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PubMed1993

Developmental brain anomalies in schizophrenia and bipolar disorder: a controlled MRI study.

Many of the structural brain abnormalities found in schizophrenia (SC) and bipolar disorder (BD) over the past decade are believed to represent impaired neurodevelopmental processes. The authors hypothesized that incidental developmental anomalies would be more frequently present in the brains of subjects with SC and BD compared with healthy control subjects. The authors systematically assessed the MRI scans of 167 subjects (SC = 67, BD/schizoaffective = 63, healthy control subjects = 37) for the presence of 23 developmental anomalies involving cortical and subcortical structures. No excess neurodevelopmental anomalies were found in the schizophrenic or bipolar/schizoaffective groups. These findings do not support the hypothesis that SC and BD are associated with an excess of gross neurodevelopmental brain anomalies.

Adolescent↗

PubMed1997

[Anatomic changes after radical surgery and reconstruction with pedunculated or revascularized flaps in advanced head and neck tumors: computerized tomography and magnetic resonance findings].

January, 1992, to October, 1995, sixty-four patients with advanced head and neck cancer underwent head and neck reconstructive surgery using myocutaneous or revascularized flaps; in the same period, all patients were consecutively examined with CT and MRI. Myocutaneous flaps wer used in 26 patients: 12 flaps were tubular and 14 linear. Revascularized flaps were used in 38 patients: to repair a large defect in 26 patients (14 latissimus dorsi flaps and 12 temporal muscle flaps) and to repair an oral damage in 12 patients (5 revascularized radial and 7 jejunal flaps). CT and MR images of myocutaneous flaps showed the flaps as fatty areas, repairing large surgical defects, hypodense at CT and hyperintense at MRI, with no post-contrast enhancement. The postoperative scar around the flap exhibited soft-tissue density with slight post-contrast enhancement at CT and slightly hypodense on T2-weighted MR images. Post-contrast CT and MRI showed slight scar enhancement with no signal changes in the fatty component. The appearance of revascularized flaps at CT and MRI depends on the characteristics of the structure used to repair the surgical defect: jejunal and radial flaps appeared as mostly fatty thickened layers with both imaging methods. Temporal and latissimus dorsi flaps are made basically of muscular tissue, fatty tissue and occasionally skin (used to repair a mucosal defect): consequently, CT showed a structure with mostly parenchymal density in all cases and MRI depicted intermediate signal intensity. MRI was useful to detect 12 revascularized jejunal or radial flaps thanks to its higher contrast resolution and multiplanar capabilities showing even such thin structures as these flaps. Moreover, MRI permitted to study skull base reconstruction with revascularized (latissimus dorsi) flaps in 5 of our patients.

Adult↗

PubMed1995

MRI of pineal region tumours: relationship between tumours and adjacent structures.

A variety of tumours may arise in the pineal region; accurate diagnosis is important in the selection of treatment and prognosis. A retrospective analysis of the MRI studies of 25 patients with pathologically proven pineal region tumours was performed, focused on the relationship between the tumour and neighbouring structures. Compression of the tectal plate was classified as expansive or invasive, and compression of the corpus callosum as inferior, anterior or posterior. In 10 of the 14 patients (71%) with germ cell tumours tectal compression was of the invasive type; 8 patients (57%) had multiple tumours and in 13 (93%) the tumor margins were irregular. Teratomas were readily diagnosed because of characteristic heterogeneous signal intensity. Pineal cell tumours were differentiated from germ cell tumours by their rounded shape, solid nature, sharp margins, and expansive type of tectal compression. Meningiomas were characterised by their falcotentorial attachments, posterior callosal compression, and a low-intensity rim on T2-weighted images. Gd-DTPA injection enabled clear demonstration of the site and extent of tumour spread and was useful in differentiating cystic and solid components. The appearances described, while not pathognomonic, are helpful in the differential diagnosis of pineal region tumours, and valuable in planning appropriate treatment.

Adolescent↗

PubMed2000

Magnetic resonance imaging of the normal temporal bone.

Recent advances in magnetic resonance imaging (MRI) technology has allowed the development of imaging sequences tailored to the assessment of exquisite anatomic detail of the temporal bone structures. This article describes MRI of the normal temporal bone anatomy, with emphasis on common anatomic variants and clinically relevant structures.

Ear, Inner↗

PubMed2003

Isolating quantum coherences in structural imaging using intermolecular double-quantum coherence MRI.

Intermolecular multiple-quantum coherence (iMQC) MR imaging provides a fundamentally different contrast mechanism. It allows probing tissue microstructure by tuning the direction and strength of the correlation gradient. However, iMQC images of a specific quantum-coherence can easily be contaminated by leakage signals from undesired quantum coherences (zero, single, and triple quantum coherence in this work). Using a modified double-quantum CRAZED imaging sequence, we show that signals originating from various coherence orders (M=0, 1, 2, 3) can be predicted in k-space and effectively isolated by means of a four-step phase cycling scheme and judicious choice of flip angles. Finally, preliminary data suggest the method to be able to provide information on trabecular bone architecture such as regional mean trabecular plate separation.

Algorithms↗

PubMed2006

Visualizing neuronal structures in the human brain via diffusion tensor MRI.

Acquisition, analysis, and visualization of diffusion tensor magnetic resonance imaging (DT-MRI) is still an evolving technology. This article reviews the fundamentals of the data acquisition process and the pipeline leading to visual results that are interpretable by physicians in their clinical practice. The limitations of common approaches for visualizing the retrieved data are discussed and a new statistical method is presented to assess the reliability of the acquired tensor field. A novel visualization method is proposed which is discussed in light of neurophysiological considerations of the perception of colored patterns. It is argued that this method is more accurate for medical data while providing a nearly optimal visual stimulus. The method is evaluated on a patient study with a brain tumor.

Adult↗

PubMed2003

MRI and PET study of deficits in hippocampal structure and function in women with childhood sexual abuse and posttraumatic stress disorder.

OBJECTIVE: Animal studies have suggested that early stress is associated with alterations in the hippocampus, a brain area that plays a critical role in learning and memory. The purpose of this study was to measure both hippocampal structure and function in women with and without early childhood sexual abuse and the diagnosis of posttraumatic stress disorder (PTSD). METHOD: Thirty-three women participated in this study, including women with early childhood sexual abuse and PTSD (N=10), women with abuse without PTSD (N=12), and women without abuse or PTSD (N=11). Hippocampal volume was measured with magnetic resonance imaging in all subjects, and hippocampal function during the performance of hippocampal-based verbal declarative memory tasks was measured by using positron emission tomography in abused women with and without PTSD. RESULTS: A failure of hippocampal activation and 16% smaller volume of the hippocampus were seen in women with abuse and PTSD compared to women with abuse without PTSD. Women with abuse and PTSD had a 19% smaller hippocampal volume relative to women without abuse or PTSD. CONCLUSIONS: These results are consistent with deficits in hippocampal function and structure in abuse-related PTSD.

Adult↗

PubMed1996

Magnetic resonance imaging in primary and secondary septorhinoplasty.

The authors emphasize the importance of MRI as a means to functionally evaluate patients in primary (PR) and secondary (SR) rhinoseptoplasty. Forty-eight subjects were appraised who underwent various types of corrective nose surgery: 31 PR, 12 SR, 4 introgenic perforations, and 1 dermoid cyst of the nasal dorsum. MRI allows the nasal structures at the level of the valve to be visualized, as well as the medial and lateral walls of the nasal fossa in all of its components. MRI studies improve pre-surgical evaluation (alar cartilages, iaterdomal distance, and valvular configuration), and the exam of structures and anomalies which are hard to evaluate by the rhinoscopy (turbino-septal-synchias, perforations, losses of bone-cartilaginous substance). Moreover, through MRI the nasal respiratory surface (NRS) is determined and used by the authors to quantify the improvement of the postsurgical nasal respiratory function. All of these points gain importance during the planning of primary, secondary, and/or corrective surgery.

Adult↗

PubMed1986

High-resolution magnetic resonance imaging of the ankle: normal anatomy.

An imaging-anatomic correlative study of ankle anatomy based upon six healthy adults and six fresh cadaveric specimens was performed to evaluate the diagnostic capabilities of magnetic resonance imaging (MRI). Optimal pulsing sequences and imaging planes for various structures of interest were established. MRI afforded exquisite depiction of anatomic detail, particularly the diagnostically important collateral ligaments. Limitations in the ability to delineate the joint capsule and articular cartilage were documented, with the former detectable only on T2 weighted images in the presence of synovial fluid.

Adult↗

PubMed2001

Diffusion tensor imaging of cryptogenic and acquired partial epilepsies.

Current optimal MRI identifies a relevant structural abnormality in up to 80% of patients with refractory partial seizures. Identification of a structural lesion is fundamental to pre-surgical evaluation. We used diffusion tensor imaging (DTI) and statistical parametric mapping (SPM) to examine objectively the diffusion properties, and hence structural organization, of cerebral tissue in 10 patients with partial seizures and acquired lesions and 30 patients with partial seizures and normal MRI. Fractional anisotropy and mean diffusivity maps were calculated and, using SPM, individual patients were compared with a group of 30 control subjects. Diffusion tensor imaging and voxel-by-voxel statistical comparisons identified significant increases in diffusivity and significant reductions of anisotropy in all patients with acquired non-progressive cerebral lesions and partial seizures. In all of these patients, the areas of increased diffusivity, and in nine patients the areas of decreased anisotropy, concurred with abnormalities identified on visual inspection of conventional MRI. In addition, there were 10 areas which were normal on conventional imaging which exhibited abnormal anisotropy or diffusivity. Individual analyses of the 30 patients with partial seizures and normal optimal MRI identified a significant increase in diffusivity in eight of the subjects. In six of these, the areas of increased diffusivity concurred with the localization of epileptiform EEG abnormality. Analysis of anisotropy in the MRI-negative patients revealed significant differences in two patients, one of which concurred with electroclinical seizure localization. Group analysis of nine patients with normal conventional MRI and electroclinical seizure onset localizing to the left temporal region revealed a significant increase in diffusivity and a significant reduction in anisotropy within the white matter of the left temporal lobe. DTI analysed using SPM was sensitive in patients with acquired cerebral damage. Significant differences in the diffusion indices in individual MRI negative patients and the group effect in patients with left temporal lobe epilepsy suggest that minor structural disorganization exists in occult epileptogenic cerebral lesions. These techniques are promising, non-invasive imaging methods for identifying the cause of partial seizures, and can contribute to pre-surgical evaluation.

Adult↗

PubMed2006

Uncoupled leftward asymmetries for planum morphology and functional language processing.

Explanations for left hemisphere language laterality have often focused on hemispheric structural asymmetry of the planum temporale. We examined the association between an index of language laterality and brain morphology in 99 normal adults whose degree of laterality was established using a functional MRI single-word comprehension task. The index of language laterality was derived from the difference in volume of activation between the left and right hemispheres. Planum temporale and brain volume measures were made using structural MRI scans, blind to the functional data. Although both planum temporale asymmetry (t(1,99) = 6.86, p < .001) and language laterality (t(1,99) = 15.26, p < .001) were significantly left hemisphere biased, there was not a significant association between these variables (r(99) = .01,ns). Brain volume, a control variable for the planum temporale analyses, was related to language laterality in a multiple regression (beta = -.30, t = -2.25, p < .05). Individuals with small brains were more likely to demonstrate strong left hemisphere language laterality. These results suggest that language laterality is a multidimensional construct with complex neurological origins.

Adolescent↗

PubMed2004

Neuroplasticity: from MRI to depressive symptoms.

Morphological and functional changes have been repeatedly reported in the brain organization of depressed patients. The main modifications demonstrated by structural magnetic resonance imaging (MRI) are a reduction in the gray matter volume within the prefrontal cortex, the hippocampus, and the striatum. The reduction in gray matter volume and the morphological atrophy are probably due to an excess of neural loss (apoptosis) and an altered regulation of the neurotrophic processes. Hence, a deficit in neurotrophic factor synthesis (brain-derived neurotrophic factor [BDNF], neurotrophin [NT]-3, NT-4/5, Bcl-2, etc.) may be responsible for increased apoptosis in the hippocampus and prefrontal cortex corresponding to the cognitive impairment described in depression. This hypothesis seems to be confirmed by the decreased expression of neurotrophic factors (e.g., BDNF mRNA) in animal models of depression. In parallel, the neural plasticity (functional aspects of synaptic connectivity and long-term potential activity [LTP]) is decreased. However, the most interesting data concern the possible reversibility of this dysregulation with antidepressant treatment. For example, communication between the hippocampus and the prefrontal cortex could be re-established, enabling in a way the cognitive processes to be "reset." From a clinical point of view, the consequences of such a phenomenon are manifold:

Antidepressive Agents↗

PubMed2005

Mindboggle: automated brain labeling with multiple atlases.

BACKGROUND: To make inferences about brain structures or activity across multiple individuals, one first needs to determine the structural correspondences across their image data. We have recently developed Mindboggle as a fully automated, feature-matching approach to assign anatomical labels to cortical structures and activity in human brain MRI data. Label assignment is based on structural correspondences between labeled atlases and unlabeled image data, where an atlas consists of a set of labels manually assigned to a single brain image. In the present work, we study the influence of using variable numbers of individual atlases to nonlinearly label human brain image data. METHODS: Each brain image voxel of each of 20 human subjects is assigned a label by each of the remaining 19 atlases using Mindboggle. The most common label is selected and is given a confidence rating based on the number of atlases that assigned that label. The automatically assigned labels for each subject brain are compared with the manual labels for that subject (its atlas). Unlike recent approaches that transform subject data to a labeled, probabilistic atlas space (constructed from a database of atlases), Mindboggle labels a subject by each atlas in a database independently. RESULTS: When Mindboggle labels a human subject's brain image with at least four atlases, the resulting label agreement with coregistered manual labels is significantly higher than when only a single atlas is used. Different numbers of atlases provide significantly higher label agreements for individual brain regions. CONCLUSION: Increasing the number of reference brains used to automatically label a human subject brain improves labeling accuracy with respect to manually assigned labels. Mindboggle software can provide confidence measures for labels based on probabilistic assignment of labels and could be applied to large databases of brain images.

Journal Article↗

PubMed2005

Gross mural cartilage in a congenital bronchogenic cyst: MRI features.

An infant who had a cardiac murmur after the delivery was evaluated with echocardiogram. A 1 cm cystic area was incidentally identified in the upper right mediastinum, that was not related with the heart. A 4 x 4.5 x 8 cm cystic mass in the superior mediastinum and lower neck was demonstrated on the magnetic resonance imaging (MRI). At surgery, a small solid structure corresponding to the nodule seen on MRI was identified, which was firm and cartilaginous in nature and attached to the wall of the cyst. Grossly visible cartilage in association with a bronchogenic cyst has not been previously reported. In conclusion, the bronchogenic cysts can have grossly visible cartilage in their wall and extend to extrathoracic spaces in a contiguous fashion, mimicking other entities such as teratomas and cystic lymphangiomas.

Bronchogenic Cyst↗

PubMed2002

Cardiac MRI: recent progress and continued challenges.

Cardiac MRI continues to develop and advance. MRI accurately depicts cardiac structure, function, perfusion, and myocardial viability with an overall capacity unmatched by any other single imaging modality. MRI is an accepted and widely utilized tool for cardiovascular research. Its clinical use has been limited, but is increasing because of its proven clinical efficacy, the proliferation of cardiac-capable MRI systems, and the development of improved pulse sequences. The following article reviews the landmark developments in this field, with an emphasis on recent progress in the evaluation of ischemic or acquired heart disease.

Heart↗

PubMed1999

Structural neuroimaging in schizophrenia. An integrative view of neuromorphology.

The use of structural magnetic resonance imaging (MRI) in studies of schizophrenia has resulted in a more detailed picture of anatomic areas which may be altered in this syndrome. Thus far, there have been over 130 studies of schizophrenia using MRI and, taken together, they present a clear picture of a group of disorders with altered brain structure. Their major finding is a confirmation of the older pneumoencephalography and computertomography studies showing an enlargement of lateral ventricles and a volume reduction seen in the temporal lobe. When structural studies are carried out in other cortical and subcortical regions, however, the volume reduction is not so uniform, but rather restricted to certain areas in a given patient. In addition medication effects can be seen especially in the caudate nucleus which tend to increase in volume after long-term neuroleptic drug usage and again normalize under the atypical drug clozapine. These data are consistent with a neurodevelopmental model of schizophrenia and with some kind of progressive neurodegenerative process. This review suggests that an integrative model with initial developmental errors may underlie the majority of cases of schizophrenia, but that cases of chronic schizophrenia appear to involve progressive neurodegeneration. In assessing the scatter in available data, it appears that there is no consistent neuropathology across all cases of schizophrenia and preferential areas of dysfunction can be determined. Thus, there seems a collection of subtle neurodevelopmental errors which can lead to various forms of schizophrenia and that at least some types of schizophrenia most probably also involve a neurodegenerative process which could in fact be a consequence of the initial developmental defect.

Brain↗

PubMed1986

Magnetic resonance imaging in childhood intracranial masses.

Magnetic Resonance Imaging (MRI) was compared with computerized tomography (CT) in 40 pediatric and adolescent patients with intracranial mass lesions as part of an ongoing project to determine the potential of MRI as a primary and definitive imaging modality. Multiplanar, multisequence MRI surpassed CT in providing mass localization, extent of involvement, and delineating the relationship to adjacent vital structures. Further development of MRI is encouraged to overcome current inconsistencies in pathologic characterization in order for this new technology to be employed not only as a primary screening modality but also as a definitive diagnostic test.

Adolescent↗

PubMed2000

Accuracy of MRI evaluation of pulmonary blood supply in patients with complex pulmonary stenosis or atresia.

Detailed imaging of pulmonary artery (PA) anatomy and significant aorto-pulmonary collaterals (APCs) is crucial for surgical planning and follow-up in patients with complex congenital heart disease (CHD) and pulmonary stenosis or atresia. Because examination by echocardiography is often technically limited and catheterization is invasive, this study evaluated the diagnostic accuracy of magnetic resonance imaging (MRI) as an alternate non-invasive tool. Thirteen patients (median age 28 years, range: 1-44 years) underwent both cardiac catheterization and MRI within a median of two months (range 0.1-8 months). Diagnoses included tetralogy of Fallot (TOF) with pulmonary atresia (n = 8), TOF with pulmonary stenosis (n = 2), single left ventricle with pulmonary stenosis (n = 2), and complex heterotaxy with pulmonary stenosis (n = 1). The MRI sequences used in this study were ECG-gated spin echo and gradient echo sequences acquired in multiple planes. Compared to catheterization, MRI had 100% sensitivity and specificity for the diagnosis of main PA (n = 6) and branch PA (n = 13) hypoplasia or stenosis, as well as discontinuous (n = 4) or absent (n = 10) branch PAs. There was complete agreement between catheterization and MRI identification of significant APCs (n = 18). Main PA atresia was noted by MRI in four patients but was not definitively seen by catheterization in any. MRI but not catheterization precisely defined the distance between discontinuous PAs and their relationship to other mediastinal structures. In conclusion, cardiac MRI is a reliable non-invasive imaging modality to define PA and APC anatomy in patients with complex pulmonary stenosis or atresia.

Adolescent↗