Engström Maria, Warntjes Jan B M, Tisell Anders, Landtblom Anne-Marie, Lundberg Peter
Division of Radiology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden; Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; SyntheticMR AB, Linköping, Sweden.
PLoS One. 2014 Nov 13;9(11):e111688. doi: 10.1371/journal.pone.0111688. eCollection 2014.
The aim of the study was to explore the possibilities of multi-parametric representations of voxel-wise quantitative MRI data to objectively discriminate pathological cerebral tissue in patients with brain disorders. For this purpose, we recruited 19 patients with Multiple Sclerosis (MS) as benchmark samples and 19 age and gender matched healthy subjects as a reference group. The subjects were examined using quantitative Magnetic Resonance Imaging (MRI) measuring the tissue structure parameters: relaxation rates, R(1) and R(2), and proton density. The resulting parameter images were normalized to a standard template. Tissue structure in MS patients was assessed by voxel-wise comparisons with the reference group and with correlation to a clinical measure, the Expanded Disability Status Scale (EDSS). The results were visualized by conventional geometric representations and also by multi-parametric representations. Data showed that MS patients had lower R(1) and R(2), and higher proton density in periventricular white matter and in wide-spread areas encompassing central and sub-cortical white matter structures. MS-related tissue abnormality was highlighted in posterior white matter whereas EDSS correlation appeared especially in the frontal cortex. The multi-parameter representation highlighted disease-specific features. In conclusion, the proposed method has the potential to visualize both high-probability focal anomalies and diffuse tissue changes. Results from voxel-based statistical analysis, as exemplified in the present work, may guide radiologists where in the image to inspect for signs of disease. Future clinical studies must validate the usability of the method in clinical practice.
本研究的目的是探索体素级定量MRI数据的多参数表示方法,以客观鉴别脑部疾病患者的病理性脑组织。为此,我们招募了19例多发性硬化症(MS)患者作为基准样本,并选取了19例年龄和性别匹配的健康受试者作为参照组。使用定量磁共振成像(MRI)对受试者进行检查,测量组织结构参数:弛豫率R(1)和R(2)以及质子密度。将所得的参数图像归一化到一个标准模板。通过与参照组进行体素级比较,并与临床指标扩展残疾状态量表(EDSS)相关联,对MS患者的组织结构进行评估。结果通过传统的几何表示法以及多参数表示法进行可视化。数据显示,MS患者脑室周围白质以及包括中央和皮质下白质结构的广泛区域中,R(1)和R(2)较低,质子密度较高。MS相关的组织异常在后部白质中较为突出,而EDSS相关性尤其出现在额叶皮质。多参数表示法突出了疾病特异性特征。总之,所提出的方法有潜力可视化高概率的局灶性异常和弥漫性组织变化。如本研究所示,基于体素的统计分析结果可能会指导放射科医生在图像中的何处检查疾病迹象。未来的临床研究必须验证该方法在临床实践中的可用性。