Kesenheimer Eva M, Wendebourg Maria Janina, Weigel Matthias, Weidensteiner Claudia, Haas Tanja, Richter Laura, Sander Laura, Horvath Antal, Barakovic Muhamed, Cattin Philippe, Granziera Cristina, Bieri Oliver, Schlaeger Regina
Neurologic Clinic and Policlinic, University Hospital Basel, Basel, Switzerland.
Department of Clinical Research, University of Basel, Basel, Switzerland.
Front Neurol. 2021 Mar 25;12:637198. doi: 10.3389/fneur.2021.637198. eCollection 2021.
MR imaging of the spinal cord (SC) gray matter (GM) at the cervical and lumbar enlargements' level may be particularly informative in lower motor neuron disorders, e. g., spinal muscular atrophy, but also in other neurodegenerative or autoimmune diseases affecting the SC. Radially sampled averaged magnetization inversion recovery acquisition (rAMIRA) is a novel approach to perform SC imaging in clinical settings with favorable contrast and is well-suited for SC GM quantitation. However, before applying rAMIRA in clinical studies, it is important to understand (i) the sources of inter-subject variability of total SC cross-sectional areas (TCA) and GM area (GMA) measurements in healthy subjects and (ii) their relation to age and sex to facilitate the detection of pathology-associated changes. In this study, we aimed to develop normalization strategies for rAMIRA-derived SC metrics using skull and spine-based metrics to reduce anatomical variability. Sixty-one healthy subjects (age range 11-93 years, 37.7% women) were investigated with axial two-dimensional rAMIRA imaging at 3T MRI. Cervical and thoracic levels including the level of the cervical (C4/C5) and lumbar enlargements (T) were examined. SC T2-weighted sagittal images and high-resolution 3D whole-brain T1-weighted images were acquired. TCA and GMAs were quantified. Anatomical variables with associations of || > 0.30 in univariate association with SC areas, and age and sex were used to construct normalization models using backward selection with TCA as outcome. The effect of the normalization was assessed by % relative standard deviation (RSD) reductions. Mean inter-individual variability and the SD of the SC area metrics were considerable: TCA: 8.1%/9.0; TCA: 8.9%/6.5; GMA: 8.6%/2.2; GMA: 12.2%/3.8. Normalization based on sex, brain WM volume, and spinal canal area resulted in RSD reductions of 23.7% for TCAs and 12.0% for GM areas at C4/C5. Normalizations based on the area of spinal canal alone resulted in RSD reductions of 10.2% for TCAs and 9.6% for GM areas at C4/C5, respectively. Anatomic inter-individual variability of SC areas is substantial. This study identified effective normalization models for inter-subject variability reduction in TCA and SC GMA in healthy subjects based on rAMIRA imaging.
在颈膨大及腰膨大水平对脊髓灰质进行磁共振成像,在诸如脊髓性肌萎缩等下运动神经元疾病中可能具有特别的诊断价值,在其他影响脊髓的神经退行性疾病或自身免疫性疾病中亦是如此。径向采样平均磁化反转恢复采集(rAMIRA)是一种在临床环境中进行脊髓成像的新方法,具有良好的对比度,非常适合脊髓灰质定量分析。然而,在将rAMIRA应用于临床研究之前,了解以下两点很重要:(i)健康受试者中脊髓总横截面积(TCA)和灰质面积(GMA)测量的个体间变异性来源;(ii)它们与年龄和性别的关系,以便于检测与病理相关的变化。在本研究中,我们旨在利用基于颅骨和脊柱的指标为rAMIRA衍生的脊髓指标制定标准化策略,以减少解剖学变异性。对61名健康受试者(年龄范围11 - 93岁,37.7%为女性)进行了3T磁共振成像的轴向二维rAMIRA成像检查。检查了包括颈膨大(C4/C5)和腰膨大(T)水平在内的颈段和胸段。采集了脊髓T2加权矢状位图像和高分辨率3D全脑T1加权图像。对TCA和GMA进行了定量分析。在单变量分析中与脊髓面积、年龄和性别相关性|| > 0.30的解剖学变量被用于构建以TCA为结果的反向选择标准化模型。通过相对标准偏差(RSD)降低百分比来评估标准化的效果。脊髓面积指标的个体间平均变异性和标准差相当可观:TCA:8.1%/9.0;TCA:8.9%/6.5;GMA:8.6%/2.2;GMA:12.2%/3.8。基于性别、脑白质体积和椎管面积的标准化使C4/C5水平的TCA的RSD降低了23.7%,GMA的RSD降低了12.0%。仅基于椎管面积的标准化分别使C4/C5水平的TCA的RSD降低了10.2%,GMA的RSD降低了9.6%。脊髓面积的解剖学个体间变异性很大。本研究基于rAMIRA成像确定了有效减少健康受试者TCA和脊髓GMA个体间变异性的标准化模型。
AJNR Am J Neuroradiol. 2019-8-22
Imaging Neurosci (Camb). 2024-2-2
Front Neuroimaging. 2022-11-2
J Neuroimaging. 2020-9
AJNR Am J Neuroradiol. 2019-8-22
Curr Treat Options Neurol. 2019-4-29
J Neuroimaging. 2018-8-13
Magn Reson Med. 2017-7-16
Neuroimage. 2017-5-15