Diffuse axonal injury has a characteristic multidimensional MRI signature in the human brain.
Diffuse axonal injury has a characteristic multidimensional MRI signature in the human brain.
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DOI：
10.1093/brain/awaa447
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发表时间：
2021-04-12
期刊：
影响因子：
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通讯作者：
Basser, Peter J
中科院分区：
文献类型：
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作者：
Benjamini, Dan;Iacono, Diego;Basser, Peter J
轴索损伤是创伤性脑损伤患者临床病理学的主要贡献者。传统的神经放射学工具，如CT和MRI，对创伤引起的弥漫性轴索损伤（DAI）不敏感。弥散张量MRI参数可能会改变DAI病变，但是，这些变化的性质是不一致的。多维MRI是一种新兴的方法，它结合了T1，T2和扩散，并取代体素平均值与分布，这使得特定的潜在异常成分的选择性隔离。通过进行联合尸检多维MRI和组织病理学研究，我们的目的是调查T1-T2扩散变化与DAI，并确定其组织病理学相关性。胼胝体来自8名患有持续创伤性脑损伤的受试者，3名对照脑供体在7 T下进行死后离体MRI。采集并处理多维、扩散张量和定量T1和T2 MRI数据。MRI采集后，对同一组织切片进行淀粉样前体蛋白（APP）免疫反应性检测，以确定DAI的严重程度。一个强大的图像配准方法被应用到准确匹配MRI衍生的参数和组织病理学，之后，每个组织块的12个感兴趣的区域被选择的基础上APP密度，但盲目的MRI。我们确定了与DAI密切相关的异常多维T1-T2、弥散-T2和弥散-T1分量，并使用它们生成轴突损伤图像。我们发现，与对照组白色物质相比，轻度和重度DAI病变包含明显更大的异常T1-T2成分（P=0.005和P
Axonal injury is a major contributor to the clinical symptomatology in patients with traumatic brain injury. Conventional neuroradiological tools, such as CT and MRI, are insensitive to diffuse axonal injury (DAI) caused by trauma. Diffusion tensor MRI parameters may change in DAI lesions; however, the nature of these changes is inconsistent. Multidimensional MRI is an emerging approach that combines T1, T2, and diffusion, and replaces voxel-averaged values with distributions, which allows selective isolation of specific potential abnormal components. By performing a combined post-mortem multidimensional MRI and histopathology study, we aimed to investigate T1-T2-diffusion changes linked to DAI and to define their histopathological correlates. Corpora callosa derived from eight subjects who had sustained traumatic brain injury, and three control brain donors underwent post-mortem ex vivo MRI at 7 T. Multidimensional, diffusion tensor, and quantitative T1 and T2 MRI data were acquired and processed. Following MRI acquisition, slices from the same tissue were tested for amyloid precursor protein (APP) immunoreactivity to define DAI severity. A robust image co-registration method was applied to accurately match MRI-derived parameters and histopathology, after which 12 regions of interest per tissue block were selected based on APP density, but blind to MRI. We identified abnormal multidimensional T1-T2, diffusion-T2, and diffusion-T1 components that are strongly associated with DAI and used them to generate axonal injury images. We found that compared to control white matter, mild and severe DAI lesions contained significantly larger abnormal T1-T2 component (P=0.005 and P