Patient-tailored multimodal neuroimaging, visualization and quantification of human intra-cerebral hemorrhage

Abstract

In traumatic brain injury (TBI) and intracerebral hemorrhage (ICH), the heterogeneity of lesion sizes and types necessitates a variety of imaging modalities to acquire a comprehensive perspective on injury extent. Although it is advantageous to combine imaging modalities and to leverage their complementary benefits, there are difficulties in integrating information across imaging types. Thus, it is important that efforts be dedicated to the creation and sustained refinement of resources for multimodal data integration. Here, we propose a novel approach to the integration of neuroimaging data acquired from human patients with TBI/ICH using various modalities; we also demonstrate the integrated use of multimodal magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) data for TBI analysis based on both visual observations and quantitative metrics. 3D models of healthy-appearing tissues and TBIrelated pathology are generated, both of which are derived from multimodal imaging data. MRI volumes acquired using FLAIR, SWI, and T 2 GRE are used to segment pathology. Healthy tissues are segmented using user-supervised tools, and results are visualized using a novel graphical approach called a 'connectogram', where brain connectivity information is depicted within a circle of radially aligned elements. Inter-region connectivity and its strength are represented by links of variable opacities drawn between regions, where opacity reflects the percentage longitudinal change in brain connectivity density. Our method for integrating, analyzing and visualizing structural brain changes due to TBI and ICH can promote knowledge extraction and enhance the understanding of mechanisms underlying recovery.

A systematic review of cross-sectional differences and longitudinal changes to the morphometry of the brain following paediatric traumatic brain injury

“…Whilst indexing different injury mechanisms, these neuroimaging methodologies provide complementary information for the basis of understanding the brain post pTBI. For instance, multimodal imaging can enhance the segmentation of pathological lesions in pTBI (Irimia et al, 2011) with each modality detecting specific properties of the lesion (Goh et al, 2016). Future research should therefore echo approaches of studies such as Konigs et al (2017), by combining multiple modalities of imaging to better understand the brain post pTBI.…”

Acute cognitive deficits after traumatic brain injury predict Alzheimer’s disease-like degradation of the human default mode network

“…The occurrence of CMBs in geriatric mTBI patients is relevant to the spatial profile and severity of post-traumatic WM alterations [16, 46, 32]. Previously, we showed that the trajectories and integrities of WM fasciculi passing through the vicinity (penumbrae) of post-traumatic CMBs can be altered in ways which persist for at least six months post-injury [47, 48].…”

“…For example, in geriatric TBI patients, post-traumatic CMBs are frequently co-morbid with CMBs of hypertensive etiology, as well as with CMBS due to cerebral amyloid angiopathy (CAA), which is also a risk factor for AD. Because of the relatively high combined prevalence of neurovascular disease, CAA and hypertension in older adults [46], studying TBI-related brain network alterations in the absence of CMBs may be either logistically impractical or of limited relevance to the pathophysiological processes of the average person’s aging brain. In other words, studying functional network alterations in CMB-free older individuals may limit the utility of the insights gained from such studies to a relatively minor subset of the aging adult population.…”