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Purpose: The purpose of this study was to investigate whether alterations of regional neural function in children with diffuse intrinsic pontine glioma (DIPG) had manifested deficit in behavioral inhibition using resting-state functional MRI (rs-fMRI)., Methods: There were 17 participants with DIPG who took part in the study. Eight children were with deficit in behavioral inhibition, whereas the other 9 children did not obtain deficit in behavioral inhibition. Five healthy children with age, sex, and education matched to the study group also participated as the control group. These 3 groups underwent rs-fMRI, and the results were then converted to amplitude of low-frequency fluctuation (ALFF) data. Amplitude of low-frequency fluctuation data were further analyzed by single-factor analysis of variance comparing among 3 groups based on the whole brain levels. Amplitude of low-frequency fluctuation results were subjected to t test of voxel-wised comparison to derive the rs-fMRI brain function differences between the 2 DIPG groups. The Pearson correlation between ALFF values of abnormal regions found in 3 groups and the scores obtained according to the Child Behavior Checklist were analyzed., Results: The 3 groups had shown significant differences in terms of the ALFF results, with the ALFF increased in several brain regions (P < 0.05, corrected with AlphaSim, clusters >59 voxels), which include left supramarginal gyrus, left dorsolateral superior frontal gyrus, right precentral gyrus, and right middle frontal gyrus. Participants with deficit in behavioral inhibition had shown significant differences (ALFF decreased) in several brain regions, including left dorsolateral superior frontal gyrus and right fusiform gyrus (P < 0.05, corrected with AlphaSim, clusters >123 voxels), whereas other brain regions had shown ALFF increased, including left supramarginal gyrus, left middle frontal gyrus, and right medial superior frontal gyrus (P < 0.05, corrected with AlphaSim, clusters >123 voxels). There was no significant correlation between ALFF values and Child Behavior Checklist scores (P > 0.05)., Conclusions: These findings of focal spontaneous hyperfunction and hypofunction, which correlate with deficit in behavioral inhibition processing, and the abnormal brain regions are considered to be inefficient (in regions of the brain that may relate to compensatory brain and behavioral functioning, and it may be that the brain region needs to exert extra energy to perform a task to the same degree as the control group) or inability (inability in a certain region, or underpowered), pointing to a pathophysiologic process in executive dysfunction.

Background: H3K27M is the most frequent mutation in brainstem gliomas (BSGs), and it has great significance in the differential diagnosis, prognostic prediction and treatment strategy selection of BSGs. There has been a lack of reliable noninvasive methods capable of accurately predicting H3K27M mutations in BSGs., Methods: A total of 151 patients with newly diagnosed BSGs were included in this retrospective study. The H3K27M mutation status was obtained by whole-exome, whole-genome or Sanger's sequencing. A total of 1697 features, including 6 clinical parameters and 1691 imaging features, were extracted from pre- and post-contrast T1-weighted and T2-weighted images. Using a random forest algorithm, 36 selected MR image features were integrated with 3 selected clinical features to generate a model that was predictive of H3K27M mutations. Additionally, a simplified prediction model comprising the Karnofsky Performance Status (KPS) at diagnosis, symptom duration at diagnosis and edge sharpness on T2 was established for practical clinical utility using the least squares estimation method., Results: H3K27M mutation was an independent prognostic factor that conferred a worse prognosis (p = 0.01, hazard ratio = 3.0, 95% confidence interval [CI], 1.57-5.74). The machine learning-based model achieved an accuracy of 84.44% (area under the curve [AUC] = 0.8298) in the test cohort. The simplified model achieved an AUC of 0.7839 in the test cohort., Conclusions: Using conventional MRI and clinical features, we established a machine learning-based model with high accuracy and a simplified model with improved clinical utility to predict H3K27M mutations in BSGs., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: Functional magnetic resonance imaging (fMRI) mapping can present the activated cortical area during movement, while little is known about precise location in facial and tongue movements., Objective: To investigate the representation of facial and tongue movements by task fMRI., Methods: Twenty right-handed healthy subjects were underwent block design task fMRI examination. Task movements included lip pursing, cheek bulging, grinning and vertical tongue excursion. Statistical parametric mapping (SPM8) was applied to analysis the data., Results: One-sample t-test was used to calculate the common activation area between facial and tongue movements. Also, paired t-test was used to test for areas of over- or underactivation in tongue movement compared with each group of facial movements., Conclusions: The common areas within facial and tongue movements suggested the similar motor circuits of activation in both movements. Prior activation in tongue movement was situated laterally and inferiorly in sensorimotor area relative to facial movements. Prior activation of tongue movement was investigated in left superior parietal lobe relative to lip pursing. Also, prior activation in bilateral cuneus lobe in grinning compared with tongue movement was detected., (© 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.)

As a study method of resting state network (RSN), resting state functional MRI (rfMRI) can be applied to detect low frequency fluctuate (LFF) in various cerebral areas based on resting state blood oxygen level dependence (BOLD) signals; and it is easier and more consistent than task-related fMRI. The development, features and methods of rfMRI as well as the application in epilepsy were reviewed in this article., (Copyright © 2011 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

Background: Wall shear stress is an important factor in the destabilization of atherosclerotic plaques. The purpose of this study was to assess the distribution of wall shear stress in advanced carotid plaques using high resolution magnetic resonance imaging and computational fluid dynamics., Methods: Eight diseased internal carotid arteries in seven patients were evaluated. High resolution magnetic resonance imaging was used to visualize the plaque structures, and the mechanic stress in the plaque was obtained by combining vascular imaging post-processing with computational fluid dynamics., Results: Wall shear stresses in the plaques in all cases were higher than those in control group. Maximal shear stresses in the plaques were observed at the top of plaque hills, as well as the shoulders of the plaques. Among them, the maximal shear stress in the ruptured plaque was observed in the rupture location in three cases and at the shoulder of fibrous cap in two cases. The maximal shear stress was also seen at the region of calcification, in thrombus region and in the thickest region of plaque in the other three cases, respectively., Conclusion: Determination of maximal shear stress at the plaque may be useful for predicting the rupture location of the plaque and may play an important role in assessing plaque vulnerability.

Objective: We investigated whether baseline vessel status evaluated by magnetic resonance angiography (MRA) can be the foremost factor to classify acute ischemic stroke patients into subgroups for thrombolytic therapy within 3-6 hours of symptom onset., Methods: Acute ischemic stroke patients beyond 3 hours after symptom onset were examined by stroke magnetic resonance imaging (MRI) (diffusion- and perfusion-weighted imaging, and MRA) before and after thrombolysis treatment within 24-48 hours. Stroke MRI was used to classify acute ischemic stroke patients into subgroups and select optimal patients for thrombolytic treatment. Clinical scores were compared to determine whether there were significant differences among subgroups., Results: The difference in day 90 modified Rankin scale (mRS) between treated salvageable and untreated salvageable patients with recombinant tissue plasminogen activator (rt-PA) was remarkably statistically significant (p=0.02). Treated salvageable patients had more favorable clinical outcomes as compared with the untreated salvageable patients. Patients who did not have baseline artery occlusion were associated with more favorable clinical outcomes than untreated salvageable patients (p<0.001). The difference between treated salvageable and patients without artery occlusion in 90 day mRS score was not statistically significant (p=0.058)., Conclusion: Baseline vessel status evaluated by MRA may be used as the first factor ahead of mismatch to categorize acute ischemic stroke patients into subgroups. Patients who do not have initial vessel occlusion may not need thrombolytic therapy.

Elasticity is an important physical property of human tissues. There is a tremendous difference in elasticity between normal and pathological tissues. Noninvasive evaluation of the elasticity of human tissues would be valuable for clinical practice. Magnetic resonance elastography (MRE) is a recently developed noninvasive imaging technique that can directly visualize and quantitatively measure tissue elasticity. This article reviewed the MRE technique and its current status.

Objective To establish a platform by using carotid MRI and computational fluid dynamics (CFD) to assess hemodynamic changes around carotid atherosclerotic plaques. Methods Thirteen patients with carotid atherosclerosis were recruited in this study. Six volunteers were regarded as normal controls. All the patients and volunteers underwent carotid MRI and contrast-enhanced magnetic resonance angiography (CEMRA). Carotid MRI was used to visualize the plaque structures and components. All plaques were divided into different types according to plaque components. CEMRA images were used to obtain three-dimensional (3D) models of carotid bifurcations, whose boundary conditions were specified using CFD front-end software, and then the mesh file of the 3D models were obtained to import to CFD software to visualize hemodynamic maps, including wall shear stress (WSS), static pressure and blood velocity. Results Fifteen diseased internal carotid arteries (ICAs) were assessed. According to the MRI appearance of the plaques, the types of these plaques were from IV-V to VIII. All of these were vulnerable plaques which caused irregular stenosis of ICAs. The WSS, static pressure and blood velocity were (79.86 ± 57.83) Pa, (- 7586.81 ± 9313.83) Pa, (2.76±1.81) m/s, respectively in the diseased ICAs group and (2.52 ± 0.58) Pa, (- 71.65 ± 30.89) Pa, (0.21 ± 0.06) m/s, respectively in the normal control group. In the diseased ICAs group WSS was elevated heterogenously and static pressure was decreased heterogenously near the plaques. The blood velocity near the plaques was increased but still streamlined. Statistical significant differences were shown for WSS, static pressure and blood velocity between 2 groups (P = 0.000, for all). Conclusions The platform combining MRI and CFD can be used to analyze the plaque structures and fluid dynamic change near the plaques, suggesting hemodynamics plays an important role in the plaque progression and vulnerability. [ABSTRACT FROM AUTHOR]

Objective: We explored the relationship between predicted infarct core, predicted ischemic penumbras and predicted final infarct volumes obtained though apparent diffusion coefficient (ADC)-based method, as well as other clinical variables, and functional outcome. Methods: Patients with acute cerebral ischemic stroke were retrospectively recruited. The National Institutes of Health Stroke Scale score was evaluated at baseline and the modified Rankin Scale (mRS) at day 90. Favorable outcome was defined as an mRS score of 0 to 2, and unfavorable outcome as 3 to 6. Multimodal stroke magnetic resonance imaging was carried out at presentation. The volumes of diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) were measured using the regions of interest (ROI) method. The volumes of predicted infarct core, predicted ischemic penumbra and predicted final infarct were obtained by an automated image analysis system based on baseline ADC maps. The association between baseline magnetic resonance imaging volumes, baseline clinical variables, and functional outcome was statistically analyzed. Results: The study included 30 males and 20 females (mean±SD age, 56±10 years). Baseline DWI, PWI and PWI-DWI mismatch volumes were not correlated with day-90 mRS (P>0·05). Predicted infarct core, predicted ischemic penumbra and predicted final infarct through ADC-based method were all correlated with day-90 mRS (P<0·05). A better outcome was associated with a smaller predicted volume. Low baseline National Institutes of Health Stroke Scale and recanalization also demonstrated a trend toward a favorable outcome. Receiver operating characteristic analysis showed that the area under the curve of predicted final infarct volume and recanalization were higher with statistical significance (P<0·001). Discussion: Predicted volumes obtained from ADC-based methods, especially predicted final infarct volume, as well as baseline National Institutes of Health Stroke Scale and recanalization may have effect on functional outcome in acute ischemic stroke. [ABSTRACT FROM AUTHOR]

Rationale and Objectives: To investigate whether baseline apparent diffusion coefficient (ADC) maps can be employed to predict both infarct core and salvageable ischemic tissue volumes in acute ischemic stroke. Materials and Methods: An automated image analysis system based on baseline ADC maps was tested against 30 patients with acute ischemic stroke of anterior circulation to predict both infarct core and salvageable ischemic tissue volumes. The predicted infarct core and predicted salvageable ischemic tissue were quantitatively and qualitatively compared with follow-up imaging data in recanalization and no recanalization groups, respectively. Direct comparisons with perfusion- and diffusion- weighted magnetic resonance imaging measures were also made. Wilcoxon signed-rank test, Spearman rank correlation, and Bland-Altman plots were performed. Results: In the recanalization group, the predicted infarct core volume was significantly correlated with the final infarct volume (r = 0. 868, P < .001). In the no recanalization group, the predicted final infarct volume (sum of the predicted infarct core and salvageable ischemic tissue volumes), as well as the predicted salvageable ischemic tissue volume, was also significantly correlated with the true final infarct volume (r = 0.955, P < .001) and infarct growth (r = 0.918, P < .001), respectively. The volumes of perfusion-diffusion mismatch were significantly larger than those of infarct growth and predicted salvageable ischemic tissue. Good agreement between predicted and true final infarct lesions was visualized by Bland-Altman plots in two groups. Direct visual comparative analysis revealed good qualitative agreement between the true final infarct and predicted lesions in 21 patients. Conclusion: The proposed ADC based approach may be a feasible and practical tool to predict the volumes of infarct core and salvageable ischemic tissue without intravenous contrast media–enhanced perfusion-weighted imaging at baseline. [Copyright &y& Elsevier]