Institute for Stroke and Cerebrovascular Diseases and Department of Neurology, McGovern Medical School, The University of Texas Health Science Center, 6431 Fannin Street, Houston, TX, 77030, USA.
Department of Neurology, Neurohospitalist and Stroke Section, University of Colorado School of Medicine, Aurora, USA.
Transl Stroke Res. 2024 Oct;15(5):893-901. doi: 10.1007/s12975-023-01168-y. Epub 2023 Jun 13.
Deep intracerebral hemorrhage (ICH) exerts a direct force on corticospinal tracts (CST) causing shape deformation. Using serial MRI, Generalized Procrustes Analysis (GPA), and Principal Components Analysis (PCA), we temporally evaluated the change in CST shape. Thirty-five deep ICH patients with ipsilesional-CST deformation were serially imaged on a 3T-MRI with a median imaging time of day-2 and 84 of onset. Anatomical and diffusion tensor images (DTI) were acquired. Using DTI color-coded maps, 15 landmarks were drawn on each CST and the centroids were computed in 3 dimensions. The contralesional-CST landmarks were used as a reference. The GPA outlined the shape coordinates and we superimposed the ipsilesional-CST shape at the two-time points. A multivariate PCA was applied to identify eigenvectors associated with the highest percentile of change. The first three principal components representing CST deformation along the left-right (PC1), anterior-posterior (PC2), and superior-inferior (PC3) respectively were responsible for 57.9% of shape variance. The PC1 (36.1%, p < 0.0001) and PC3 (9.58%, p < 0.01) showed a significant deformation between the two-time points. Compared to the contralesional-CST, the ipsilesional PC scores were significantly (p < 0.0001) different only at the first-timepoint. A significant positive association between the ipsilesional-CST deformation and hematoma volume was observed. We present a novel method to quantify CST deformation caused by ICH. Deformation most often occurs in left-right axis (PC1) and superior-inferior (PC3) directions. As compared to the reference, the significant temporal difference at the first time point suggests CST restoration over time.
脑深部出血（ICH）直接作用于皮质脊髓束（CST）导致形状变形。我们使用连续 MRI、广义 Procrustes 分析（GPA）和主成分分析（PCA），从时间上评估 CST 形状的变化。35 例同侧 CST 变形的深部 ICH 患者在 3T-MRI 上进行连续成像，中位成像时间为发病后第 2 天和 84 天。采集解剖和弥散张量图像（DTI）。使用 DTI 彩色编码图，在每个 CST 上绘制 15 个地标，并在 3 个维度上计算质心。将对侧 CST 地标用作参考。GPA 概述了形状坐标，我们将同侧 CST 形状叠加在两个时间点。应用多元 PCA 以识别与变化最高百分比相关的特征向量。代表 CST 沿左右（PC1）、前后（PC2）和上下（PC3）方向变形的前三个主成分分别占形状方差的 57.9%。PC1（36.1%，p<0.0001）和 PC3（9.58%，p<0.01）在两个时间点之间显示出明显的变形。与对侧 CST 相比，同侧 PC 评分仅在第一个时间点（p<0.0001）显著不同。同侧 CST 变形与血肿体积之间存在显著的正相关关系。我们提出了一种量化 ICH 引起的 CST 变形的新方法。变形最常发生在左右轴（PC1）和上下（PC3）方向。与参考相比，第一个时间点的显著时间差异表明 CST 随时间恢复。
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