MR Imaging of Midbrain Pathologies

Hattingen, Elke; Blasel, Stella; Nichtweiß, Michael; Zanella, Friedhelm E.; Weidauer, Stefan

doi:10.1007/s00062-010-0009-6

Cited by 15 publications

(9 citation statements)

References 95 publications

(97 reference statements)

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“…Furthermore, the brainstem has less movement freedom than the higher lying parts of the brain, which results from the fact that it is connected to the base of the skull. Therefore, rotational shearing injury might occur at the upper brainstem, thalamus and corpus callosum [26,80]. Specific vulnerability of the brainstem in patients with DOC with traumatic aetiologies has previously been found in a diffusion tensor imaging study [30].…”

Section: Aetiology-related Injurymentioning

confidence: 88%

Structural brain injury in patients with disorders of consciousness: A voxel-based morphometry study

et al. 2016

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Main objective: Disorders of consciousness (DOC; encompassing coma, vegetative state/unresponsive wakefulness syndrome (VS/UWS) and minimally conscious state minus/plus (MCS-/+)) are associated with structural brain injury. The extent of this damage remains poorly understood and merits a detailed examination using novel analysis techniques. Research design/methods and procedures: This study used voxel-based morphometry (VBM) on structural magnetic resonance imaging scans of 61 patients with DOC to examine grey and white matter injury associated with DOC, time spent in DOC, aetiology and diagnosis. Main outcomes and results: DOC and time spent in DOC were found to be associated with widespread structural brain injury, although the latter did not correlate strongly with injury in the right cerebral hemisphere. Traumatic, as compared to non-traumatic aetiology, was related to more injury in the brainstem, midbrain, thalamus, hypothalamus, basal forebrain, cerebellum, and posterior corpus callosum. Potential structural differences were found between VS/ UWS and MCS and between MCS-and MCS+, but need further examination. Conclusions: The findings indicate that both traumatic and non-traumatic DOC are associated with widespread structural brain injury, although differences exist that could lead to aetiologyspecific treatment strategies. Furthermore, the high degree of atrophy occurring after initial brain injury prompts the development and use of neuroprotective techniques to potentially increase patients' chances of recovery. KeywordsVegetative state/unresponsive wakefulness syndrome, minimally conscious state, structural brain injury, voxel-based morphometry History

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Section: Aetiology-related Injurymentioning

confidence: 88%

Structural brain injury in patients with disorders of consciousness: A voxel-based morphometry study

et al. 2016

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“…The implementation of 7.0 T MRI is a further technical advance to a higher signal and a superior spatial resolution compared to 1.5 T and 3.0 T [27,37,55] . Nevertheless, due to its localization in the subthalamic region, adjacent to a number of vital structures [19,20,28] , the ZI is difficult to visualize and localize. Hence, the use of 7.0 T MRI may facilitate the direct visualization of the ZI.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, a prospective study suggested that bilateral stimulation of the cZI nucleus is effective in suppressing tremors of various etiologies of both the distal and proximal extremities [25] . Previous studies including magnetic resonance imaging (MRI) studies up to 1.5 T showed that the visualization of the ZI is unsatisfactory as the small nucleus is hard to distinguish from the surrounding vital structures in the subthalamic region [27,28] . Therefore, different indirect targeting approaches have been established.…”

Section: Deep Brain Stimulation (Dbs)mentioning

confidence: 99%

Imaging for deep brain stimulation: The zona incerta at 7 Tesla

Kerl

Gerigk²,

Brockmann³

et al. 2013

WJR

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AIM:To evaluate different promising magnetic resonance imaging (MRI) methods at 7.0 Tesla (T) for the pre-stereotactic visualization of the zona incerta (ZI). METHODS:Two neuroradiologists qualitatively and quantitatively examined T2-turbo spin-echo (T2-TSE), T1-weighted gradient-echo, as well as FLASH2D-T2Star and susceptibility-weighted imaging (SWI) for the visualization of the ZI at 7.0 T MRI. Delineation and image quality for the ZI were independently examined using a 6-scale grading system. Inter-rater reliability using Cohen's kappa coefficient (κ ) were assessed. Contrast-tonoise ratios (CNR), and signal-to-noise ratios (SNR) for the ZI were calculated for all sequences. Differences in delineation, SNR, and CNR between the sequences were statistically assessed using a paired t -test. For the anatomic validation the coronal FLASH2D-T2Star images were co-registered with a stereotactic atlas (Schaltenbrand-Wahren). RESULTS:The rostral part of the ZI (rZI) could easily be identified and was best and reliably visualized in the coronal FLASH2D-T2Star images. The caudal part was not definable in any of the sequences. No major artifacts in the rZI were observed in any of the scans. FLASH2D-T2Star and SWI imaging offered significant higher CNR values for the rZI compared to T2-TSE images (P > 0.05). The co-registration of the coronal FLASH2D-T2Star images with the stereotactic atlas schema (Schaltenbrand-Wahren) confirmed the correct localization of the ZI in all cases.CONCLUSION: FLASH2D-T2Star imaging (particularly coronal view) provides the reliable and currently optimal visualization of the rZI at 7.0 T. These results can facilitate a better and more precise targeting of the caudal part of the ZI than ever before.

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“…the provisional nature of these studies is mirrored by the fact that the prevalence of pineal cysts in these studies (0.14-4.3%) is much lower than those reported after autopsy (33-40%, [2,12]). However, adequate Mri protocols are extremely important for the imaging of the pediatric brain [32] and especially of midbrain architecture [33]. PPV solid has by far the highest correlation for age and head circumference.…”

Section: Discussionmentioning

confidence: 99%