MRA & Flow of Neurovascular Diseases

Hall D                                   Tuesday 13:30-15:30                                                                                                                                             

13:30         3416.     A Novel Technique of Cranial MR Angiography: Hybrid MRA

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Takao Kodama1, Takanori Yano1, Shozo Tamura1, Yoshio Machida2, Tokunori Kimura2

1Faculty of Medicine, University of Miyazaki, Miyazaki, Japan; 2Toshiba Medical Systems, Otawara, Japan

We developed a new MRA sequence, hybrid MRA (HMRA), combining the contrast of time-of-flight (TOF) and flow-sensitive black blood (FSBB) by using the dual-echo data acquisition. The gradient moment nulling (GMN) and dephasing gradient was applied to obtain the first echo and the second echo, respectively. Original images of the HMRA were made by subtracting the second-echo images from the first-echo images. This sequence was more sensitive to slow flow than 3D TOF MRA and seemed to be a feasible technique or evaluating steno-occlusive vascular disease.

 

14:00         3417.     GRAPPA with a TWIST: Dynamic 4D CE MRA of the Cerebral Vasculature at Near Isotropic Resolution

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Jens Olaf Heidenreich1, Martin Blaimer1, Randall Kroeker, Gerhard Laub, Jeffrey L. Duerk1, Jeffrey Sunshine1, Mark Griswold1

1Case Western Reserve University, Cleveland, USA

GRAPPA and TWIST were combined to a novel 4D dynamic high resolution contrast enhanced magnetic resonance angiography allowing for the first time to image the entire cerebral vasculature during a contrast bolus passage at near isotropic resolution. In 25 neurological patients this technique showed improved small vessel depiction over the current clinical standard TOF-MRA. It also delivered superior results in patients prone to motion and those with metal artifacts. The simplicity of data acquisition makes bolus timing unnecessary, readily shows all phases of anatomy from arteries through veins, and can strongly impact imaging of patient cerebral vasculature in daily practice.

 

14:30         3418.     Phase Contrast Flow Quantification of Carotico-Vertebral Blood Flow at 3.0T in Patients with Angiographically Normal Vessels

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Fatemeh Barkhordarian1, Derek G. Lohan1, Aparna Singhal1, reza habibi1, Abbas Nasiraei-Moghaddam1, Roya Saleh1, Pablo Villablanca1, Paul J. Finn1

1UCLA, Los Angeles, USA

Precise quantification of cerebral blood volume flow with combined morphological and hemodynamic data has many potential applications in neurovascular imaging.We sought to evaluate the normal ranges of caroticovertebral blood flow in a large number of patients with normal MR Angiography using a high temporal resolution protocol at 3.0 Tesla,thus providing reference values for future access and suggest that there is considerable variability in ‘normal’ cerebral blood flow in the absence of strong relationship with patient age or gender.   

 

15:00         3419.     Using Vessel Encoded Arterial Spin Labeling Technique to Evaluate Cerebral Blood Flow Territories in Volunteers and Carotid Occlusion Patients

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WU Bing1,2, GUO Jia3, Wong Eric C.4, WANG Xiaoying1,3, ZHANG Jue3, JIANG Xue-xiang1, FANG Jing3

1Peking University 1st Hospital, Beijing, People's Republic of China; 2Peking University , Beijing, People's Republic of China; 3Peking University, Beijing, People's Republic of China; 4University of California,

We present a new method, vessel encoded imaging(VEI), for evaluating the individual brain-feeding arteries of healthy volunteers and carotid occlusion patients quantitatively and qualitatively. VEI can measure elective cerebral blood flow (sCBF) mapping of the flow territories of the left and right internal carotid arteries and vertebrobasilar arteries, which could aid in the planning and staging of interventions such as carotid endarterectomy, stenting, or bypass.

 

13:30         3420.     Non-Contrast MR Angiography with Multiple Inversion Pulses: Separation of Arteries from Veins with Flexible Inversion Time

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Naoyuki Takei1, Mitsuharu Miyoshi1, Tetsuji Tsukamoto1

1GE Yokogawa Medical Systems.Ltd, Hino, Japan

Selective inversion recovery pulse (SIR) has been used for non-contrast agent MR angiography. However in-flow time is restricted to the inversion time (TI). Aim of our study is to enhance depiction of arteries with longer in-flow time over TI for background suppression. At first SlR is applied. After a waiting time, non-selective inversion pulse follows. The multiple inversion pulses offer a longer in-flow time. Separation of arteries from veins was successfully performed with TI=1300 to 2000 ms in volunteer scans. This method provides a longer in-flow time of arteries than the T1 value of vein and improved depiction of arteries.

 

14:00         3421.     Carotid Plaque Imaging with BLADE

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Masahiro Ida1, Kennichi Motoyoshi1, Hiroyuki Fukuyama1, Hisashi Yoshizawa1, Naoya Yorozu1, Keiko Hino1

1Tokyo Metroplolitan Ebara Hospital, Oota-ku, Japan

BLADE-T2WI and T1WI are feasible for detecting not only atherosclerotic carotid plaque but also the neighboring

turbulent flow, which is a risk factor of the intimal injury. Multi-slice BLADE sequences are useful methods and the initial sequences of choice for screening of carotid plaque and its risk factor.BLADE dark blood (DB) sequences with cardiac gating are the best-preferred methods for precise evaluation of anatomical details and plaque contents. When multi-slice BLADE T2WI and T1WI show positive findings, single-slice BLADE-DB sequences with cardiac gating should be added to access carotid plaque precisely.

 

14:30         3422.     Assessment of Intracranial Aneurysm Thrombosis with Patient-Specific Computational Models Based on MRI Data

Vitaliy L. Rayz1, Loic Boussel1,2, Joseph R. Leach1, Gabriel Acevedo-Bolton1, Randall T. Higashida3, Michael T. Lawton3, Alastair J. Martin3, William L. Young3, David Saloner,13

1VA Medical Center, San Francisco, USA; 2Créatis-LRMN (LB, PCD),  UMR CNRS 5515, INSERM U630, Lyon, France; 3University of California San Francisco, USA

MR imaging and velocimetry were used to predict the flow in patients who had thrombus-free vessels, and then proceeded to develop intra-aneurysmal thrombus. High resolution, contrast-enhanced MRA images were used to obtain patient-specific lumenal geometries. Images obtained at baseline and at follow up studies were co-registered to determine regions of thrombus formation. Computational Fluid Dynamics (CFD) models were constructed using the baseline geometries and inlet conditions. Results indicate a strong similarity between the slow flow regions predicted in CFD simulations and the regions filled with thrombus in vivo. This study indicates computational models may offer guidance for cerebral aneurysms treatment.

 

15:00         3423.     Evaluation of Unruptured Intracranial Aneurysms with 3 Tesla 3D Time-Of-Flight MR Angiography : Comparison of 64-Channel Multidetector Row CT Angiography

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Yoshiyasu Hiratsuka1, Hitoshi Miki1, Keiichi Kikuchi1, Ikuko Kiriyama1, Teruhito Mochizuki1, Shizue Takahashi2, Ichiro Matsubara3, Kazuhiko Sadamoto3

1Ehime University School of Medicine, Toon, Japan; 2Ehime National Hospital, Toon, Japan; 3Washo-kai Sadamoto Hospital, Matsuyama, Japan

The purpose of this study was to compare 3D time-of-flight magnetic resonance angiography (3D TOF MRA) at 3 tesla (T) and 64-channnel multidetector row computed tomographic angiography (64-MDCTA) in the detection of angiographically proved unruptured intracranial aneurysms with a blind reader study.3 T 3D TOF MRA and 64-MDCTA are excellent examinations with high diagnostic accuracy for detection of unruptured intracranial aneurysms. These two modalities have the almost same ability for evaluation of intracranial aneurysms, and there is no significant difference. 3D TOF MRA is free from the risks concerning the use of contrast media or the exposure of x-ray, and widely applied for the screening examination of evaluation of intracranial aneurysms. From this results, with regard to the evaluation of intracranial aneurysms, improvement of diagnosis on 3 T TOF MRA will reduce the necessity for the additional CTA examination after MRA.

 

13:30         3424.     Can the Hemodynamic Geographical Factors Be the Cause of Concurrent Cavernous Malformation in the Cerebral Developmental Venous Anomaly? [Not Available]

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Yoo Jin Hong1, Tae-Sub Chung2, Kwon Duk Seo1, Sang Hyun Suh2, Kyung Yul Lee2

1Yongdong Severance Hospital,Yonsei University College of Medicine, Seoul, Republic of Korea; 2Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

Hemodynamic disturbance within the territory DVA by geographical factors may be a key factor in leading to cascade of events and subsequent development of a CM and 3.0 T high resolution MR units would be helpful to depict the find morphological detail of small vascular structures of DVA and CM and find such hemodynamic geographical factors.

 

14:00         3425.     Flow-Sensitive Black Blood Imaging for Evaluating Vascular Malformations

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Takao Kodama1, Takanori Yano2, Shozo Tamura1, Yoshio Machida3, Tokunori Kimura3

1Faculty of Medicine, University of Miyazaki, Miyazaki, Japan; 2Faculty of Medicine, University of Miyazaki,, Miyazaki, Japan; 3Toshiba Medical Systems, Otawara, Japan

The Purpose of this study was to estimate the utility of the newly developed flow-sensitive black blood (FS-BB) sequence in the evaluation of the vascular malformations. On the FS-BB imaging, the vascular structures can be enhanced by applying the dephaging gradient to susceptibility-weighted imaging. All venous malformations were more clearly visualized on FS-BB than flow-insensitive black blood (FI-BB) images. On FS-BB images, all of arteries, niduses, veins, and hemorrhagic lesions appeared as gblackh structures in patients with arteriovenous malformation or dural arteriovenous fistula. FS-BB can be a feasible tool for evaluating vascular malformations.

 

14:30         3426.     Imaging the Cerebral Venous Sinuses’ Puls Curve by Ultrafast Dynamic BOLD MRI

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Jan-Hendrik Buhk1,2, Gunther Schütze1, Kai Kallenberg1, Gunther Helms1, Jürgen Baudewig1, Andreas Wellmer1, Michael Knauth1, Peter Dechent1

1University Göttingen, Göttingen, Germany

Fast and dynamic imaging of the cerebral venous sinuses’ puls curve could be a useful additional tool in clinical diagnostic imaging of diseases like cerebral sinus thrombosis. We present a pilot study to evaluate the possibilities of fast dynamic single-slice blood oxygen level dependent (BOLD) imaging in displaying rhythmic signal changes in the cerebral venous sinuses. These findings highly correlate with reference techniques like phase contrast angiography (PCA) and duplex sonography, therefore the demonstration of an intracranial venous pulse curve is feasible.

 

15:00         3427.     Quantification of Cerebrovascular Reactivity by BOLD MRI and Correlation with Conventional Angiography in Patients with Moyamoya Disease

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Chris Heyn1, Julien Poublanc1, Jay S. Han2, Danny M. Mandell1, Jeff A. Stainsby3, Adrian P. Crawley1, Karel G. terBrugge1, Joseph A. Fisher2, David J. Mikulis1

1Toronto Western Hospital, Toronto, Canada; 2Toronto General Hospital, Toronto, Canada; 3GE Healthcare, Toronto, Canada

Moyamoya disease (MMD) is a vasculopathy characterized by progressive narrowing of proximal circle of Willis vessels and the formation of secondary collaterals.  As the disease advances, adequate perfusion distal to vessel stenoses is lost when compensatory vasodilatation reaches a maximum.  Further increases in vascular resistance ultimately leads to tissue oligemia and possible ischemia.  Recently, we have developed a methodology for rapidly and accurately controlling end tidal PCO2 utilizing a CO2 rebreathing device.  Using this technique with blood oxygen level dependent (BOLD) MRI, a quantitative map of cerebrovascular reactivity (CVR), defined as the change in MR signal per mmHg change in end tidal PCO2, can be generated for patients with MMD.  In the present work, we apply BOLD CVR to patients with MMD and correlate the quantitative high resolution maps with angiographic features found on conventional vessel angiography.  Reduction in mean CVR correlates well with the degree of MMD disease measured by modified Suzuki score or the presence of moya vessels and pial collaterals as visualized by conventional angiography.

 

Multiple Sclerosis: Disease Severity, Progression

Hall D                                   Tuesday 13:30-15:30                                                                                                                                             

13:30         3428.     The Relationship Between Brain NAWM and GM Damage is Localised to Specific Clinically Relevant Regions in Early PPMS

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Benedetta Bodini1,2, Zhaleh Khaleeli1, Mara Cercignani1,3, David H. Miller1, Alan J. Thompson1, Olga Ciccarelli1

1University College of London, London, UK; 2Sapienza, Università di Roma, Roma, Italy; 3Fondazione Santa Lucia, Roma, Italy

We used tract based spatial statistics and voxel based morphometry to assess separately white and grey matter abnormalities in patients with early primary progressive MS to clarify in vivo the relationship between the pathological processes occurring in the two compartments. We found 11 areas of anatomical correspondence between white and grey matter damage; however, when investigating the presence of a quantitative correlation, this was only found in 4 clinically eloquent regions. In such regions, we found that grey and white matter damage contribute to disability independently from each other.

 

14:00         3429.     MRI Correlates of Hippocampal Demyelination in Multiple Sclerosis Brains

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Elizabeth Fisher1, Ansi Chang1, Kunio Nakamura1, Richard A. Rudick1, Bruce D. Trapp1

1Cleveland Clinic, Cleveland, Ohio, USA

Histopathologic studies have demonstrated extensive demyelination in hippocampus in MS brains, but MRI correlates have not been defined. To investigate whether hippocampal pathology can be detected using common MRI sequences, we compared imaging characteristics in normally myelinated (n=4) and severely demyelinated (n=5) hippocampi obtained from MS patients post-mortem. MRIs were acquired in situ, prior to tissue fixation. Mean T2, T1, and MTR contrast ratios were not different, but MTR histograms from demyelinated hippocampi were shifted downward. These data suggest that MTR histogram peak position may a marker of hippocampal pathology in MS patients.

 

14:30         3430.     Cognitive Dysfunction in Benign MS is Associated with Increased Severity of Corpus Callosum Damage

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Elisabetta Pagani1, Sarlota Mesaros1, Marco Rovaris1, Domenico Caputo2, Angelo Ghezzi3, Ruggero Capra4, Antonio Bertolotto5, Gianna Riccitelli1, Vittorio Martinelli1, Giancarlo Comi1, Massimo Filippi1

1Scientific Institute and University Ospedale San Raffaele, Milan, Italy; 2Scientific Institute Don Gnocchi, Milan, Italy; 3Ospedale di Gallarate, Gallarate, Italy; 4Spedali Civili, Brescia, Italy; 5O

In this study we wished to investigate the relationship between the cognitive profile of benign multiple sclerosis (BMS) patients and the extent of tissue damage in the corpus callosum (CC). A method, which enables us to track and investigate atrophy and tissue damage of the CC was used in 54 BMS patients and correlations with neuropsychological tests (NPT) exploring memory, attention and frontal lobe cognitive domains were investigated. We found that cognitive dysfunction is associated with an increased severity of CC damage, in terms of both discrete lesions and fiber bundle disruption.

 

15:00         3431.     Changes in Blood-Brain Barrier Permeability and Blood Volume During MS Lesion Development and Evolution

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Jeffrey Moses Njus1, Xin Li1,2, Charles S. Springer1,2, Maria Taylor3, Tiana Greisel1, Frank W. Telang2, Patricia K. Coyle3, William D. Rooney1,2

1Oregon Health and Science University, Portland, Oregon, USA; 2Brookhaven National Laboratory, Upton, USA; 3Stony Brook University, Stony Brook, USA

Brain 1H8O R1 [&[ident] T1-1] data were collected from 12 healthy controls and 16 MS subjects at 4 T before and after gadolinium contrast reagent administration.  Normal appearing white and gray matter ROIs were selected and Ktrans and mole fraction blood water (pb) values were compared between control and MS groups.  These were monitored during the development and evolution of MS lesions.

 

13:30         3432.     Correlation of Regional Brain Tissue Loss and Disease Severity in Relapsing-Remitting Multiple Sclerosis: A VBM Study in a Large Patient Population

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Anna Prinster1, Mario Quarantelli1,2, Roberta Lanzillo3, Carmine Mollica2, Petronilla Salvatore2, Giuseppe Orefice2, Bruno Alfano1, Vincenzo Brescia Morra2, Arturo Brunetti,12, Marco Salvatore2

1National Research Council, Naples, Italy; 2University "Federico II", Naples, Italy; 3Hermitage Hospital IDC, Naples, Italy

Possible correlations between brain tissue loss and clinical severity were investigated using optimized VBM in 128 RR MS patients, showing a preferential correlation with EDSS of GM volume reduction in the primary motor cortex bilaterally, with an associated preferential right-sided tWM loss in subcortical regions stemming from the rolandic areas and following the pyramidal tract down to the brainsteam.

 

14:00         3433.     Susceptibility-Weighted MR Imaging of Vascular Distribution in White-Matter MS Lesions

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Jennifer Elizabeth Dixon1, Emma C. Tallantyre1, Paul S. Morgan1, Matthew J. Brookes1, Nikos Evangelou1, Peter G. Morris1

1The University of Nottingham, Nottingham, UK

The relationship between white-matter MS lesions and parenchymal blood vessels has been found to be predictive of treatment response, and is therefore of considerable clinical interest. Previous in vivo studies have been limited by the inability to view both the lesion and blood vessel on one MR image, resulting in the failure to determine their exact spatial relationship. In this study, we present susceptibility-weighted MR imaging at 7 Tesla as a technique for the identification of both lesions and blood vessels, aiding the study of the perivascular distribution of MS lesions.

 

14:30         3434.     DCE-MRI Ktrans Mapping of MS Lesion Evolution in Individuals

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Jeffrey Moses Njus1, Xin Li1,2, Charles S. Springer, Jr.1,2, Maria Taylor3, Frank W. Telang2, Patricia K. Coyle3, William D. Rooney1,2

1Oregon Health and Science University, Portland, Oregon, USA; 2Brookhaven National Laboratory, Upton, USA; 3Stony Brook University, Stony Brook, USA

Transient focal disruption of the blood-brain barrier (BBB) is the most pronounced cerebrovascular abnormality in multiple sclerosis (MS) brain tissue.  Though serial MRI studies involving gadolinium (Gd) contrast reagents have provided evidence that BBB permeability compromise is among the earliest expressions of MS pathology detectable by imaging techniques, quantitative BBB permeability changes throughout the course of lesion evolution have not be examined. In this study, we apply pharmacokinetic mapping techniques via dynamic-contrast-enhanced (DCE) MRI as means of investigating quantitative BBB permeability heterogeneity changes in relapsing-remitting MS (RRMS) brain tissue throughout the different phases of lesion development.

 

15:00         3435.     Deep Gray Matter Atrophy as an MRI Metric of Physical and Cognitive Impairment in Patients with Multiple Sclerosis

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Antonio Gallo1, Iordanis E. Evangelou1, Vasiliki N. Ikonomidou1, Robert L. Kane, Susan K. Stern1, Joan M. Ohayon1, Fredric Cantor1, Henry McFarland1, Francesca Bagnato1

1National Institutes of Health, Bethesda, Maryland, USA

We investigated the role of deep gray matter (dGM) atrophy in determining physical and cognitive impairment in patients with Multiple Sclerosis (MS). Twenty-four MS patients and 24 age-, gender- and education-matched healthy volunteers (HVs) underwent 3T MPRAGE, clinical and an extensive neuropsychological evaluation. dGM structures were segmented using the FreeSurfer software and volumes of both the thalamus (Th-vol) and basal ganglia (BG-vol) were obtained. Th-vol was significantly reduced in MS patients with respect to HVs, whereas differences in BG-vol did not reach statistical significance. Further analysis showed that atrophy of dGM structures correlated well with physical and several cognitive scores.

 

13:30         3436.     Correlating Iron with T2 Signal Intensity in Multiple Sclerosis Lesions Using Susceptibility Weighted Imaging

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E. Mark Haacke1, Malek Makki1, Yulin Ge2, Megha Maheshwari1, James Garbern1, Omar Khan1, Jiani Hu1, Madesh Selvan1, Latif Zahid1

1Wayne State University, Detroit, Michigan, USA; 2New York University, New York, New York, USA

Susceptibility weighted imaging (SWI) filtered phase data provides a means to monitor changes in iron content from hemosiderin. We used SWI to image multiple sclerosis lesions and compare them to those seen in T2 imaging. We find that the putative iron content associated with SWI phase images correlates negatively with T2 hyperintensities in multiple sclerosis lesions.

 

14:00         3437.     Automated System for Temporal Tracking of Multiple Sclerosis Lesions

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Michel Bilello1, Chamith S. Rajapakse1, Neerav Mehta1, Ragini Verma1, Elias R. Melhem1

1University of Pennsylvania, Philadelphia, USA

Interpretation of MRI scans of multiple sclerosis patients can be a very challenging task for the neuroradiologist due to changes in size, shape and position of the lesions. Manual tracking of temporal evolution of lesions is time and labor intensive and prone to inter-rater variability. Some of these limitations and challenges can be overcome by using a standardized automated system presented here. The accuracy and robustness of the predictions given by the automated system was validated with data made available by collaborative MS studies and those generated by a modified protocol.

 

14:30         3438.     Multiparametric MR Analysis of Temporal Evolution of Abnormality in MS

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Nematollah Batmanghelich1, Xiaoying Wu1, Christos Davatzikos1, Clyde E. Markowitz1, Ragini Verma1

1University of Pennsylvania, Philadelphia, USA

Various modalities, have been used individually to quantify damage in the normal appearing brain tissue(NABT); however, few studies combine these modalities to derive better information about tissue abnormality, with most methods concentrating on lesion segmentation rather than tissue abnormality characterization. We combine several MR modalities into a probabilistic pattern classification method to determine a voxel-wise probabilistic tissue abnormality score. This score can then been correlated with clinical and cognitive scores to study temporal WM changes. This method is applicable to studying treatment effects and can help physicians determine the extent of abnormality beyond the conventional visual symptoms like lesions.

 

15:00         3439.     A Voxel-Wise Random Field Theory-Based Magnetization Transfer Approach for Detecting Focal Demyelination and Remyelination in Multiple Sclerosis

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Michael G. Dwyer1, Milena Stosic1, Sara Hussein1, Arpad Kelemen1, David Wack1, Robert Zivadinov1

1State University of New York at Buffalo, Buffalo, New York, USA

Magentization transfer imaging (MTI) may provide a means for detecting demyelination and remyelination in-vivo in patients with multiple scelrosis.  We demonstrate a sensitive and statistically sound technique for identifying and quantifying areas of focal magentization transfer ratio (MTR) via longitudinal MTI.  This method is based on random field theory (RFT), and may have significant sensitivity and specificity advantages over whole-brain, region-of-interest, or purely voxel-wise approaches.

 

13:30         3440.     Voxel Based DTI Analysis Predicts Suggestive of MS Track in Clinically Isolated Syndrome Patients

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Yasheng Chen1, Valerie Jewells1, Silva Markovic-Plese1, Hongtu Zhu1, Diane Armao1, Hongyu An1, Elizabeth Bullitt1, Weili Lin1

1The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Patients presenting as clinically isolated syndrome (CIS) were imaged using DTI and were clinically evaluated ~2yrs after the initial DTI scans.  Based on the clinical status, patients were divided into two groups: suggestive of multiple sclerosis (CIS-MS) and not suggestive of MS (CIS-NMS).  Voxel-based analysis of the baseline DTI revealed that CIS-MS patients demonstrated significantly more severe sub-cortical abnormalities when compared with CIS-NMS patients.  Thus, our findings strongly supported that DTI may be a powerful imaging marker to predict CIS patients who may evolve into MS in future, allowing potentially early therapeutic intervention to reverse/retard the disease processes.

 

14:00         3441.     Structural MRI Correlates of Benign Multiple Sclerosis. A Voxel-Based Morphometry Study of Regional Grey Matter Atrophy

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Elisabetta Pagani1, Sarlota Mesaros1, Marco Rovaris1, Domenico Caputo2, Mauro Zaffaroni3, Ruggero Capra4, Antonio Bertolotto5, Vittorio Martinelli1, Giancarlo Comi1, Massimo Filippi1

1Scientific Institute and University Ospedale San Raffaele, Milan, Italy; 2Scientific Institute Don Gnocchi, Milan, Italy; 3Ospedale di Gallarate, Gallarate, Italy; 4Spedali Civili, Brescia, Italy; 5O

We used voxel-based morphometry to assess regional grey matter (GM) atrophy changes in 60 patients with benign mulitple sclerosis (BMS), 35 with secondary progressive (SP) MS and 21 controls. Compared to controls, SPMS patients showed a pattern of widespread GM atrophy, while BMS had reduced GM volume in the subcortical and frontoparietal regions. In comparison with BMS patients, those with SPMS had significant GM loss in the both cerebellar hemispheres, as well as in the right nucleus dentatus. Cerebellar atrophy seems to be a major determinant of irreversible locomotor disability in MS.

 

14:30         3442.     Segmentation of 3T Diffusion Tensor Images with Multiple Sclerosis Lesions

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Mustafa Okan Irfanoglu1, Steffen Sammet1, Regina Maria Koch1, Raghu Machiraju1, Michael V. Knopp1

1The Ohio State University, Columbus, Ohio, USA

Diffusion Tensor Imaging has a significant use in early diagnosis of Multiple Sclerosis (MS). The traditional methods of MS lesion detection are based on building statistical distributions of white matter fractional anisotropy (FA) and diffusivity (ADC) of healthy regions and trying to detect deviations from these distributions. In this study, we propose a novel method for segmenting diffusion tensors, which makes use of the entire tensor information instead of derived scalar fields and use this segmentation approach to detect candidate MS lesions.

 

15:00         3443.     High-Resolution in Vivo Imaging of Cortical Lesions in Multiple Sclerosis: A Comparison of 3T and 7T

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Jennifer Elizabeth Dixon1, Paul S. Morgan1, Emma C. Tallantyre1, Matthew J. Brookes1, Nikos Evangelou1, Peter G. Morris1

1The University of Nottingham, Nottingham, UK

Post-mortem MS studies have shown significant demyelination of the deep and cortical grey matter (GM), but in vivo study is made difficult due to the insensitivity of MRI to this type of lesion. The spatial resolution and contrast mechanisms available at 7T appears to be advantageous in the detection and delineation of these lesions, suggesting that it will be a useful tool in the study of cortical pathology.

 

13:30         3444.     3T Sodium MRI of Patients with Multiple Sclerosis

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Guillaume Madelin1, Niels Oesingmann2, Sonia Nielles-Vallespin3, Joseph Herbert1, Glyn Johnson1, Matilde Inglese1

1New York University, New York, New York, USA; 2Siemens Medical Solutions, New York, New York, USA; 3AG Siemens Medical Solutions, Erlangen, Germany

Axonal degeneration occurs from the onset of multiple sclerosis (MS) and it is thought to be a significant cause of disability. Several studies have shown that the accumulation of sodium in the axons can promote degeneration. Sodium MRI provides an indicator of cellular and metabolic integrity and has been applied to the study of patients with brain tumors and stroke. The aim of this study was to demonstrate the feasibility of performing sodium MRI of the brain in patients with MS and to report preliminary results of the changes of tissue sodium concentration in MRI-visible lesions and normal-appearing white matter.

 

14:00         3445.     Definition and Classification of Registration Artifact (“Yin Yang” Artifact) on MR Subtraction Imaging in Multiple Sclerosis (MS): A Pilot Study

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Yang Duan1,2, Mehu P. Sampat1, Peter G. Hildenbrand1, David F. Tate1, Yi Tang1, Annika M. Berger1, Dominik S. Meier1, Charles R.G. Guttmann R.G Guttmann1

1Brigham and Women’s Hospital Harvard Medical School, Boston, Massachusetts, USA; 2The First Hospital, China Medical School, Shenyang, People's Republic of China

We analyzed YYA based on the underlying registration mechanism, to facilitate in understanding of the their causes and accuracy in interpreting lesion progressions on subtraction images. Dual echo PD/T2 weighted MR images were acquired, co-registered, intensity normalized and subtracted. YYA is a counterpoised increase and decrease of signal changes around lesions on subtraction images. YYA was identified and classified into four subtypes by radiologists according to mis-registration orientation, corresponding to patients’ movement on right-left (I), anterior-posterior (II), cranial-caudal (III) and combined shifting dimension (IV) respectively. Type III and IV occurred more frequent than type II and I. 

  

14:30         3446.     Coarseness of MRI Texture in Acute Lesions Relates to Subsequent Recovery Activity in Multiple Sclerosis

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Yunyan Zhang1, Hongmei Zhu2, Joseph Ross Mitchell1, Luanne M. Metz1

1University of Calgary, Calgary, Canada; 2York University, Toronto, Canada

Texture property in new multiple sclerosis (MS) lesions were quantified on 1.5T T2-weighted MRI 2 months before and 8 months after the appearance of gadolinium-enhancement using the multiscale polar Stockwell transform (PST). Seven/12 lesions were persisting (T2 hyperintensity) and 5/12 were invisible (no hyperintensity) 8 months post-enhancement. Significantly higher coarse texture (low frequency) was observed in the persisting lesions than that in the invisible lesions in the pre-lesional NAWM, during acute phase, and at chronic phase (P<0.05). This preliminary study indicates that the PST analysis may be useful in predicting lesion recovery on conventional T2-weighted MRI in MS.

 

15:00         3447.     Betainterferon Treatment: Absolute Quantification of White Matter Metabolites in Patients with Multiple Sclerosis

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Olof Dahlqvist Leinhard1,2, Jacek Jaworski1, Maria Gustavsson1, Anders Tisell1, Dominique Gladigau1, Anne-Marie Landtblom1, Peter Lundberg1

1University of Linkoping, Linkoping, Sweden

Multiple sclerosis can be treated with immunomodulatory drugs that can decrease the number and severity of bouts and also slower disability-progress. The mechanism, however is not fully understood. In order to improve the assessment of changes in the brain metabolome using MRS, a method was developed that allows for absolute quantification of metabolites as NAA, Cho, myo-Ins, Cr, Lac, Glc etc. Proton-MRS spectroscopy was performed before and after more than two years of betainterferon treatment. We report a decrease of NAA, as a marker of neuronal status and an increase of myo-Inositol due to degradation in these treated patients.

 

Prion Disease & Neurodegenerative Disorders

Hall D                                   Tuesday 13:30-15:30                                                                                                                                             

13:30         3448.     Cytoarchitecture of Frontal Cerebral Cortex in Variant Creutzfeldt-Jakob Disease: Post Mortem MR Microscopy at 9.4 Tesla

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Harpreet Hyare1,2, Po-Wah So2, John S. Thornton1, Caroline Powell1, Harry Parkes1, Durrenajaf Siddique1, Steve Wroe1, Sebastian Brandner1, Tarek Yousry1

1Institute of Neurology, London, UK; 2MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London, UK

Ex vivo MRM at 9.4T can depict pathology characteristic of vCJD by demonstrating apparent loss of the normal intracortical laminations.  These observations will be increasingly relevant as high-field MRI systems with improved spatial resolution enter clinical practice, when in vivo assessment of the cerebral cortex may prove highly beneficial in the diagnosis and monitoring of vCJD

 

14:00         3449.     The Pulvinar Sign in Variant Creutzfeldt-Jakob Disease: Quantitative Diffusion-Weighted Imaging in Vivo at 1.5T and Ex Vivo at 9.4T with Histopathological Correlation

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Harpreet Hyare1,2, John S. Thornton1, Durrenajaf Siddique1, Laura Mancini1, Jager Rolf1, Steve Wroe1, Caroline Powell1, Sebastian Brandner1, Po-Wah So2, Tarek Yousry1

1Institute of Neurology, London, UK; 2MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London, UK

Despite the hyperintensity seen on DWI, in vivo pulvinar ADCs were increased in vCJD compared with controls, suggesting that this pulvinar hyperintensity is a T2 effect, while histological analysis demonstrated that gliosis in the pulvinar is likely to be the pathological substrate.  Correlations between ex vivo FA and histopathological scores were negative for spongiosis and positive for gliosis, suggesting the latter may reinforce the directional organization of the neuropil. Future studies will determine the value of in vivo DTI metrics as pathologically specific indices of disease severity in vCJD.

 

14:30         3450.     Influence of B Factor on ADC Sensitivity in Creutzfeldt-Jakob Disease

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Hedok Lee1, Andrew Degnan1, Chen Hoffmann2, Peter Barbara Kingsley3,4, Isak Prohovnik1

1Mount Sinai School of Medicine, New York, New York, USA; 2Chaim Sheba Medical Center, Israel; 3North Shore University Hospital, Manhasset, USA; 4New York University School of Medicine, New York, New York, USA

In this first rigorous test of the influence of b factor (1000 Vs 2000 s/mm^2) on the sensitivity of DWI to detect Creutzfeldt-Jakob disease, we scanned 13 CJD patients and 15 healthy relatives at both b levels, computed ADC, and quantitatively compared the results both in voxel-level (SPM5) and VOI (FSL) analyses.  The b=2000 data showed greater ADC reductions in patients compared to controls, and larger areas of statistically significant ADC reductions, especially in the thalamus and caudate nucleus.  The findings demonstrate that MRI can be more sensitive to reduced diffusivity in basal ganglia at b=2000 than at b=1000.

 

15:00         3451.     Global and Tissue-Specific Cerebral Magnetisation Transfer Ratios in Inherited Prion Disease: Correlation with Disease Severity

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Durrenajaf Siddique1,2, S Wroe1,2, H Hyare2, T Webb1,2, R Macfarlane1,2, J Collinge1,2, S Walker3, T Yousry4, JS Thornton4

1National Prion Clinic, National Hospital for Neurology and Neurosurgery, London, UK; 2Institute of Neurology, Queen Square, London, UK; 3Medical Research Council Clinical Trials Unit, London, UK; 4Lysholm Depar

Inherited prion diseases (IPD) are progressive neurodegenerative disorders, conventional MR neuroimaging often being unremarkable. Global and tissue-specific cerebral magnetisation transfer ratios (MTRs) were investigated in twenty-three patients, using MTR and conventional imaging. Whole-brain, white and grey matter histogram mean, peak height, peak location, and MTR at the 25th, 50th and 75th percentile were calculated, and  patients evaluated using videoed and non-videoed neurological rating scales. Significant (p<0.01) bivariate Spearman rank correlations were found between multiple histogram parameters and clinical scores, with a single pathological conventional MR. MTR histogram measures may provide valuable indices of IPD disease severity for future therapeutic trials.

 

13:30         3452.     Postmortem Magnetisation Transfer Ratio in Human Prion Diseases at 1.5T and Histopathological Correlation at 9.4T

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Durrenajaf Siddique1, Harpreet Hyare1, Steve Wroe1, John Collinge1, Caroline Powell1, Sebastian Brandner1, Po-Wah So2, Tarek Yousry1, John S. Thornton1

1Institute of Neurology, London, UK; 2MRC Clinical Sciences Centre, Hammersmith Hospital, Imperial College London, London, UK

We have shown for the first time that, ex vivo, MTR is lower in cortical and deep grey matter, but not white matter, in patients with prion disease compared to controls, presumably reflecting an increase in the fraction of free-to-bound water. In targeted high-resolution MTR measurements we have also shown that cortical MTR correlated negatively with increasing spongiosis, a histopathological feature unique to prion disease.  The major advantage of post mortem quantitative MRI is the possibility of direct comparison with histology; our results suggest that MTR may provide a useful in vivo surrogate marker for pathology in human prion disease.

 

14:00         3453.     Abnormal Connectivity Pattern of Fronto-Striatal-Thalamic Circuits of Patients with Tourette Syndrome Based on Probabilistic Tractography

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Rajkumar Munian Govindan1, Malek Makki1, Michael Behen1, Harry T. Chugani1

1Wayne State University, Detroit, Michigan, USA

Volumetric and functional imaging studies of individuals with Tourette Syndrome (TS) have revealed regional abnormalities typically in structures comprising the fronto-striato-thalamic circuit.  However, few studies have evaluated connectivity between the components of this circuit.  With diffusion tensor imaging (DTI) and probabilisitic tractography, it is now possible to evaluate white matter integrity.  We used DTI tractography to evaluate fronto-striatal and fronto-thalamic connectivity in children with TS as compared to age and gender matched healthy controls.  Results showed decreased connectivity in fronto-striatal and fronto-thalamic pathways of TS group, which provides further support for the involvement of the fronto-striato-thalamic circuit in TS.

 

14:30         3454.     Combined 31P and 1H-MRS Study on Brain Energy Metabolism in Progressive Supranuclear Palsy (PSP)

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Ulrich Pilatus1, Maria Stamelou, Jörg Magerkurth1, P Niklowitz, A Reuss, K M. Eggert, C Schade-Brittinger, W Oertel, Heiner Lanfermann1, G U. Höglinger

1Johann Wolfgang Goethe-Universität, Frankfurt, Germany

Progressive Supranuclear Palsy (PSP) is a sporadic neurodegenerative disorder. In vivo MRS using either 31P  or 1H  nuclei disclosed significant metabolic differences between patients and age-matched normal controls. This study was aimed at exploiting the full potential of combined 31P and 1H MRS to thoroughly specify parameters for energy metabolism and neuronal damage.

 

No significant differences were detected for 1H detectable metabolites total creatine (tCr) and N-acetylaspartate (tNAA).  However, 31P MRS showed a significant decrease of inorganic phosphate (Pi), phosphocreatine (PCr), and ATP in the basal ganglia while in the occipital cortex only ATP was reduced. Lactate was never detected in controls but in approximately 20% of the patients. Calculation of ADP and the phosphorylation potential (PP) using standard equilibrium constant for creatine kinase  yielded no differences between patients and controls. This indicates that reduced mitochondrial activity is compensated by reduction of ATP and inorganic phosphate leaving the PP constant, which may account for the rather mild decrease in tNAA. The decrease of phosphometabolites like ATP and Pi should be a marker of the severity of the disease and potential effects of treatment.

 

15:00         3455.     Adults with Significant Childhood Lead Exposure Evaluated with Proton MR Spectroscopy

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Kim M. Cecil1, Kim N. Dietrich2, Mekibib Altaye1, John C. Egelhoff1, Stephanie D. Wessel2, Bruce P. Lanphear1

1Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA; 2University of Cincinnati, Cincinnati, Ohio, USA

We hypothesized that adults with childhood lead exposure would demonstrate evidence of irreversibly altered neural metabolism. Participants (N=159) of a longitudinal birth cohort studying the effects of lead exposure completed a quantitative, short echo spectroscopy protocol evaluating seven brain regions. Higher mean childhood blood lead levels were associated with reduced metabolite concentrations upon adjusting for age at time of imaging and full scale intelligence quotient. Gray matter reductions of N-acetyl aspartate are consistent with the concept that sustained childhood lead exposure results an irreversible, pattern of injury consistent with an insult from childhood. White matter choline changes suggest an alteration to the myelin structure. These neural alterations may be responsible for the cognitive and behavioral changes attributed to lead exposure.

 

Pediatric Brain: DTI, Structural

Hall D                                   Tuesday 13:30-15:30                                                                                                                                             

13:30         3456.     Application of a Fast High Resolution Whole Brain MRI for Segmentation

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Ying Wu1,2, Dunkle Eugene1, Andres Carrillo1, Ann Ragin2, Robert Edelman1,2

1Evanston Northwestern Healthcare, Evanston, Illinois, USA; 2Northwestern University, Chicago, Illinois, USA

MRI segmentation and visualization have gained increasing importance

 both in research and clinical applications.  The conventional MR sequence, FSPGR (or MP-RAGE), has been widely utilized in MR segmentation and in clinical fMRI because its contrast behavior is suitable for segmentation and this sequence can provide thin slice whole brain coverage.  In this investigation, we present a fast whole brain high resolution MR technique, EZ Step (EZ).  Images generated with the sub-milliliter isotropic EZ Step sequence have similar GM/WM contrast behavior as FSPGR.  Available automated segmentation utilities, such as FSL and Freesurfer, can be adapted for EZ.  Moreover, EZ has higher CNR than FSPGR in basal ganglia and other clinically significant regions of interest.EZ can also be used to derive superior quality brain volume rendering for fMRI applications, while reducing data acquisition scan time of current clinical routines by 40%.

 

 

14:00         3457.     Regionally Specific Cortical Thinning in Paediatric Sickle Cell Disease [Not Available]

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Richard Alan Jones1,2, Gregory Kirk3, Michael Ryan Haynes4, Susan Palasis5, Clark Brown6

1Children's Healthcare of Atlanta, Atlanta, Georgia, USA; 2Emory University, Atlanta, Georgia, USA; 3Children's Healthcare of Atlanta, Atlanta, USA; 4Georgia Institute of Technology, Atlanta, USA; 5Ch

Cortical thickness was compared in control and sickle cell paediatric subjects using Freesurfer. The groups were split into two components by age; The first group consisted of all subjects< 12 years of age, and the second group all subjects >=12 years of age. Separate group analyses were performed on each of the two groups. In the younger group relatively few differences were found, while in the older group more extensive areas of bilateral thinning were found in the sickle cell subjects, suggesting that their gray matter is abnormal and that the amount of thinning is age dependent.

 

14:30         3458.     Treatment-Induced Plasticity in Central Motor Pathways in Cerebral Palsy: Diffusion Tensor Imaging

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Rakesh K. Gupta1, Richa Trivedi1, Vipul Shah, Mukesh Tripathi1, Ram KS Rathore2, Manoj Kumar1, Ponnada A. Narayana3

1Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; 2Indian Institute of Technology, Kanpur, India; 3University of Texas Medical School at Houston, Houston, USA

Serial diffusion tensor imaging (DTI) was performed on eight pediatric patients with cerebral palsy (CP) at the time of diagnosis and after 6 months of botulinum treatment followed by intensive physiotherapy. Region of interests were placed on corticospinal tracts at the level of corona radiate (CR), posterior limb of internal capsule (PLIC), mid brain (MB), pons, and medulla in patients as well as controls. On 6 month follow-up significantly increased FA values were observed in CST at the level of CR, PLIC, and MB compared to baseline study. The observed increase in FA along with improved clinical motor score suggests plasticity of the central motor pathway following the combined therapy.

 

15:00         3459.     Correlation of Brain Diffusion Tensor Imaging Metrics with Cognitive Functions in Patients of Spina Bifida Cystica

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Manoj Kumar1, Rakesh Kumar Gupta1, Mazhar Husain2, Sanjay Behari1, Gyanendra K. Malik2, S N. Kureel2, Richa Trivedi1, Ram Kishore Singh Rathore3

1Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India; 2CSMM University, Lucknow, India; 3Indian Institute of Technology, Kanpur, India

Neural tube defect during early pregnancy affects the normal brain development and leads to deficits in cognitive functions and memory. DTI and battery of neuropsychological test (NPT) were performed in 19 SBC patients and controls.  ROIs were placed in different region of th