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Pratik Mukherjee

Publications and source records attributed to Pratik Mukherjee.

22 records · Page 2Linked to original sources

Measurement of cerebral blood flow in chronic carotid occlusive disease: comparison of dynamic susceptibility contrast perfusion MR imaging with positron emission tomography.

BACKGROUND AND PURPOSE: Our purpose was to evaluate the accuracy of cerebral blood flow (CBF) measurements obtained by using dynamic susceptibility contrast-enhanced MR imaging, including the influence of arterial input function (AIF) selection, compared with those obtained by using [(15)O]-H(2)O positron emission tomography (PET) for patients with chronic carotid occlusion. METHODS: MR images and PET scans were obtained of seven patients with unilateral carotid occlusion and were co-registered for region of interest analysis. PET CBF maps were generated by using the autoradiographic method. MR imaging CBF maps were calculated by deconvolution of the susceptibility time curve with a proximal middle cerebral artery AIF and were converted to absolute flow rates either by assuming a constant contralateral white matter CBF value of 22 mL/100 mL/min or by using individually determined PET white matter CBF values. RESULTS: Although CBF values measured by PET and MR imaging were positively correlated for every patient, the slopes and y intercepts of the regression lines varied widely among patients. The correlation was better when individual white matter CBF values measured by PET were used to scale the white matter CBF values measured by MR imaging (r = 0.84, P <.0001) than when constant contralateral CBF values were assumed (r = 0.54, P <.0001). The choice of AIF ipsilateral or contralateral to the occluded carotid artery made no statistically significant difference (P >.05) to the correlation coefficient, slope, or y intercept of the MR imaging versus PET CBF regressions for six of the seven patients. CONCLUSION: Although linearly correlated with CBF values measured by PET, dynamic susceptibility contrast-enhanced MR imaging was not accurate for measuring absolute CBF values. AIF selection relative to the side of carotid occlusion did not significantly affect calculated MR imaging CBF values for six of the seven patients.

Aged↗

Diffusion-tensor MR imaging of gray and white matter development during normal human brain maturation.

BACKGROUND AND PURPOSE: Conventional MR imaging findings of human brain development are thought to result from decreasing water content, increasing macromolecular concentration, and myelination. We use diffusion-tensor MR imaging to test theoretical models that incorporate hypotheses regarding how these maturational processes influence water diffusion in developing gray and white matter. METHODS: Experimental data were derived from diffusion-tensor imaging of 167 participants, ages 31 gestational weeks to 11 postnatal years. An isotropic diffusion model was applied to the gray matter of the basal ganglia and thalamus. A model that assumes changes in the magnitude of diffusion while maintaining cylindrically symmetric anisotropy was applied to the white matter of the corpus callosum and internal capsule. Deviations of the diffusion tensor from the ideal model predictions, due to measurement noise, were estimated by using Monte Carlo simulations. RESULTS: Developing gray matter of the basal ganglia and developing white matter of the internal capsule and corpus callosum largely conformed to theory, with only small departures from model predictions in older children. However, data from the thalamus substantially diverged from predicted values, with progressively larger deviations from the model with increasing participant age. CONCLUSION: Changes in water diffusion during maturation of central gray and white matter structures can largely be explained by theoretical models incorporating simple assumptions regarding the influence of brain water content and myelination, although deviations from theory increase as the brain matures. Diffusion-tensor MR imaging is a powerful method for studying the process of brain development, with both scientific and clinical applications.

Basal Ganglia↗

Diffusion-weighted imaging of acute corticospinal tract injury preceding Wallerian degeneration in the maturing human brain.

BACKGROUND AND PURPOSE: Wallerian degeneration, the secondary degeneration of axons from cortical and subcortical injury, is associated with poor neurologic outcome. Since diffusion-weighted (DW) imaging is sensitive to early changes of cytotoxic edema, DW imaging may depict the acute injury to descending white matter tracts that precedes Wallerian degeneration; this injury is not visible on conventional CT or MR images in the maturing human brain. METHODS: Two neuroradiologists retrospectively analyzed clinical MR images in six children (aged 3 days to 5 months) with DW findings consistent with acute injury of the descending white matter tract due to territorial anterior or middle cerebral artery infarction. In five patients, images were obtained as a part of routine clinical evaluation. The remaining patient was a part of a prospective study of brain injury. Imaging findings were correlated with clinical outcomes. RESULTS: In all six patients, DW imaging performed 2-8 days after the onset of ischemia depicted injury to the descending white matter tract ipsilateral to the territorial infarct. Conventional MR images of the ipsilateral descending white matter tracts were abnormal in three patients. In all five patients for which follow-up results were available, the presence of DW changes was correlated with persistent neurologic disability. CONCLUSION: As shown in this retrospective analysis, DW imaging can depict acute injury to the descending white matter tract in neonates and infants, when conventional MR imaging may show normal findings. These DW findings likely precede the development of Wallerian degeneration, and they may portend a poor clinical outcome.

Acute Disease↗

Unilateral putaminal CT, MR, and diffusion abnormalities secondary to nonketotic hyperglycemia in the setting of acute neurologic symptoms mimicking stroke.

A 75-year-old Asian man presented with two episodes of chorea associated with nonketotic hyperglycemia. His chorea rapidly resolved after restitution of a normal serum glucose level, although an MR image obtained at the time of acute symptoms demonstrated high signal intensity on T1-weighted images, low signal intensity on T2-weighted images, and restricted diffusion, all involving the left putamen. A CT scan obtained 1 month later demonstrated faint hyperattenuation of the involved putamen. The reported pathophysiologic considerations for these imaging features are reviewed, and an original explanation is proposed.

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