 H]-MRS, including N-acetyl asparate ( NAA) , choline ( Cho) , myo-inositol ( MI) , creatine ( Cr) . All patients were divided into 2 groups[cognitive impairment (CI) and non-cognitive impairment (NCI) groups] by MoCA. Results (1) Compared with patients in NCI group, the serum ghrelin level, bilateral hippocampal volume, and NAA/Cr ratio of [1H]-MRS metabolites in CI group were decreased, but MI/Cr and Cho/Cr ratios were increased(all P<0.05). (2) Serum ghrelin was positively correlated with a variety of RBANS scores ( including immediate memory, attention, delayed memory, and total scores) , bilateral hippocampal volume, and NAA/Cr ratio of [ 1 H]-MRS metabolites in T2DM patients, but it was negatively correlated with MI/Cr ratio and Cho/Cr ratio ( all P<0. 05 ) . ( 3 ) Logistic regression analysis showed that ghrelin was a protective factor of cognition in T2DM patients. Conclusions T2DM patients with cognitive impairment had lower levels of ghrelin, and serum ghrelin was postively correlated with their cognitive performance, hippocampal volume, and [1 H]-MRS metabolites, suggesting that serum ghrelin may be involved in the occurrence and development of cognitive dysfunction in patients with T2DM.
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Objective To study the quantification method based on Hankel matrix,the water suppression method and the metabolite imaging method for magnetic resonance spectroscopic imaging (MRSI) data.Methods Impact of Hankel data matrix on quantification MRSI methods were analyzed to obtain the most efficient Hankel matrix structure.The maximum amplitude method of the water signal peak was proposed for MRSI data water suppression.The interested metabolites information was extracted from MRSI data,and then metabolite image was obtained through bilinear interpolation algorithm.Results The minimum amplitude error and the minimum frequency error were acquired when columns number was 3/4 sampling points.The amplitude,frequency and the damping factor of the simulation data accuracy was 96.94％,99.72％ and 95.55％ respectively.Hankel lanczos with partial reorthogonalization singular value decomposition (HLSVDPRO) method with 3/4 sampling points was used to form Hankel matrices.The speed of quantification decreased with the increase of sampling points.The error of quantification parameter reached minimum when the number of sampling points was 512.The water suppression degree of simulation data was 99.55％ with the maximum amplitude water suppression method.Conclusions The accuracy and the speed of the quantification are promoted with an optimized Hankel matrix structure for the MRSI quantization method.The optimal length of sampling points is 512.The maximum amplitude method can suppress water perfectly.Doctors can detect the presence of tumor regions in human body at the (super) early stage by metabolite information images.
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The article briefly discribed the high-risk factors and presentations of neonatal hypoglycemia,with stressing on the advances comprising the mechanism,the changes of electroencephalography,MRI,and magnetic resonance spectrum of neonatal hypoglycemic brain injury.These advances had demonstrated that the hypoglycemic brain injury resulted from a series of cascade reactions.The changes of electroencephalography occured earlier than the symptoms.The characteristic changes of magnetic resonance spectrum and MRI would be helpful for distinguishing hypoglycemic brain injury from the other brain injuries.
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Objective To explore the cell metabolism of the bilateral hippocampus effected by the inflammatory factor of blood serum in the development of the depression.Methods Using Proton magnetic resonance spectroscopy 1 H-MRS technology to detect multiple metabolic indices of the bilateral hippocampus of 20 first episode depression patients and 20 healthy persons,and detecting the levels of IL-6,IL-2,IL-10 in blood serum were detected.Finally the correlation between them was analyzed.Results Compared with the healthy group,the values of Glx/Cr and NAA/ Cr were reduced in left hippocampus (Glx/Cr: (0.82±0.48),t=2.69,P＜0.05 ; NAA/Cr: (1.12 ±0.44),t =2.81,P＜ 0.05) and the value of Cho/ Cr was increased in left hippocampus ((2.49± 0.78),t =2.36,P＜0.05),but only the value of Glx/ Cr were reduced in right hippocampus ((0.84 ± 0.47),t =2.43,P＜ 0.05),and the other metabolic indices changed unobvious.The depressive group had the significantly higher levels of IL-6,IL-2 in blood serum(IL-6: (12.47±3.19) ng/L,t=4.53,P＜0.05 ; IL-2: (29.44±5.72) ng/L,t=2.44,P＜0.05),but no significant difference was found in the IL-10 level in blood serum.The Glx/ Cr of bilateral hippocampus level was negatively correlated to the IL-6 and IL-2 level in blood serum(left:(IL-6: r=-0.555,P＜0.05;IL-2: r=-0.624,P＜0.05) ;right:(IL-6: r=-0.575,P＜0.05; IL-2: r=-0.523,P＜0.05)).The NAA/ Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in blood serum(IL-6: r=-0.582,P＜0.05;IL-2: r=-0.607,P＜0.05).The Cho/Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in blood serum(IL-6: r=0.601,P＜0.05; IL-2: r=0.552,P＜0.05).Conclusion The abnormal of glutamic acid system in bilateral hippocampus maybe the important performance and the potential originating link,the changes of the inflammatory cytokines level maybe the factor of these abnormal changes.
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Objective To explore the brain biochemical changes in the frontal lobe of adolescents with depression using proton magnetic resonance spectroscopy (1H-MRS). Methods Twenty-four patients and twenty-three healthy subjects matched for age, sex and education level were enrolled in the study. All the subjects underwent multivoxel 1H MRS to measure the bilateral metabolic levels of N-acetylaspartate (NAA), choline (Cho), creatine (Cr) in the prefrontal lobes. Results The NAA/Cr and Cho/Cr ratios in the left dorsolateral prefrontal white matter of the depressive adolescents were significantly lower than those of the healthy subjects [NAA/Cr: 1.67 ± 0.32, t = 3.126, P = 0.004; Cho/Cr: 1.28 ± 0.30, t = 2.362, P = 0.024], and the ratios of NAA/Cr in the right dorsolateral prefrontal white matter of the depressive adolescents was also significantly lower than that of the healthy subjects [NAA/Cr:1.65 ± 0.26, t=2.969, P=0.006]. There was no significant difference in the metabolic ratios in the bilateral anterior cingulate gray matter between the depressive adolescents and the healthy controls. Conclusions Biochemical abnormalities in prefrontal white matter are involved in the pathophysiology of depression. Importantly , these abnormalities are already present early in the course of the disorder.
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Objective To explore the sensibility of the encephalic region affected by the inflammatory factor of cerebrospinal fluid(CSF) and the role of the inflammatory factor in the development of the depression.Methods Based on the evaluation of ethology,forty SD rats were randomly and equally divided into control group and model group which was exposed to chronic unpredictable mild stress for 4 weeks.Using analyzing technology 1 H-MRS to detect prefrontal cortex and hippocampus of each group and detecting the levels of interlukin 6(IL-6),interlukin 2 (IL-2),interlukin 10 (IL-10) in CSF at the beginning and 4 weeks later,and the correlation was analyzed between them.Results Compared with the control group,the values of Glx/ Cr and NAA/ Cr in bilateral prefrontal cortex were reduced which did not reach statistically significance (P ＞ 0.05),and the value of Cho/ Cr had no significant difference.The values of Glx/Cr and NAA/Cr in left hippocampus reduced significantly(Glx/Cr:(1.16 ±0.07),t =2.50,P＜0.05 ;NAA/Cr:(1.30 ±0.09),t=5.94,P＜0.01),and the value of Cho/Cr was increased which did not reach statistically significance(P＞ 0.05).The values of Glx/Cr and NAA/Cr were reduced and the value of Cho/Cr was increased in right hippocampus which did not reach statistical significance(P＞0.05).The depressive group had the significantly higher levels of IL-6,IL-2 in CSF(IL-6:(32.41 ± 3.52),t =11.46,P ＜ 0.01 ; IL-2:(18.89 ± 2.56),t =7.42,P ＜ 0.01),but no significant difference was found in the IL-10 level in CSF.The Glx/Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in CSF (IL-6:r =-0.555,P＜ 0.05 ; IL-2:r=-0.582,P＜ 0.05) ; the NAA/Cr of left hippocampus level was negatively correlated to the IL-6 and IL-2 level in CSF(IL-6:r=-0.582,P＜0.05;IL-2:r=-0.607,P＜0.05).Conclusion The development of inchoate depression has a correlation with the high sensibility of the left hippocampus affected by the inflammatory factor levels.The metabolism of never cells has changed,which maybe constitutes the physiopathology basis of the depression.
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Objective To explore the brain's metabolism about the hippocampus, anterior cingulate and thalamus of first episode depressive patients. Methods Using proton magnetic resonance spectroscopy and 1 HMRS analyzing technology to detect multiple metabolic indices of the hippocampus, anterior cingulate and thalamus of 20 patients and 20 healthy persons, including N-acetylaspartate ( NAA), choline ( Cho ), myoinositol ( MI ), creatine(Cr). Results The ratios of MI/Cr of the bilateral thalamus of the depressive patients group decreased ( Left (0.23 ±0.13) ,(0.25 ±0.09), t=2.25, P=0.03,Right(0.33 ±0.15,0.34 ±0.04), t=2.42, P=0.02).The ratios of NAA/Cr and Cho/Cr of the bilateral hippocampus of the depressive patients group were both lower (NAA/Cr: Left t=3.06, P=0.004,Right t=3.54, P=0.001. Cho/Cr: Left t=2.94, P=0.006,Right t=4.02,P=0.001 ). The ratios of Cho/Cr and MI/Cr of the anterior cingulate of the depressive patients group were both significantly higher (NAA/Cr: t=3.12, P=0. 003;Cho/Cr: t=2.62, P=0.01). Conclusion The metabolic abnormalities of hippocampus, anterior cingulate and thalamus maybe constitute the nervous biochemical basis of first episode depression.
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Objective To study the metabolic change of proton magnetic resonance spectroscopy (1 H-MRS)in the visual cortex and optic radiation region of patients with diabetic retinopathy (DR).Methods 1H-MRS was performed in 20 patients with DR and 20 healthy volunteers on GE 1.5 T MR system respectively.Metabolic peaks of N-acetylasparte(NAA),creatine(Cr,in 3.02 and 3.94 ppm),choline-containing compounds(Cho)and myo-inositol(mI)were observed,and the ratios were analyzed by each other.Independent-samples t test was performed between two sets of data.Results In both visual cortex and optic radiation,the ratios of ml/Cr and mI/CrSee in DR group(0.664 ± 0.052 and 1.453±0.068 in visual cortex,0.717±0.074 and 1.484±0.114 in optic radiation)were significant higher than those in normal group(0.602±0.047 and 1.249±0.044 in visual cortex,0.679 ± 0.075 and 1.334±0.089 in optic radiation,P＜0.05).In DR group,the ratios of CrSec/Cr,Cho/Cr and NAA/Cr in visual cortex and optic radiation were 0.458±0.043 and 0.488±0.052,0.481±0.057 and 0.807±0.110,1.633±0.105 and 1.709±0.140 respectively.In control group.the ratios of those were 0.484±0.041 and0.502±0.056,0.471±0.065 and 0.786±0.109,1.625±0.098 and 1.716±0.135 respectively.The ratios of CrSec/Cr,Cho/Cr and NAA/Cr had no statistic difference between two groups(P＜0.05).Conclusion mI/CrSec is a typical change in the visual cortex and optic radiation region,1H-MRS as a noninvasive examination could provide biochemical and metabolic informations for diabetic patients.
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Objective To summarize the principle and application of functional MR imaging of pancreatic carcinoma and chronic mass-forming type pancreatitis.Methods Articles about diffusion-weighted imaging(DWI),magnetic resonance spectrum imaging(MRSI) and dynamic contrast-enhanced MR imaging of pancreatic carcinoma and chronic pancreatitis were reviewed and analyzed.Results Functional MR imaging could reflected the differences in molecules diffusion,metabolism and tissue perfusion between pancreatic carcinoma and chronic pancreatitis.Conclusion As a non-invasive protocol,functional MR imaging can provide useful information in differential diagnosis between chronic mass-forming type pancreatitis and pancreatic carcinoma.
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Objective: To evaluate the liver function status in patients with obstructive jaundice using in vivo 31-phosphorus magnetic resonance spectroscopy (31P-MRS). Methods:31P-MRS scan with a single voxel on hepatic parenchyma was carried out in 31 patients with obstructive jaundice and in 40 healthy controls. Intracellular pH value (pHi), and some metabolic parameters including phosphomonoester (PME), phosphodiester (PDE), inorganic phosphate (Pi), ?-ATP, ?-ATP, ?-ATP, lower energetic phosphate (LEP), and the ratios of PME/ATP, Pi/ATP, PME/PDE, PME/Pi, PDE/Pi and PDE/ATP were calculated. Serum markers of liver function including AST, ALT, TBIL, DBIL, IBIL, TP, ALB, GLO, A/G, ALP and GGT were also recorded. The relationship between themwas analyzed. Results: 31P-MRS showed an increase in PME, PDE, PME/ATP, PME/Pi, PDE/ATP and LEP in jaundice patients compared with controls (P