Diffusion tensor free water MRI predicts progression of FLAIR white matter hyperintensities after ischemic stroke.
Diffusion tensor free water MRI predicts progression of FLAIR white matter hyperintensities after ischemic stroke.
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DOI：
10.3389/fneur.2023.1172031
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发表时间：
2023
影响因子：
3.4
通讯作者：
中科院分区：
文献类型：
--
作者：
MRI上FLAIR白质高信号(WMH)的进展预示着血管介导的认知功能下降。甚至在FLAIR WMH进展之前，邻近的正常白质(NAWM)在弥散张量成像(DTI)上已经显示出微结构恶化。我们假设DTI游离水(FW)升高将先于FLAIR WMH进展，暗示间质积液是脑小血管疾病进展的关键病理步骤。参与者在缺血性中风或短暂性脑缺血发作后至少3个月，MRI显示WMH，在接下来的一年中每3个月进行一次连续的脑核磁共振检查。对于每个参与者，WMH被自动分割，序列磁共振成像被对齐，并通过在任何时间点扩张病变并减去基线病变来定义WMH半影区的风险区域。如果半影体素被分割为新的病变，并显示随着时间的推移FLAIR强度增加，则被归类为稳定或进展为WMH。对齐的DTI图像包括FW和FW校正的分数各向异性(FATIssue)和平均弥散率(MDTIssue)。使用Logistic回归和受试者-操作者特征曲线下面积(AUC)来检验基线DTI是否预测稳定型半暗带或进展为WMH的体素分类，同时与临床危险因素协变。在纳入的参与者(n=26，平均年龄71±9岁，31%女性)中，我们检测到WMH的年平均体素增长为2.9ml±2.6ml。每个基线DTI指标都与半影区的病变进展相关，但FW的AUC值最大，为0.732(0.730-0.733)，可以预测参与者的WMH进展。基线增加的间质液体在DTI上估计为FW，预测下一年NAWM向WMH的进展。这些结果提示FW的存在在脑小血管疾病进展的发病机制中起作用。
The progression of FLAIR white matter hyperintensities (WMHs) on MRI heralds vascular-mediated cognitive decline. Even before FLAIR WMH progression, adjacent normal appearing white matter (NAWM) already demonstrates microstructural deterioration on diffusion tensor imaging (DTI). We hypothesized that elevated DTI free water (FW) would precede FLAIR WMH progression, implicating interstitial fluid accumulation as a key pathological step in the progression of cerebral small vessel disease. Participants at least 3 months after an ischemic stroke or TIA with WMH on MRI underwent serial brain MRIs every 3 months over the subsequent year. For each participant, the WMHs were automatically segmented, serial MRIs were aligned, and a region of WMH penumbra tissue at risk was defined by dilating lesions at any time point and subtracting baseline lesions. Penumbra voxels were classified as either stable or progressing to WMH if they were segmented as new lesions and demonstrated increasing FLAIR intensity over time. Aligned DTI images included FW and FW-corrected fractional anisotropy (FATissue) and mean diffusivity (MDTissue). Logistic regression and area under the receiver-operator characteristic curve (AUC) were used to test whether baseline DTI predicted voxel-wise classification of stable penumbra or progression to WMH while covarying for clinical risk factors. In the included participants (n = 26, mean age 71 ± 9 years, 31% female), we detected a median annual voxel-wise WMH growth of 2.9 ± 2.6 ml. Each baseline DTI metric was associated with lesion progression in the penumbra, but FW had the greatest AUC of 0.732 (0.730 – 0.733) for predicting voxel-wise WMH progression pooled across participants. Baseline increased interstitial fluid, estimated as FW on DTI, predicted the progression of NAWM to WMH over the following year. These results implicate the presence of FW in the pathogenesis of cerebral small vessel disease progression.
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影响因子：
3.5
作者：
Garyfallidis E;Brett M;Amirbekian B;Rokem A;van der Walt S;Descoteaux M;Nimmo-Smith I;Dipy Contributors
通讯作者：
Dipy Contributors
影响因子：
8.2
作者：
Cho AH;Kim HR;Kim W;Yang DW
通讯作者：
Yang DW
DOI：
10.1016/j.dadm.2015.10.004
发表时间：
2015-12
期刊：
Alzheimer's & dementia (Amsterdam, Netherlands)
影响因子：
--
作者：
Adams HH;Hilal S;Schwingenschuh P;Wittfeld K;van der Lee SJ;DeCarli C;Vernooij MW;Katschnig-Winter P;Habes M;Chen C;Seshadri S;van Duijn CM;Ikram MK;Grabe HJ;Schmidt R;Ikram MA
通讯作者：
Ikram MA
影响因子：
5.9
作者：
通讯作者：
--
影响因子：
6.7
作者：
Arba, Francesco;Quinn, Terence J.;Inzitari, Domenico
通讯作者：
Inzitari, Domenico