Direct visualization of cerebellar nuclei in patients with focal cerebellar lesions and its application for lesion-symptom mapping
Direct visualization of cerebellar nuclei in patients with focal cerebellar lesions and its application for lesion-symptom mapping
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DOI：
10.1016/j.neuroimage.2012.07.063
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发表时间：
2012-11-15
期刊：
影响因子：
5.7
通讯作者：
Timmann, D.
中科院分区：
文献类型：
--
作者：
Maderwald, S.;Thuerling, M.;Timmann, D.
到目前为止，人类小脑病变研究尚未利用个体患者小脑核的直接磁共振成像（MRI）。本研究采用敏感性加权成像（SWI）观察慢性局灶性病变患者的齿状核病变。15例因脑卒中或肿瘤手术引起的小脑病变患者使用1.5 T MRI扫描仪进行SWI成像。所有患者的齿状核均呈低密度。3例患者在3 T和7 T时进行了额外的SWI成像，与1.5 T相比，齿状壁的波纹更精确，背侧，缺铁部分更清晰。基于1.5 T MR图像进行病变症状定位。将患者分为有上肢共济失调和无上肢共济失调两组。研究使用了一种兴趣区域（ROI）驱动的归一化技术，该技术最初由Diedrichsen等人（2011年）开发，用于齿状核的功能MRI （fMRI）。与常规的小脑正常化相比，齿状病变的重叠得到改善，并导致病变症状图的敏感性增加。减法分析显示，齿状核的背侧和吻侧部分与上肢共济失调有关。结果与最近的功能磁共振成像研究显示的齿状手区域一致。这些数据提供的证据表明，直接识别齿状病变和roi驱动的归一化技术允许在常规1.5 T MRI场强下在小脑核水平上改善病变症状映射。(C) 2012爱思唯尔公司版权所有。
As yet, human cerebellar lesion studies have not taken advantage of direct magnetic resonance imaging (MRI) of the cerebellar nuclei in individual patients. In the present study, susceptibility weighted imaging (SWI) was used to visualize lesions of the dentate nuclei in patients with chronic focal lesions. Fifteen patients with cerebellar lesions either due to stroke or tumor surgery underwent SWI imaging using a 1.5 T MRI scanner. Dentate nuclei were seen as hypointensities in all patients. Three of the patients underwent additional SWI imaging at 3 T and 7 T. Compared to 1.5 T, corrugation of the dentate wall was seen with greater precision and the dorsal, iron-poorer part was seen more fully. Lesion-symptom mapping was performed based on the 1.5 T MR images. Patients were divided into two groups with and without upper limb ataxia. A region-of-interest-(ROI)-driven normalization technique was used which had initially been developed by Diedrichsen et al. (2011) for functional MRI (fMRI) of the dentate nuclei. Compared to conventional normalization of the cerebellum, overlap of dentate lesions improved and lead to increased sensitivity of lesion-symptom maps. Subtraction analysis revealed that the more dorsal and rostral parts of the dentate nuclei were related to upper limb ataxia. Findings were in good accordance with the dentate hand area shown in recent fMRI studies. These data provide evidence that direct identification of dentate lesions together with the ROI-driven normalization technique allows for improved lesion-symptom mapping at the level of the cerebellar nuclei already at conventional 1.5 T MRI field strength. (C) 2012 Elsevier Inc. All rights reserved.