A DTI study of leukoaraiosis and the differential diagnosis between leukoaraiosis and acute lacunar infarction

Zhao, Dongdong; Wang, Zhanwen; Cheng, Ying; Yuan, Zhen; Frydman, René; Liu, Haoyi; Pliss, Artem; Luan, Ping

doi:10.1111/cns.13191

Cited by 5 publications

(6 citation statements)

References 8 publications

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“…Diffusion magnetic resonance imaging (dMRI) is appropriate for WM microstructure study . Diffusion tensor imaging (DTI) is currently the only noninvasive method that can effectively observe and track the WM fiber tracts in a living human brain . Fractional anisotropy (FA) and mean diffusivity (MD) are two quantitative measures of DTI that, respectively, detect the anisotropy and overall displacement of water molecule diffusion .…”

Section: Introductionmentioning

confidence: 99%

Microstructural disruption of the right inferior fronto‐occipital and inferior longitudinal fasciculus contributes to WMH‐related cognitive impairment

Chen

Huang

et al. 2020

CNS Neurosci Ther

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Aims: White matter hyperintensity (WMH) is the most common neuroimaging manifestation of cerebral small vessel disease and is related to cognitive dysfunction or dementia. This study aimed to investigate the mechanism and effective indicators to predict WMH-related cognitive impairment. Methods:We recruited 22 healthy controls (HC), 25 cases of WMH with normal cognition (WMH-NC), and 23 cases of WMH with mild cognitive impairment (WMH-MCI). All individuals underwent diffusion tensor imaging (DTI) and a standardized neuropsychological assessment. Automated Fiber Quantification was used to extract altered DTI metrics between groups, and partial correlation was performed to assess the associations between WM integrity and cognitive performance. Furthermore, machine learning analyses were performed to determine underlying imaging markers of WMH-related cognitive impairment. Results: Our study found that mean diffusivity (MD) values of several fiber bundles including the bilateral anterior thalamic radiation (ATR), the left inferior fronto-occipital fasciculus (IFOF), the right inferior longitudinal fasciculus (ILF), and the right superior longitudinal fasciculus (SLF) were negatively correlated with memory function, while that of the anterior component of the right IFOF and the posterior and intermediate component of the right ILF showed significant negative correlation with MMSE and episodic memory, respectively. Furthermore, machine learning analyses showed that the accuracy of recognizing WMH-MCI patients from the WMH populations was up to 80.5% and the intermediate and posterior components of the right ILF and the anterior component of the right IFOF contribute the most. Conclusions:Changes in the properties of DTI may be the potential mechanism of WMH-related MCI, especially the right IFOF and the right ILF, which may become imaging markers for predicting WMH-related cognitive dysfunction. | 577 CHEN Et al.

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Section: Introductionmentioning

confidence: 99%

Microstructural disruption of the right inferior fronto‐occipital and inferior longitudinal fasciculus contributes to WMH‐related cognitive impairment

Chen

Huang

et al. 2020

CNS Neurosci Ther

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“…In our final example, an investigation by Zhao, Wang, Cheng et al, in 2019 investigated differences with a Student's t-test between subjects with leukoaraiosis (LA) and lacunar infarct subjects from two hospitals in China using subjects' DTI scans. 48 Lacunar infarct subjects had DTI values of (FA: 0.35 ± 0.03, MD: 0.40 ± 0.05) and LA subjects corresponded to (FA: 0.32 ± 0.02, MD: 1.08 ± 0.03) in normal appearing white matter, with a statistically significant difference between the two groups (p < 0.05). This example is a nuanced example as it requires the attempt to distinguish a white matter hyperintensity as either leukoaraiosis (LA) or an acute lacunar infarction.…”

Section: Clinical Research Examples: Infarctsmentioning

confidence: 82%

“…A higher FA and lower MD like in this example is noted in the acute phase but may normalize during the subacute phase before MD increases and FA decreases once chronic, as indicative of structural disorganization. 48 A chronic lesion would be the same intensity to CSF, as Gore, Bansal, & Asuncion described. 53 This example should promote a well-rounded view for how to make an impression of DTI results.…”

Section: Clinical Research Examples: Infarctsmentioning

confidence: 84%

“…52,53 In this final DTI example study, it was found that patients with acute lacunar infarcts had higher FA and lower MD than LA patients. 48 The reason regarding the lower MD in the infarct was that the cytotoxic edema that occurred acutely decreased the ability for water diffusion, but over time MD would be increased once the edema is resolved. While ischemic injury may be thought to increase cellular damage and thus increase MD, this is dependent on the phase of injury and whether edema is present or not.…”

Section: Clinical Research Examples: Infarctsmentioning

confidence: 99%

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Diffusion Tensor Imaging: A Step-by-Step Guide for Radiology and Neurology Clerkship Students, Residents, and Graduate Students Using Clinical Research Examples

Goodman¹,

Richerson²,

Wolfgram³

2023

MSRJ

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Diffusion-tensor imaging has become common practice in radiology and imaging research due to its many applications in brain connectivity and neurodevelopment as well as for pathologies including tumors, ischemia, trauma, and neurodegeneration. However, its novelty compared to other neuroimaging techniques has meant that graduate programs, particularly medical schools, have not included opportunities to learn how diffusion tensor imaging can visualize the brain and interpretation of the data clinically and in research. Diffusion tensor imaging can be a challenging utility to understand for newcomers and is subject to wide interpretation. We offer for medical and graduate students as well as residents a step-by-step guide in interpreting diffusion tensor imaging results for clinical analysis using simple explanations of physics and neuroscience and its application in clinical and translational research.

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“…38 Clinical Research Examples: Infarcts In our final example, an investigation by Zhao et al, in 2019 investigated differences with a Student's t-test between subjects with leukoaraiosis (LA) and lacunar infarct subjects from two hospitals in China using subjects' DTI scans. 48 Lacunar infarct subjects had DTI values of (FA: 0.35 ± 0.03, MD: 0.40 ± 0.05) and LA subjects corresponded to (FA: 0.32 ± 0.02, MD: 1.08 ± 0.03) in normal appearing white matter, with a statistically significant difference between the two groups (p < 0.05).…”

Section: Clinical Research Examples: White Tract Variationsmentioning

confidence: 82%

Impact of Imposter Phenomenon on Medical Learners and Clinicians: A Scoping Review

2023

MSRJ

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A DTI study of leukoaraiosis and the differential diagnosis between leukoaraiosis and acute lacunar infarction

Cited by 5 publications

References 8 publications

Microstructural disruption of the right inferior fronto‐occipital and inferior longitudinal fasciculus contributes to WMH‐related cognitive impairment

Microstructural disruption of the right inferior fronto‐occipital and inferior longitudinal fasciculus contributes to WMH‐related cognitive impairment

Diffusion Tensor Imaging: A Step-by-Step Guide for Radiology and Neurology Clerkship Students, Residents, and Graduate Students Using Clinical Research Examples

Impact of Imposter Phenomenon on Medical Learners and Clinicians: A Scoping Review

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