- Email: [email protected]
5-37-06 Semiautomatic segmentation of MR images of the brain in multiple sclerosis
S328 15-37-02
Neuroimging ] Sa3a$;@&a
calcification:
A CT scan population
A.P. Narata, W.O. Arruda, A.A. Pedrozo. Unidade Hospital das [email protected], Curitiba. PR, Brazil
de Ci&cias
Neuro/6gicas,
3931 head CT-scans out of 2554 patients performed during one year were reviewed. Sex ratio was female 1.23:1 male. Most patients were from Curitiba (77%). Abnormalities were observed in 1272 (41%) CT-scans. Bilateral basal ganglia calcification (BGC) was observed in 61 patients (2.4%). Ratio sex was female 2.2:1 male. Age distribution in shown in figure 1.
14 12
f 3
10 8
3
6
I
4 2 0
Thirty nine patients (64%) were aged 60 or older. Psychiatric findings were observed in 7 cases (11.5%). Unrelated clinical picture was present in 19 cases (31%): headache was the most common isolated or combined symptom (25 cases, 41%). No patient had a calciumlphosphorus metabolic disease nor other known basal ganglia disease. BGC is a relatively common CT scan finding, mostly in older patients. A small proportion of these patients may have a clinical picture probably related to BGC from pathogenic point of view.
15-37-03
1 Maturation and myelination of white matter fibers on magnetic resonance imaging and spectroscopy in infants and children
Sharon E. Byrd. Chi/dren’s
Memorial
Hospital,
Chicago,
IL, USA
Purpose: To understand the normal progression of myelination of the white matter fiber tracts on MRI during the first two years of life and to correlate these findings with their normal maturation on MRS. Materlals and Methods: MRI scans using Tl and T2-weighted Spin Echo and Inverse Recovery Pulse Sequences and MRS scans using Proton Brain Exam Single Voxel (PROBE/SV) General Electric spectroscopy software with STEAM and PRESS pulse sequences in newborns, infants and young children. Results and Discussion: The normal MRI and MRS appearance in infants and children is due to the changing water content of the gray and white and to the myelination of the white matter structures. A serial progression on MRI scans is presented and distinct MR spectra are identified. The MR spectra of normal brain maturation provide additional insights. First, neonatally the choline and myo-inositol are in excess acting as a reservoir of precursors needed to build myelin and the inositol signaling pathway. Second, in brain maturation there is an increase in N-acetyl aspartate and phosphocreatine implying maturation occurring in the neuron and in the high-energy pathway. Using pattern recognition of the spectra and using the normal curves, an unknown neonate, infant or child can be assessed for brain development. Since metabolit&reatine ratios can be generated, the progress of brain maturation can be followed and charted over time.
5-37-04
The pseudo-delta sign is unreliable in differentiating between aneurysmal SAH and sinus thrombosis in unenhanced brain CT
AK. Daif, T.M. Kolawole, A. Cgunniyi, Hospital, Riyadh, Saudi Arabia
S. Al Rajeh. King Khalid University
The pseudo-delta sign (PDS) is seen as a hypodensity surrounding the core density of the superior sagittal sinus in non-enhanced brain CT. It has been described in some cases of subarachnoid hemorrhage (SAH) and sagittal sinus thrombosis (SSST). In this study, the brain CT of 3 groups of patients were compared: Group 1 = 19 patients with aneurysmal SAH; Group 2 = 24 patients with (SSST) and Group 3 = 25 “controls” with other neurological disorders. PDS was present in 42.1%, 41.7% and 32% in the 3 groups respectively. The difference did not reach statistical significance (Xs = 0.52 p z- 0.01). In SAH patients, the highest frequency of PDS was encountered in patients with
ruptured anterior communicating artery aneurysms and the lowest in those with middle cerebral artery aneurysms. Although PDS could enhance clinical suspicion of acute neurological catastrophies, it however has low sensitivity for it to be used as a diagnostic ‘gold standard’ for either SAH or SSST.
5-37-05
MR volumetry and digital neuroanatomic in Vascular Dementia
mapping
P. Dastidar 1,3, T. Kulkas 2, T. Heinonen 4, A. Lahtinen 4, P. Ryymin ‘, H. Frey 2,3. ’ Department of Diagnostic Radiolog)! Tampere University Hospital Tampere, Fin/and, 2 Departments of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Find/and, 3 Medical School, University of Tampere, Tampere, Finland, 4 Ragnar Granit Institute, Tampere University of Technology; Tampere, Finland Purpose: To study the correlation between the total volume estimates of infarctions and the degree of clinical disability in Vascular Dementia. Memods: We studied 26 patients with vascular dementia using a 0.5 T MRI system. On the basis of DSM-IV-Rand HIS-R cnterias, 8 patients had moderate dementia (MMSE (Mini mental status examination) 523) 9 patients had mild dementia (MMSE > 23) and 7 patients had no dementia but positive risk factors and MRI findings. MR images were transferred to different personal computers (PC) where segmentation was performed using a semiautomatic IARD (Image Enhancement, Amplitude Segmentation, Region Growing, Decision Tree) method (PCl) and the real MR images matched with digital neuroanatomic atlas images (PC2). Volumetric examinations of infarctions and 3D display of these were performed. Resufts: The total volumetric estimates of infarctions correlated well with the degree of dementia. Matching of MR images with neuroanatomic atlas images gave an accurate localisation of the lesions in different neural pathways. Conclusion: Using IARD segmentation method, a good correlation was observed between the degree of dementia and infarct volumes. Digital neuroanatomic human maps are essential to accurately localise the area of lesions.
5-37-06
Semiautomatic segmentation brain in multiple sclerosis
of MR images of the
P. Dastidar’,3, T. Vahvelainen2, T. Heinonen4. P. Ryymin’, I. Elovaara*, H. Frey2,3. ’ Department of Diagnostic Radiolog) Tampere University Hospital, Tampere, Fin/and, *Departments of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Tamper. Finland, 3Medical School, University of Tampere, Finland, 4 Ragnar Granit Institute, Tampere University of Technology Tampere, Finland Purpose: To study the correlation between the total volume of MS plaques and EDSS (Expanded Disability Status Scale) scores and neuropsychological impairment using a semiautomatic segmentation method. Methods: We examined 23 patients (aged 31 to 52 years, 20 females and 3 males) with chronic progressive MS (group 1) and 10 patients (aged 35 to 53 years, 8 females and 2 males) with relapsing remitting MS (group 2) using a 0.5 T MRI system. EDSS scores varied between 3 and 6.5. Detailed neuropsychological tests were performed. MR images were transferred to a personal computer where segmentation was performed using a semiautomatic IARD (Image Enhancement, Amplitude Segmentation, Region Growing, Decision Tree) method. Volumetric estimations of plaques and 3D display of plaques were performed. Results: In group 1, in only 22% the total volume estimates correlated with EDSS scores and in 52% they correlated with the degree of neuropsychological defects. In group 2 the total volume estimates of plaques correlated with neuropsychological defects in 60% of cases. Conclusions: Using IARD segmentation method, fairly accurate volumetric measurements were recorded. A good correlation with neuropsychological defects and a poor correlation with EDSS scores were observed in both groups. Use of digital neuroanatomic maps has been planned for the near future.
5-37-07
Cerebral perfusion changes in lupus erythematosus and related diseases assessed by brain SPECT; paradoxically inversed effect of acetazolamide
P. Lass, M. Koseda, P. Lyczak, J. Mechlinska, M. Hebanowski. University and Navy Hospital, Gdafisk, Poland
Medical
Collagen diseases are frequently accompanied by psychoneurological symp toms and signs. We know little on cerebral perfusion in asymptomatic collagenotic patients, also on cerebrovascular reactivity in those diseases. We decided to study cerebral perfusion and it’s reactivity in symptomatic and neurologically asymptomatic patients. We performed brain SPECT scans in 58 patients with lupus erythematosus (LED), 12 with systemic sclerosis, 10 with Sjoegren’s syndrome before and 20 min. after iv. injection of 1.0 g of acetazolamide with a triple-head
Neuroimging ] Sa3a$;@&a
calcification:
A CT scan population
A.P. Narata, W.O. Arruda, A.A. Pedrozo. Unidade Hospital das [email protected], Curitiba. PR, Brazil
de Ci&cias
Neuro/6gicas,
3931 head CT-scans out of 2554 patients performed during one year were reviewed. Sex ratio was female 1.23:1 male. Most patients were from Curitiba (77%). Abnormalities were observed in 1272 (41%) CT-scans. Bilateral basal ganglia calcification (BGC) was observed in 61 patients (2.4%). Ratio sex was female 2.2:1 male. Age distribution in shown in figure 1.
14 12
f 3
10 8
3
6
I
4 2 0
Thirty nine patients (64%) were aged 60 or older. Psychiatric findings were observed in 7 cases (11.5%). Unrelated clinical picture was present in 19 cases (31%): headache was the most common isolated or combined symptom (25 cases, 41%). No patient had a calciumlphosphorus metabolic disease nor other known basal ganglia disease. BGC is a relatively common CT scan finding, mostly in older patients. A small proportion of these patients may have a clinical picture probably related to BGC from pathogenic point of view.
15-37-03
1 Maturation and myelination of white matter fibers on magnetic resonance imaging and spectroscopy in infants and children
Sharon E. Byrd. Chi/dren’s
Memorial
Hospital,
Chicago,
IL, USA
Purpose: To understand the normal progression of myelination of the white matter fiber tracts on MRI during the first two years of life and to correlate these findings with their normal maturation on MRS. Materlals and Methods: MRI scans using Tl and T2-weighted Spin Echo and Inverse Recovery Pulse Sequences and MRS scans using Proton Brain Exam Single Voxel (PROBE/SV) General Electric spectroscopy software with STEAM and PRESS pulse sequences in newborns, infants and young children. Results and Discussion: The normal MRI and MRS appearance in infants and children is due to the changing water content of the gray and white and to the myelination of the white matter structures. A serial progression on MRI scans is presented and distinct MR spectra are identified. The MR spectra of normal brain maturation provide additional insights. First, neonatally the choline and myo-inositol are in excess acting as a reservoir of precursors needed to build myelin and the inositol signaling pathway. Second, in brain maturation there is an increase in N-acetyl aspartate and phosphocreatine implying maturation occurring in the neuron and in the high-energy pathway. Using pattern recognition of the spectra and using the normal curves, an unknown neonate, infant or child can be assessed for brain development. Since metabolit&reatine ratios can be generated, the progress of brain maturation can be followed and charted over time.
5-37-04
The pseudo-delta sign is unreliable in differentiating between aneurysmal SAH and sinus thrombosis in unenhanced brain CT
AK. Daif, T.M. Kolawole, A. Cgunniyi, Hospital, Riyadh, Saudi Arabia
S. Al Rajeh. King Khalid University
The pseudo-delta sign (PDS) is seen as a hypodensity surrounding the core density of the superior sagittal sinus in non-enhanced brain CT. It has been described in some cases of subarachnoid hemorrhage (SAH) and sagittal sinus thrombosis (SSST). In this study, the brain CT of 3 groups of patients were compared: Group 1 = 19 patients with aneurysmal SAH; Group 2 = 24 patients with (SSST) and Group 3 = 25 “controls” with other neurological disorders. PDS was present in 42.1%, 41.7% and 32% in the 3 groups respectively. The difference did not reach statistical significance (Xs = 0.52 p z- 0.01). In SAH patients, the highest frequency of PDS was encountered in patients with
ruptured anterior communicating artery aneurysms and the lowest in those with middle cerebral artery aneurysms. Although PDS could enhance clinical suspicion of acute neurological catastrophies, it however has low sensitivity for it to be used as a diagnostic ‘gold standard’ for either SAH or SSST.
5-37-05
MR volumetry and digital neuroanatomic in Vascular Dementia
mapping
P. Dastidar 1,3, T. Kulkas 2, T. Heinonen 4, A. Lahtinen 4, P. Ryymin ‘, H. Frey 2,3. ’ Department of Diagnostic Radiolog)! Tampere University Hospital Tampere, Fin/and, 2 Departments of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Find/and, 3 Medical School, University of Tampere, Tampere, Finland, 4 Ragnar Granit Institute, Tampere University of Technology; Tampere, Finland Purpose: To study the correlation between the total volume estimates of infarctions and the degree of clinical disability in Vascular Dementia. Memods: We studied 26 patients with vascular dementia using a 0.5 T MRI system. On the basis of DSM-IV-Rand HIS-R cnterias, 8 patients had moderate dementia (MMSE (Mini mental status examination) 523) 9 patients had mild dementia (MMSE > 23) and 7 patients had no dementia but positive risk factors and MRI findings. MR images were transferred to different personal computers (PC) where segmentation was performed using a semiautomatic IARD (Image Enhancement, Amplitude Segmentation, Region Growing, Decision Tree) method (PCl) and the real MR images matched with digital neuroanatomic atlas images (PC2). Volumetric examinations of infarctions and 3D display of these were performed. Resufts: The total volumetric estimates of infarctions correlated well with the degree of dementia. Matching of MR images with neuroanatomic atlas images gave an accurate localisation of the lesions in different neural pathways. Conclusion: Using IARD segmentation method, a good correlation was observed between the degree of dementia and infarct volumes. Digital neuroanatomic human maps are essential to accurately localise the area of lesions.
5-37-06
Semiautomatic segmentation brain in multiple sclerosis
of MR images of the
P. Dastidar’,3, T. Vahvelainen2, T. Heinonen4. P. Ryymin’, I. Elovaara*, H. Frey2,3. ’ Department of Diagnostic Radiolog) Tampere University Hospital, Tampere, Fin/and, *Departments of Neurology and Rehabilitation, Tampere University Hospital, Tampere, Tamper. Finland, 3Medical School, University of Tampere, Finland, 4 Ragnar Granit Institute, Tampere University of Technology Tampere, Finland Purpose: To study the correlation between the total volume of MS plaques and EDSS (Expanded Disability Status Scale) scores and neuropsychological impairment using a semiautomatic segmentation method. Methods: We examined 23 patients (aged 31 to 52 years, 20 females and 3 males) with chronic progressive MS (group 1) and 10 patients (aged 35 to 53 years, 8 females and 2 males) with relapsing remitting MS (group 2) using a 0.5 T MRI system. EDSS scores varied between 3 and 6.5. Detailed neuropsychological tests were performed. MR images were transferred to a personal computer where segmentation was performed using a semiautomatic IARD (Image Enhancement, Amplitude Segmentation, Region Growing, Decision Tree) method. Volumetric estimations of plaques and 3D display of plaques were performed. Results: In group 1, in only 22% the total volume estimates correlated with EDSS scores and in 52% they correlated with the degree of neuropsychological defects. In group 2 the total volume estimates of plaques correlated with neuropsychological defects in 60% of cases. Conclusions: Using IARD segmentation method, fairly accurate volumetric measurements were recorded. A good correlation with neuropsychological defects and a poor correlation with EDSS scores were observed in both groups. Use of digital neuroanatomic maps has been planned for the near future.
5-37-07
Cerebral perfusion changes in lupus erythematosus and related diseases assessed by brain SPECT; paradoxically inversed effect of acetazolamide
P. Lass, M. Koseda, P. Lyczak, J. Mechlinska, M. Hebanowski. University and Navy Hospital, Gdafisk, Poland
Medical
Collagen diseases are frequently accompanied by psychoneurological symp toms and signs. We know little on cerebral perfusion in asymptomatic collagenotic patients, also on cerebrovascular reactivity in those diseases. We decided to study cerebral perfusion and it’s reactivity in symptomatic and neurologically asymptomatic patients. We performed brain SPECT scans in 58 patients with lupus erythematosus (LED), 12 with systemic sclerosis, 10 with Sjoegren’s syndrome before and 20 min. after iv. injection of 1.0 g of acetazolamide with a triple-head