scholarly journals Direct Rating Estimation of Enlarged Perivascular Spaces (EPVS) in Brain MRI Using Deep Neural Network

2021 ◽  
Vol 11 (20) ◽  
pp. 9398
Author(s):  
Ehwa Yang ◽  
Venkateswarlu Gonuguntla ◽  
Won-Jin Moon ◽  
Yeonsil Moon ◽  
Hee-Jin Kim ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Brain Mri ◽  
Model Performance ◽  
Classification Problem ◽  
Perivascular Spaces ◽  
Risk Indicator ◽  
Estimation Model ◽  
Problem Model ◽  
Magnetic Resonance Imaging Mri ◽  
Multi Class Classification

In this article, we propose a deep-learning-based estimation model for rating enlarged perivascular spaces (EPVS) in the brain’s basal ganglia region using T2-weighted magnetic resonance imaging (MRI) images. The proposed method estimates the EPVS rating directly from the T2-weighted MRI without using either the detection or the segmentation of EVPS. The model uses the cropped basal ganglia region on the T2-weighted MRI. We formulated the rating of EPVS as a multi-class classification problem. Model performance was evaluated using 96 subjects’ T2-weighted MRI data that were collected from two hospitals. The results show that the proposed method can automatically rate EPVS—demonstrating great potential to be used as a risk indicator of dementia to aid early diagnosis.

Perivascular Spaces in the Basal Ganglia and Long-term Motor Prognosis in Newly Diagnosed Parkinson Disease

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011797
Author(s):  
Seok Jong Chung ◽  
Han Soo Yoo ◽  
Na-Young Shin ◽  
Yae Won Park ◽  
Hye Sun Lee ◽  
...  
Keyword(s):  
Basal Ganglia ◽  
Cox Regression ◽  
Small Vessel Disease ◽  
Symptom Control ◽  
Brain Mri ◽  
Freezing Of Gait ◽  
Initial Assessment ◽  
Perivascular Spaces ◽  
Wearing Off

Objectives:To investigate the association between enlarged perivascular spaces (PVSs) in the basal ganglia (BG-PVSs) and long-term motor outcomes in Parkinson’s disease (PD).Methods:We reviewed the medical records of 248 patients with drug-naïve early-stage PD (follow-up >3 years, mean age 67.44 ± 8.46 years, 130 females) who underwent brain MRI and dopamine transporter (DAT) scans at initial assessment. The number of baseline enlarged BG-PVSs was counted on axial T2-weighted images. Then, patients were divided into two groups: a PD group with a low number (0−10) of enlarged PVSs (PD-EPVS−; n = 156) and that with a high number (>10) of enlarged PVSs (PD-EPVS+; n = 92). We used Cox regression models to compare the levodopa-induced dyskinesia (LID)-, wearing-off-, and freezing of gait (FOG)-free times between groups. We also compared longitudinal increases in levodopa-equivalent dose per body weight between groups using a linear mixed model.Results:Patients in the PD-EPVS+ group were older (72.28 ± 6.07 years) and had greater small vessel disease burden than those in the PD-EPVS− group (64.58 ± 8.38 years). The PD-EPVS+ group exhibited more severely decreased DAT availability in all striatal sub-regions except the ventral striatum. The risk of FOG was higher in the PD-EPVS+ group, but the risk of LID or wearing-off was comparable between groups. The PD-EPVS+ group required higher doses of dopaminergic medications for effective symptom control compared to the PD-EPVS− group.Conclusions:This study suggests that baseline enlarged BG-PVSs can be an indicator of the progression of motor disability in PD.

scholarly journals Large anterior temporal Virchow–Robin spaces: Evaluating MRI features over the years—Our experience and literature review

2020 ◽  
Vol 4 (1) ◽  
pp. 2514183X2090525
Author(s):  
Raffaella Capasso ◽  
Alberto Negro ◽  
Sossio Cirillo ◽  
Silvia Iovine ◽  
Gianfranco Puoti ◽  
...  
Keyword(s):  
Brain Mri ◽  
Perivascular Spaces ◽  
Mri Features ◽  
Signal Change ◽  
Long Term Follow Up ◽  
Magnetic Resonance Imaging Mri ◽  
Preferential Location ◽  
The Stability

Dilated Virchow–Robin spaces (VRSs) are expansions of the normal perivascular spaces with a short axis greater than 2 mm or, according to some authors, greater than 3 mm. They are usually documented at the basal ganglia, at the convexity white matter (WM) and centrum semiovale, and at the mesencephalon. The anterior temporal WM is a recently described preferential location for large (≥5 mm) VRSs. The aim of our study was to evaluate the magnetic resonance imaging (MRI) features and their modifications during a long-term follow-up period (≥24 months) of the anterior temporal VRSs with a retrospective analysis among all brain MRI studies performed at our institution between January 2010 and January 2017. In our study, the presence and the stability of characteristic MRI features certainly increased our diagnostic confidence allowing us to continue conservative approach while the surrounding signal change, as reported in the literature, should not in itself prompt alternative diagnoses to be entertained.

scholarly journals Perivascular spaces on 7 Tesla brain MRI are related to markers of small vessel disease but not to age or cardiovascular risk factors

2016 ◽  
Vol 36 (10) ◽  
pp. 1708-1717 ◽  
Author(s):  
Willem H Bouvy ◽  
Jaco JM Zwanenburg ◽  
Rik Reinink ◽  
Laura EM Wisse ◽  
Peter R Luijten ◽  
...  
Keyword(s):  
Risk Factors ◽  
Basal Ganglia ◽  
Small Vessel Disease ◽  
Brain Mri ◽  
Vascular Risk Factors ◽  
Small Vessel ◽  
7 Tesla ◽  
Perivascular Spaces ◽  
Vascular Risk ◽  
Vessel Disease

Cerebral perivascular spaces (PVS) are small physiological structures around blood vessels in the brain. MRI visible PVS are associated with ageing and cerebral small vessel disease (SVD). 7 Tesla (7T) MRI improves PVS detection. We investigated the association of age, vascular risk factors, and imaging markers of SVD with PVS counts on 7 T MRI, in 50 persons aged ≥ 40. The average PVS count ± SD in the right hemisphere was 17 ± 6 in the basal ganglia and 71 ± 28 in the semioval centre. We observed no relation between age or vascular risk factors and PVS counts. The presence of microbleeds was related to more PVS in the basal ganglia (standardized beta 0.32; p = 0.04) and semioval centre (standardized beta 0.39; p = 0.01), and white matter hyperintensity volume to more PVS in the basal ganglia (standardized beta 0.41; p = 0.02). We conclude that PVS counts on 7T MRI are high and are related SVD markers, but not to age and vascular risk factors. This latter finding may indicate that due to the high sensitivity of 7T MRI, the correlation of PVS counts with age or vascular risk factors may be attenuated by the detection of “normal”, non-pathological PVS.

scholarly journals Perivascular spaces and brain waste clearance systems: relevance for neurodegenerative and cerebrovascular pathology

2021 ◽  
Author(s):  
Kaylene Gouveia-Freitas ◽  
António J. Bastos-Leite
Keyword(s):  
Basal Ganglia ◽  
Lymphatic Vessels ◽  
Vascular Wall ◽  
Lymphatic Drainage ◽  
Basement Membranes ◽  
Amyloid Angiopathy ◽  
Perivascular Spaces ◽  
Functional Abnormality ◽  
Ischaemic Injury ◽  
Cerebrovascular Pathology

AbstractPerivascular spaces (PVS) of the brain, often called Virchow-Robin spaces, comprise fluid, cells and connective tissue, and are externally limited by astrocytic endfeet. PVS are involved in clearing brain waste and belong to the “glymphatic” system and/or the “intramural periarterial drainage” pathway through the basement membranes of the arteries. Related brain waste clearance systems include the blood–brain barrier, scavenger cells, cerebrospinal fluid, perineural lymphatic drainage pathways and the newly characterised meningeal lymphatic vessels. Any functional abnormality of PVS or related clearance systems might lead to accumulation of brain waste. It has been postulated that PVS enlargement can be secondary to accumulation of β-amyloid. Lack of integrity of the vascular wall, microbleeds, cerebral amyloid angiopathy (CAA) and enlarged PVS often occur in the preclinical stages of Alzheimer’s disease, preceding substantial brain atrophy. PVS enlargement in the form of état criblé at the basal ganglia has also been considered to reflect focal atrophy, most probably secondary to ischaemic injury, based upon both pathological and imaging arguments. In addition, distinct topographic patterns of enlarged PVS are related to different types of microangiopathy: CAA is linked to enlarged juxtacortical PVS, whereas subjects with vascular risk factors tend to have enlarged PVS in the basal ganglia. Therefore, enlarged PVS are progressively being regarded as a marker of neurodegenerative and cerebrovascular pathology. The present review addresses the evolving concept of PVS and brain waste clearance systems, the potential relevance of their dysfunction to neurodegenerative and cerebrovascular pathology, and potential therapeutic approaches of interest.

Intrapartum Basal Ganglia–Thalamic Pattern Injury and Radiologically Termed “Acute Profound Hypoxic–Ischemic Brain Injury” Are Not Synonymous

2020 ◽  
Author(s):  
Johan Smith ◽  
Regan Solomons ◽  
Lindi Vollmer ◽  
Eduard J. Langenegger ◽  
Jan W. Lotz ◽  
...  
Keyword(s):  
Brain Injury ◽  
Basal Ganglia ◽  
Caesarean Section ◽  
Median Time ◽  
Mode Of Delivery ◽  
Time Interval ◽  
Key Points ◽  
Admission Status ◽  
Sentinel Event ◽  
Magnetic Resonance Imaging Mri

Objective Human cases of acute profound hypoxic-ischemic (HI) injury (HII), in which the insult duration timed with precision had been identified, remains rare, and there is often uncertainty of the prior state of fetal health. Study Design A retrospective analysis of 10 medicolegal cases of neonatal encephalopathy-cerebral palsy survivors who sustained intrapartum HI basal ganglia-thalamic (BGT) pattern injury in the absence of an obstetric sentinel event. Results Cardiotocography (CTG) admission status was reassuring in six and suspicious in four of the cases. The median time from assessment by admission CTG or auscultation to birth was 687.5 minutes (interquartile range [IQR]: 373.5–817.5 minutes), while the median time interval between first pathological CTG and delivery of the infant was 179 minutes (IQR: 137–199.25 minutes). The mode of delivery in the majority of infants (60%) was by unassisted vaginal birth; four were delivered by delayed caesarean section. The median (IQR) interval between the decision to perform a caesarean section and delivery was 169 minutes (range: 124–192.5 minutes). Conclusion The study shows that if a nonreassuring fetal status develops during labor and is prolonged, a BGT pattern HI injury may result, in the absence of a perinatal sentinel event. Intrapartum BGT pattern injury and radiologically termed “acute profound HI brain injury” are not necessarily synonymous. A visualized magnetic resonance imaging (MRI) pattern should preferably solely reflect the patterns description and severity, rather than a causative mechanism of injury. Key Points

scholarly journals Confidence interval for micro-averaged F1 and macro-averaged F1 scores

2021 ◽  
Author(s):  
Kanae Takahashi ◽  
Kouji Yamamoto ◽  
Aya Kuchiba ◽  
Tatsuki Koyama
Keyword(s):  
Binary Classification ◽  
Classification Problem ◽  
Classification Problems ◽  
Summary Measure ◽  
Medical Field ◽  
Predictive Values ◽  
Binary Classification Problem ◽  
Multi Class Classification ◽  
Sensitivity Specificity ◽  
Measures Of Performance

AbstractA binary classification problem is common in medical field, and we often use sensitivity, specificity, accuracy, negative and positive predictive values as measures of performance of a binary predictor. In computer science, a classifier is usually evaluated with precision (positive predictive value) and recall (sensitivity). As a single summary measure of a classifier’s performance, F1 score, defined as the harmonic mean of precision and recall, is widely used in the context of information retrieval and information extraction evaluation since it possesses favorable characteristics, especially when the prevalence is low. Some statistical methods for inference have been developed for the F1 score in binary classification problems; however, they have not been extended to the problem of multi-class classification. There are three types of F1 scores, and statistical properties of these F1 scores have hardly ever been discussed. We propose methods based on the large sample multivariate central limit theorem for estimating F1 scores with confidence intervals.

scholarly journals Methomyl poisoning presenting with decorticate posture and cortical blindness

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Chih-Ming Lin
Keyword(s):  
Brain Mri ◽  
Vital Signs ◽  
Altered Mental Status ◽  
Cortical Blindness ◽  
High Signal ◽  
Blurred Vision ◽  
Cerebral Disease ◽  
Cerebral Magnetic Resonance Imaging ◽  
Neurological Effects ◽  
Magnetic Resonance Imaging Mri

Methomyl is a potent pesticide that is widely used in the field of agriculture. The systemic toxic effects of methomyl have been well described. However, the neurological effects of methomyl intoxication are not well understood. In this study, we report a 61-year-old Taiwanese man sent to our emergency department because of altered mental status. His family stated that he had consumed liquid methomyl in a suicide attempt. He was provided cardiopulmonary resuscitation because of unstable vital signs. He was then sent to an intensive care unit for close observation. On the second day of admission, he regained consciousness but exhibited irregular limb and torso posture. On the sixth day, he started to complain of blurred vision. An ophthalmologist was consulted but no obvious abnormalities could be identified. On suspicion of cerebral disease, a neurologist was consulted. Further examination revealed cortical blindness and decorticate posture. Cerebral magnetic resonance imaging (MRI) was arranged, which identified bilateral occipital regions lesions. The patient was administered normal saline and treated with aspirin and piracetam for 3 weeks in hospital. During the treatment period, his symptom of cortical blindness resolved, whereas his decorticate posture was refractory. Follow-up brain MRI results supported our clinical observations by indicating the disappearance of the bilateral occipital lesions and symmetrical putaminal high signal abnormalities. In this article, we briefly discuss the possible mechanisms underlying the cerebral effects of methomyl poisoning. Our study can provide clinicians with information on the manifestations of methomyl intoxication and an appropriate treatment direction.

Fish Intake and MRI Burden of Cerebrovascular Disease in Older Adults

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000012916
Author(s):  
Aline Thomas ◽  
Fabrice Crivello ◽  
Bernard Mazoyer ◽  
Stephanie Debette ◽  
Christophe Tzourio ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Cerebrovascular Disease ◽  
Brain Mri ◽  
Large Population ◽  
Population Based ◽  
Fish Intake ◽  
Mixed Data ◽  
Perivascular Spaces ◽  
Intracranial Volume ◽  
Cross Sectional

Background and Objective:Fish intake may prevent cerebrovascular disease (CVD), yet the mechanisms are unclear, especially regarding its impact on subclinical damage. Assuming that fish may have pleiotropic effect on cerebrovascular health, we investigated the association of fish intake with global CVD burden based on brain MRI markers.Methods:This cross-sectional analysis included participants from the Three-City Dijon population-based cohort (aged ≥65 years) without dementia, stroke, or history of hospitalized cardiovascular disease, who underwent brain MRI with automated assessment of white matter hyperintensities, visual detection of covert infarcts, and grading of dilated perivascular spaces. Fish intake was assessed through a frequency questionnaire and the primary outcome measure was defined as the first component of a factor analysis of mixed data applied to MRI markers. The association of fish intake with the CVD burden indicator was studied using linear regressions.Results:In total, 1,623 participants (mean age, 72.3 years; 63% women) were included. The first component of factor analysis (32.4% of explained variance) was associated with higher levels of all three MRI markers. Higher fish intake was associated with lower CVD burden. In a model adjusted for total intracranial volume, compared to participants consuming fish <1 per week, those consuming fish 2-3 and ≥4 times per week had a β = -0.19 (95% CI, -0.37; -0.01) and β = -0.30 (-0.57; -0.03) lower indicator of CVD burden, respectively (P trend <0.001). We found evidence of effect modification by age, so that the association of fish to CVD was stronger in younger participants (65-69 years) and not significant in participants aged ≥75 years. For comparison, in the younger age group, consuming fish 2-3 times a week was roughly equivalent (in opposite direction) to the effect of hypertension.Discussion:In this large population-based study, higher frequency of fish intake was associated with lower CVD burden, especially among participants younger than 75 years, suggesting a beneficial effect on brain vascular health before manifestation of overt brain disease.Classification of Evidence:This study provides Class II evidence that in individuals without stroke or dementia, higher fish intake is associated with lower subclinical CVD at MRI.

Pediatric Reversible Cerebral Vasoconstriction Syndrome: Two Unique Cases with a Review of all Reported Children

2021 ◽  
Author(s):  
Neelu Desai ◽  
Rahul Badheka ◽  
Nitin Shah ◽  
Vrajesh Udani
Keyword(s):  
Magnetic Resonance ◽  
Cerebral Arteries ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Reversible Cerebral Vasoconstriction Syndrome ◽  
Neurological Deficits ◽  
Cerebral Vasoconstriction ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Mr Angiogram

AbstractReversible cerebral vasoconstriction syndrome (RCVS) has been well described in adults, but pediatric cases are yet under recognized. We describe two children with RCVS and review similar already published pediatric cases. The first patient was a 10-year-old girl who presented with severe headaches and seizures 3 days after blood transfusion. Brain magnetic resonance imaging (MRI) showed changes compatible with posterior reversible encephalopathy syndrome and subarachnoid hemorrhage. Magnetic resonance angiogram showed diffuse vasoconstriction of multiple cerebral arteries. The second patient was a 9-year-old boy who presented with severe thunderclap headaches. Brain MRI showed isolated intraventricular hemorrhage. Computed tomography/MR angiogram and digital subtraction angiogram were normal. A week later, he developed focal neurological deficits. Repeated MR angiogram showed diffuse vasospasm of multiple intracranial arteries. Both children recovered completely. A clinico-radiological review of previously reported childhood RCVS is provided.

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