Penumbra quantification from MR SWI‐DWI mismatch and its comparison with MR ASL PWI‐DWI mismatch in patients with acute ischemic stroke

Bhattacharjee, Rupsa; Gupta, Rakesh K.; Das, Biplab; Dixit, Vijay Kant; Gupta, Praveen Kumar; Singh, Anup

doi:10.1002/nbm.4526

Cited by 13 publications

(9 citation statements)

References 48 publications

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“…( B ) T2*-weighted MRI images at 24 and 72 hours after MCAO show penumbra (yellow) and infarct (gray) zones in Prg-1 WT and Prg-1 R346T animals with and without ATX inhibition by PF8380. Penumbra and infarct core were assessed as described in ( 48 ) (see also Supplementary Materials and Methods). Asterisk marks penumbra in the lower cortical layers of the somatosensory cortex.…”

Section: Resultsmentioning

confidence: 99%

Inhibition of the enzyme autotaxin reduces cortical excitability and ameliorates the outcome in stroke

et al. 2022

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Stroke penumbra injury caused by excess glutamate is an important factor in determining stroke outcome; however, several therapeutic approaches aiming to rescue the penumbra have failed, likely due to unspecific targeting and persistent excitotoxicity, which continued far beyond the primary stroke event. Synaptic lipid signaling can modulate glutamatergic transmission via presynaptic lysophosphatidic acid (LPA) 2 receptors modulated by the LPA-synthesizing molecule autotaxin (ATX) present in astrocytic perisynaptic processes. Here, we detected long-lasting increases in brain ATX concentrations after experimental stroke. In humans, cerebrospinal fluid ATX concentration was increased up to 14 days after stroke. Using astrocyte-specific deletion and pharmacological inhibition of ATX at different time points after experimental stroke, we showed that inhibition of LPA-related cortical excitability improved stroke outcome. In transgenic mice and in individuals expressing a single-nucleotide polymorphism that increased LPA-related glutamatergic transmission, we found dysregulated synaptic LPA signaling and subsequent negative stroke outcome. Moreover, ATX inhibition in the animal model ameliorated stroke outcome, suggesting that this approach might have translational potential for improving the outcome after stroke.

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Section: Resultsmentioning

confidence: 99%

Inhibition of the enzyme autotaxin reduces cortical excitability and ameliorates the outcome in stroke

et al. 2022

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“…“Ischaemic penumbra” is a concept of acute cerebral ischaemia, referring to the area of brain tissue that can be recovered with prompt medical treatment, usually referring to the area of brain tissue between DWI and perfusion-weighted imaging (PWI) ( 24 ). Gliomas also lead to the appearance of similar areas of tissue due to tumour brain infiltration, that is, the areas shown by conventional MR and the true borders of gliomas.…”

Section: Discussionmentioning

confidence: 99%

Differentiation of Meningiomas and Gliomas by Amide Proton Transfer Imaging: A Preliminary Study of Brain Tumour Infiltration

Zhang

Wang

et al. 2022

Front. Oncol.

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BackgroundGliomas are more malignant and invasive than meningiomas.ObjectiveTo distinguish meningiomas from low-grade/high-grade gliomas (LGGs/HGGs) using amide proton transfer imaging (APT) combined with conventional magnetic resonance imaging (MRI) and to explore the application of APT in evaluating brain tumour invasiveness.Materials and MethodsThe imaging data of 50 brain tumors confirmed by pathology in patients who underwent APT scanning in our centre were retrospectively analysed. Of these tumors, 25 were meningiomas, 10 were LGGs, and 15 were HGGs. The extent of the tumour-induced range was measured on APT images, T2-weighted imaging (T2WI), and MRI enhancement; additionally, and the degree of enhancement was graded. Ratios (RAPT/T2 and RAPT/E) were obtained by dividing the range of changes observed by APT by the range of changes observed via T2WI and MR enhancement, respectively, and APTmean values were measured. The Mann–Whitney U test was used to compare the above measured values with the pathological results obtained for gliomas and meningiomas, the Kruskal-Wallis test was used to compare LGGs, HGGs and meningiomas, and Dunn’s test was used for pairwise comparisons. In addition, receiver operating characteristic (ROC) curves were drawn.ResultsThe Mann–Whitney U test showed that APTmean (p=0.005), RAPT/T2 (p<0.001), and RAPT/E (p<0.001) values were statistically significant in the identification of meningioma and glioma. The Kruskal-Wallis test showed that the parameters APTmean, RAPT/T2, RAPT/E and the degree of enhancement are statistically significant. Dunn’s test revealed that RAPT/T2 (p=0.004) and RAPT/E (p=0.008) could be used for the identification of LGGs and meningiomas. APTmean (p<0.001), RAPT/T2 (p<0.001), and RAPT/E (p<0.001) could be used for the identification of HGGs and meningiomas. APTmean (p<0.001) was statistically significant in the comparison of LGGs and HGGs. ROC curves showed that RAPT/T2 (area under the curve (AUC)=0.947) and RAPT/E (AUC=0.919) could be used to distinguish gliomas from meningiomas.ConclusionAPT can be used for the differential diagnosis of meningioma and glioma, but APTmean values can only be used for the differential diagnosis of HGGs and meningiomas or HGGs and LGGs. Gliomas exhibit more obvious changes than meningiomas in APT images of brain tissue; this outcome may be caused by brain infiltration.

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“…It is noteworthy that although only a few non-specific white matter lesions were observed on structural brain MRI in patient III-11, pCASL demonstrated a marked decrease in the CBF in the bilateral periventricular areas, corona radiata, and corpus callosum that was not captured by the structural brain MRI. It has been recently reported that CBF values measured using pCASL are more sensitive than those obtained with conventional structural MRI to evaluate the blood flow and neural activity in numerous neurological conditions, including AD ( Leeuwis et al, 2017 ), stroke ( Bhattacharjee et al, 2021 ), and brain tumor ( Cohen et al, 2020 ). However, pCASL has seldom been used for imaging leukoencephalopathies and even less so for CSF1R-microglial encephalopathy.…”

Section: Discussionmentioning

confidence: 99%

Two Novel Intronic Mutations in the CSF1R Gene in Two Families With CSF1R-Microglial Encephalopathy

Jiang

Wang

et al. 2022

Front. Cell Dev. Biol.

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Objective: To describe two novel heterozygous splicing variants of the CSF1R gene responsible for CSF1R-microglial encephalopathy in two unrelated Han Chinese families and further explore the relationship between the pathological and neuroimaging findings in this disease.Methods: The demographic data, detailed medical history, and clinical manifestations of two unrelated Han families with CSF1R-microglial encephalopathy were recorded. Some family members also underwent detailed neuropsychological evaluation, neuroimaging, and genetic testing. The probands underwent whole-exome sequencing (WES) or next-generation sequencing (NGS) to confirm the diagnosis. The findings were substantiated using Sanger sequencing, segregation analysis, and phenotypic reevaluation.Results: Both families presented with a dominant hereditary pattern. Five of 27 individuals (four generations) from the first family, including the proband and his sister, father, uncle, and grandmother, presented with cognitive impairments clinically during their respective lifetimes. Brain magnetic resonance imaging (MRI) depicted symmetric, confluent, and diffuse deep white matter changes, atrophy of the frontoparietal lobes, and thinning of the corpus callosum. The proband’s brother remained asymptomatic; brain MRI revealed minimal white matter changes, but pseudo-continuous arterial spin labeling (pCASL) demonstrated a marked reduction in the cerebral blood flow (CBF) in the bilateral deep white matter and corpus callosum. Seven family members underwent WES, which identified a novel splice-site heterozygous mutation (c.2319+1C>A) in intron 20 of the CSF1R gene in four members. The proband from the second family presented with significant cognitive impairment and indifference; brain MRI depicted symmetric diffuse deep white matter changes and thinning of the corpus callosum. The proband’s mother reported herself to be asymptomatic, while neuropsychological evaluation suggested mild cognitive impairment, and brain MRI demonstrated abnormal signals in the bilateral deep white matter and corpus callosum. NGS of 55 genes related to hereditary leukodystrophy was performed for three members, which confirmed a novel splice-site heterozygous mutation (c.1858+5G>A) in intron 13 of the CSF1R gene in two members.Conclusions: Our study identified two novel splicing mutation sites in the CSF1R gene within two independent Chinese families with CSF1R-microglial encephalopathy, broadening the genetic spectrum of CSF1R-microglial encephalopathy and emphasizing the value of pCASL for early detection of this disease.

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Penumbra quantification from MR SWI‐DWI mismatch and its comparison with MR ASL PWI‐DWI mismatch in patients with acute ischemic stroke

Cited by 13 publications

References 48 publications

Inhibition of the enzyme autotaxin reduces cortical excitability and ameliorates the outcome in stroke

Inhibition of the enzyme autotaxin reduces cortical excitability and ameliorates the outcome in stroke

Differentiation of Meningiomas and Gliomas by Amide Proton Transfer Imaging: A Preliminary Study of Brain Tumour Infiltration

Two Novel Intronic Mutations in the CSF1R Gene in Two Families With CSF1R-Microglial Encephalopathy

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