Diffusion Kurtosis Imaging of Leptin Intervention in Early Hypoxic-Ischemic Brain Edema.
He Xiaoning,Xiao Juan,Tian Juan,Chen Honghai,Liu Jing,Yang Chao
Neuroscience
The role of leptin in neuroprotection has recently been recognized. However, there are few reports on the use of imaging methods to dynamically evaluate the neuroprotection role of leptin. Diffusion kurtosis imaging (DKI), which is a method used to measure non-Gaussian water diffusion, can reflect the real water diffusion in brain tissues. In this study, a newborn piglet model was used to dynamically evaluate the leptin intervention in early hypoxic-ischemic brain edema via DKI. Thirty-two Yorkshire newborn piglets were divided into three groups: the hypoxic-ischemic encephalopathy (HIE) group, the leptin group, and the control group. DKI scanning was performed at time points of 3, 6, 9, 12, 16, and 24 h after hypoxic-ischemic exposure. After scanning, arterial blood was extracted from all piglets to measure NSE and S100β levels. Then, the brain was completely extracted for pathological examination. In the lesion areas, the MK, Ka, and Kr values in the leptin group were significantly lower than those in the HIE group, the MD, Da, and Dr values showed an opposite trend. The lesion areas in the leptin group were smaller than those of in the HIE group. In addition, the pathological results showed that less cell and organelle injury occurred in the leptin group. Our findings indicate that leptin can effectively reduce hypoxic-ischemic brain edema, and DKI can be more sensitive than conventional diffusivity metrics for visualizing the microstructural changes of HIE. This provides a new clue for the treatment and evaluation of HIE.
10.1016/j.neuroscience.2020.02.009
Mapping white matter maturational processes and degrees on neonates by diffusion kurtosis imaging with multiparametric analysis.
Li Xianjun,Li Mengxuan,Wang Miaomiao,Wu Fan,Liu Heng,Sun Qinli,Zhang Yuli,Liu Congcong,Jin Chao,Yang Jian
Human brain mapping
White matter maturation has been characterized by diffusion tensor (DT) metrics. However, maturational processes and degrees are not fully investigated due to limitations of univariate approaches and limited specificity/sensitivity. Diffusion kurtosis imaging (DKI) provides kurtosis tensor (KT) and white matter tract integrity (WMTI) metrics, besides DT metrics. Therefore, we tried to investigate performances of DKI with the multiparametric analysis in characterizing white matter maturation. Developmental changes in metrics were investigated by using tract-based spatial statistics and the region of interest analysis on 50 neonates with postmenstrual age (PMA) from 37.43 to 43.57 weeks. Changes in metrics were combined into various patterns to reveal different maturational processes. Mahalanobis distance based on DT metrics (D ) and that combing DT and KT metrics (D ) were computed, separately. Performances of D and D were compared in revealing correlations with PMA and the neurobehavioral score. Compared with DT metrics, WMTI metrics demonstrated additional changing patterns. Furthermore, variations of D across regions were in agreement with the maturational sequence. Additionally, D demonstrated stronger negative correlations with PMA and the neurobehavioral score in more regions than D . Results suggest that DKI with the multiparametric analysis benefits the understanding of white matter maturational processes and degrees on neonates.
10.1002/hbm.25689
Diffusion kurtosis imaging and diffusion weighted imaging comparison in diagnosis of early hypoxic-ischemic brain edema.
European journal of medical research
BACKGROUND:Hypoxic-ischemic encephalopathy (HIE) refers to cerebral hypoxic-ischemic injury caused by asphyxia during perinatal period, which is one of the important causes of neonatal death and sequelae. Early and accurate diagnosis of HIE is of great significance for the prognostic evaluation of patients. The purpose of this study is to explore the efficacy of diffusion-kurtosis imaging (DKI) and diffusion-weighted imaging (DWI) in the diagnosis of early HIE. METHODS:Twenty Yorkshire newborn piglets (3-5 days) were randomly divided into control group and experimental group. DWI and DKI scanning were performed at timepoints of 3, 6, 9, 12, 16, and 24 h after hypoxic-ischemic exposure. At each timepoint, the parameter values obtained by each group scan were measured, and the lesion area of the apparent diffusion coefficient (ADC) map and mean diffusion coefficient (MDC) map were measured. (For better interpretation of this study, we replaced the description of MD with MDC). Then, we completely removed the brain for pathological examination, and observed the state of cells and mitochondria in the ADC/MDC matching area (the actual area of the lesion), and the mismatch area (the area around the lesion). RESULTS:In the experimental group, the ADC and MDC values decreased with time, but the MDC decreased more significantly and the change rate was higher. Both MDC and ADC values changed rapidly from 3 to 12 h and slowly from 12 to 24 h. The MDC and ADC images showed obvious lesions at 3 h for the first time. At this time, the area of ADC lesions was larger than that of MDC. As the lesions developed, the area of ADC maps was always larger than that of the MDC maps within 24 h. By observing the microstructure of the tissues by light microscopy, we found that the ADC and MDC matching area in the experimental group showed swelling of neurons, infiltration of inflammatory cells, and local necrotic lesions. Consistent with the observation under light microscope, pathological changes were observed in the matching ADC and MDC regions under electron microscopy as well, including collapse of mitochondrial membrane, fracture of partial mitochondrial ridge, and emergence of autophagosomes. In the mismatching region, the above pathological changes were not observed in the corresponding region of the ADC map. CONCLUSIONS:DKI's characteristic parameter MDC is better than ADC (parameter of DWI) to reflect the real area of the lesion. Therefore, DKI is superior to DWI in diagnosing early HIE.
10.1186/s40001-023-01090-x
Magnetic Resonance Image of Neonatal Acute Bilirubin Encephalopathy: A Diffusion Kurtosis Imaging Study.
Zheng Hongyi,Lin Jiefen,Lin Qihuan,Zheng Wenbin
Frontiers in neurology
The abnormal T1-weighted imaging of MRI can be used to characterize neonatal acute bilirubin encephalopathy (ABE) in newborns, but has limited use in evaluating the severity and prognosis of ABE. This study aims to assess the value of diffusion kurtosis imaging (DKI) in detecting ABE and understanding its pathogenesis. Seventy-six newborns with hyperbilirubinemia were grouped into three groups (mild group, moderate group, and severe group) based on serum bilirubin levels. All the patients underwent conventional MRI and DKI serial, as well as 40 healthy full-term infants (control group). The regions of interest (ROIs) were the bilateral globus pallidus, dorsal thalamus, frontal lobe, auditory radiation, superior temporal gyrus, substantia nigra, hippocampus, putamen, and inferior olivary nucleus. The values of mean diffusivity (MD), axial kurtosis (AK), radial kurtosis (RK), and mean kurtosis (MK), and fractional anisotropy (FA), radial diffusivity (RD), and axis diffusivity (AD) of the ROIs were evaluated. All newborns were followed up and evaluated using the Denver Development Screening Test (DDST). According to the follow-up results, the patients were divided into the normal group, the suspicious abnormal group, and the abnormal group. Compared with the control group, significant differences were observed with the increased MK of dorsal thalamus, AD of globus pallidus in the moderate group, and increased RD, MK, AK, and RK value of globus pallidus, dorsal thalamus, auditory radiation, superior temporal gyrus, and hippocampus in the severe group. The peak value of total serum bilirubin was moderately correlated with the MK of globus pallidus, dorsal thalamus, and auditory radiation and was positively correlated with the other kurtosis value. Out of 76 patients, 40 finished the DDST, and only 9 patients showed an abnormality. Compared with the normal group, the AK value of inferior olivary nucleus showed significant differences ( < 0.05) in the suspicious abnormal group, and the MK of globus pallidus, temporal gyrus, and auditory radiation; RK of globus pallidus, dorsal thalamus, and auditory radiation; and MD of globus pallidus showed significant differences ( < 0.05) in the abnormal group. DKI can reflect the subtle structural changes of neonatal ABE, and MK is a sensitive indicator to indicate the severity of brain damage.
10.3389/fneur.2021.645534
Differential cortical microstructural maturation in the preterm human brain with diffusion kurtosis and tensor imaging.
Ouyang Minhui,Jeon Tina,Sotiras Aristeidis,Peng Qinmu,Mishra Virendra,Halovanic Cathy,Chen Min,Chalak Lina,Rollins Nancy,Roberts Timothy P L,Davatzikos Christos,Huang Hao
Proceedings of the National Academy of Sciences of the United States of America
During the third trimester, the human brain undergoes rapid cellular and molecular processes that reshape the structural architecture of the cerebral cortex. Knowledge of cortical differentiation obtained predominantly from histological studies is limited in localized and small cortical regions. How cortical microstructure is differentiated across cortical regions in this critical period is unknown. In this study, the cortical microstructural architecture across the entire cortex was delineated with non-Gaussian diffusion kurtosis imaging as well as conventional diffusion tensor imaging of 89 preterm neonates aged 31-42 postmenstrual weeks. The temporal changes of cortical mean kurtosis (MK) or fractional anisotropy (FA) were heterogeneous across the cortical regions. Cortical MK decreases were observed throughout the studied age period, while cortical FA decrease reached its plateau around 37 weeks. More rapid decreases in MK were found in the primary visual region, while faster FA declines were observed in the prefrontal cortex. We found that distinctive cortical microstructural changes were coupled with microstructural maturation of associated white matter tracts. Both cortical MK and FA measurements predicted the postmenstrual age of preterm infants accurately. This study revealed a differential 4D spatiotemporal cytoarchitectural signature inferred by non-Gaussian diffusion barriers inside the cortical plate during the third trimester. The cytoarchitectural processes, including dendritic arborization and neuronal density decreases, were inferred by regional cortical FA and MK measurements. The presented findings suggest that cortical MK and FA measurements could be used as effective imaging markers for cortical microstructural changes in typical and potentially atypical brain development.
10.1073/pnas.1812156116
Differentiating T2 hyperintensity in neonatal white matter by two-compartment model of diffusional kurtosis imaging.
Gao Jie,Li Xianjun,Li Yanyan,Zeng Lingxia,Jin Chao,Sun Qinli,Xu Duan,Yu Bolang,Yang Jian
Scientific reports
In conventional neonatal MRI, the T2 hyperintensity (T2h) in cerebral white matter (WM) at term-equivalent age due to immaturity or impairment is still difficult to identify. To clarify such issue, this study used the metrics derived from a two-compartment WM model of diffusional kurtosis imaging (WM-DKI), including intra-axonal, extra-axonal axial and radial diffusivities (Da, De,// and De,⊥), to compare WM differences between the simple T2h and normal control for both preterm and full-term neonates, and between simple T2h and complex T2h with hypoxic-ischemic encephalopathy (HIE). Results indicated that compared with control, the simple T2h showed significantly increased De,// and De,⊥, but no significant change in Da in multiple premyelination regions, indicative of expanding extra-axonal diffusion microenvironment; while myelinated regions showed no changes. However, compared with simple T2h, the complex T2h with HIE had decreased Da, increased De,⊥ in both premyelination and myelinated regions, indicative of both intra- and extra-axonal diffusion alterations. While diffusion tensor imaging (DTI) failed to distinguish simple T2h from complex T2h with HIE. In conclusion, superior to DTI-metrics, WM-DKI metrics showed more specificity for WM microstructural changes to distinguish simple T2h from complex T2h with HIE.
10.1038/srep24473
Initial Application of Diffusional Kurtosis Imaging in Evaluating Brain Development of Healthy Preterm Infants.
Shi Jingjing,Chang Liwen,Wang Jian,Zhang Shun,Yao Yihao,Zhang Shuixia,Jiang Rifeng,Guo Linying,Guan Hanxiong,Zhu Wenzhen
PloS one
OBJECTIVE:To explore the parametric characteristics of diffusional kurtosis imaging (DKI) in the brain development of healthy preterm infants. MATERIALS AND METHODS:Conventional magnetic resonance imaging (MRI) and DKI were performed in 35 preterm (29 to 36 weeks gestational age [GA]; scanned at 33 to 44 weeks postmenstrual age [PMA]) and 10 term infants (37.4 to 40.7 weeks GA; scanned at 38.3 to 42.9 weeks PMA). Fractional anisotropy (FA), mean diffusivity (MD) and mean kurtosis (MK) values from 8 regions of interest, including both white matter (WM) and gray matter (GM), were obtained. RESULTS:MK and FA values were positively correlated with PMA in most selected WM regions, such as the posterior limbs of the internal capsule (PLIC) and the splenium of the corpus callosum (SCC). The positive correlation between MK value and PMA in the deep GM region was higher than that between FA and PMA. The MK value gradually decreased from the PLIC to the cerebral lobe. In addition, DKI parameters exhibited subtle differences in the parietal WM between the preterm and term control groups. CONCLUSIONS:MK may serve as a more reliable imaging marker of the normal myelination process and provide a more robust characterization of deep GM maturation.
10.1371/journal.pone.0154146
Microstructural changes of white matter assessed with diffusional kurtosis imaging in extremely preterm infants with severe intraventricular hemorrhage.
Frontiers in pediatrics
Objective:Intraventricular hemorrhage (IVH) is a serious neurological complication in premature infants. This study aimed to investigate the white matter impairments and neurodevelopmental outcomes of severe IVH in extremely preterm infants with gestation age less than 28 weeks. Methods:We retrospectively evaluated the extremely preterm infants between 2017 and 2020. Neurodevelopmental outcomes were evaluated with the Bayley Scales of Infant and Toddler Development-III at 2 years of corrected age. Diffusional kurtosis imaging (DKI) was employed to evaluate the microstructural changes in white matter tracts. Mean kurtosis (MK) and fractional anisotropy (FA) values of DKI were measured in the brain regions including posterior limbs of the internal capsule (PLIC) and the corpus callosum at term equivalent age. Results:Of 32 extremely preterm infants with severe IVH during the follow-up period, 18 cases were identified as neurodevelopmental impairments. The delay rates of motor and language were 58.4% and 52.7%. The cases with neurodevelopmental impairments had lower MK and FA values in both bilateral PLIC and the corpus callosum. The analysis of multivariable regression models predicting motor and language outcomes at 2 years of corrected age, showed that the decreases of MK values in both PLIC and the corpus callosum at the term equivalent age contributed to a significantly increased risk of neurodevelopmental impairments (all < 0.05). During follow-up period, obvious loss of nerve fiber bundles was observed with DKI tractography. Conclusion:Motor and language abilities at age 2 years were associated with MK values of DKI at the term equivalent age in both PLIC and the corpus callosum of extremely preterm infants with severe IVH. The evaluation of white matter microstructural changes with MK values might provide feasible indicators of neurodevelopmental outcomes of extremely preterm infants with severe intraventricular hemorrhage.
10.3389/fped.2022.1054443
Assessment of brain structure and volume reveals neurodevelopmental abnormalities in preterm infants with low-grade intraventricular hemorrhage.
Scientific reports
There is increasing evidence of abnormal neurodevelopmental outcomes in preterm infants with low-grade intraventricular hemorrhage (IVH). The purpose of the study was to explore whether brain microstructure and volume are associated with neuro-behavioral outcomes at 40 weeks corrected gestational age in preterm infants with low-grade IVH. MR imaging at term-equivalent age (TEA) was performed in 25 preterm infants with mild IVH (Papile grading I/II) and 40 control subjects without IVH. These subjects all had neonatal behavioral neurological assessment (NBNA) at 40 weeks' corrected age. Microstructure and volume evaluation of the brain were performed by using diffusion kurtosis imaging (DKI) and Synthetic MRI. Correlations among microstructure parameters, volume, and developmental outcomes were explored by using Spearman's correlation. In preterm infants with low-grade IVH, the volume of brain parenchymal fraction (BPF) was reduced. In addition, mean kurtosis (MK), fractional anisotropy (FA), radial kurtosis (RK), axial kurtosis (AK) in several major brain regions were reduced, while mean diffusivity (MD) was increased (P < 0.05). BPF, RK in the cerebellum, MK in the genu of the corpus callosum, and MK in the thalamus of preterm infants with low-grade IVH were associated with lower NBNA scores (r = 0.831, 0.836, 0.728, 0.772, P < 0.05). DKI and Synthetic MRI can quantitatively evaluate the microstructure alterations and brain volumes in preterm infants with low-grade IVH, which provides clinicians with a more comprehensive and accurate neurobehavioral assessment of preterm infants with low-grade IVH.
10.1038/s41598-024-56148-5
The Value of Diffusion Kurtosis Imaging in Detecting Delayed Brain Development of Premature Infants.
Zhao Xin,Zhang Chunxiang,Zhang Bohao,Yan Jiayue,Wang Kaiyu,Zhu Zitao,Zhang Xiaoan
Frontiers in neurology
Preterm infants are at high risk of the adverse neurodevelopmental outcomes. Our aim is to explore the value of diffusion kurtosis imaging (DKI) in diagnosing brain developmental disorders in premature infants. A total of 52 subjects were included in this study, including 26 premature infants as the preterm group, and 26 full-term infants as the control group. Routine MRI and DKI examinations were performed. Mean kurtosis (MK), radial kurtosis (RK), fractional anisotropy (FA), and mean diffusivity (MD) values were measured in the brain regions including posterior limbs of the internal capsule (PLIC), anterior limb of internal capsule (ALIC), parietal white matter (PWM), frontal white matter (FWM), thalamus (TH), caudate nucleus (CN), and genu of the corpus callosum (GCC). The chi-squared test, -test, Spearman's correlation analysis, and receiver operating characteristic curve were used for data analyses. In the premature infant group, the MK and RK values of PLIA, ALIC, and PWM were lower than those in the control group ( < 0.05). The FA values of PWM, FWM, and TH were also lower than those of the control group ( < 0.05). The area under curves of MK in PLIC and ALIC, MD in PWM, and FA in FWM were 0.813, 0.802, 0.842, and 0.867 ( < 0.05). In the thalamus and CN, the correlations between MK, RK values, and postmenstrual age (PMA) were higher than those between FA, MD values, and PMA. Diffusion kurtosis imaging can be used as an effective tool in detecting brain developmental disorders in premature infants.
10.3389/fneur.2021.789254