Multi-delay arterial spin labeling brain magnetic resonance imaging study for pediatric autism

Introduction Arterial spin labeling (ASL) is a non-invasive magnetic resonance imaging (MRI) technique that can measure regional cerebral blood flow (rCBF) without radiation exposure. This study aimed to evaluate rCBF in individuals with autism and their age-matched controls, globally and regionally. Methods We performed ASL MRI (3T, pulsed-continuous ASL, 3 delayed ASL imaging sequences) for 33 patients with autism spectrum disorder (ASD) (average age: 7.3 years, range: 2-14 years). Nineteen children (average age: 8.6 years, range: 3-15 years) without ASD and intellectual delay were included as controls. Patients with morphological abnormalities detected on MRI were excluded. Objective analysis was performed with automatic region of interest analysis of the ASL results. The Mann-Whitney U test was used to compare the rCBF results between the groups. Results Compared to the controls, patients with ASD showed a statistically significant decrease in rCBF, respectively, in the insula [left, rCBF 51.8±9.5 mL/100 g/min (mean±SD) versus 59.9±9.8, p=0.0017; right, 51.2±10.1 versus 57.8±8.8, p=0.0354], superior parietal lobule (left, 44.6±8.4 versus 52.0±7.8, p=0.003), superior temporal gyrus (left, 50.0±8.6 versus 56.9±8.6, p=0.007; right, 49.5±8.4 versus 56.4±7.7, p=0.0058), and inferior frontal gyrus (left, 53.0±9.8 versus 59.3±9.9, p=0.0279), which are associated with the mirror neuron system. Conclusions We concluded that patients with ASD showed a statistically significant decline in CBF in regions associated with the mirror neuron system. The advantages of ASL MRI include low invasiveness (no radiation exposure) and short imaging time (approximately 5 min). Studies with larger sample sizes are required to establish the diagnostic value of ASL MRI for ASD

ノウソッチュウ チョウキュウセイキ ニオケル ガゾウ シンダン プロトコール

We described our imaging protocol for apoplexy to select a therapeutic way. The recent advance of MR technology much contributes to diagnosis of cerebral ischemic disease. Especially the EPI method is now applied to clinical MR machine and make possible to obtain diffusion-weighted images (DWI) with excellent quality, which can detect super-acute phase of cerebral infarction. Then we choose MRI as the first modality conducted for patients of apoplexy and measured DWI and perfusion MRI before conducting conventional cerebral angiography. The mismatch area between DWI and perfusion MRI will suggest the necessity of re-circulation therapy because rescuable neuronal cells from ischemia will exist in the mismatch area. Furthermore cerebral hemorrhage can be detected using EPI-T2 weighted images and DWI, and the luxury perfusion will be also evaluated by perfusion MRI. Therefore we considered that MR examination could be the first modality conducted for diagnosis of cerebral vascular accident of acute phase

MRS Study of ACC in Asperger's Syndrome

Purpose Proton magnetic resonance spectroscopy (1H MRS) is a noninvasive neuroimaging method to quantify biochemical metabolites in vivo and it can serve as a powerful tool to monitor neurobiochemical profiles in the brain. Asperger's syndrome (AS) is a type of autism spectrum disorder, which is characterized by impaired social skills and restrictive, repetitive patterns of interest and activities, while intellectual levels and language skills are relatively preserved. Despite clinical aspects have been well-characterized, neurometabolic profiling in the brain of AS remains to be clear. The present study used proton magnetic resonance spectroscopy (1H MRS) to investigate whether pediatric AS is associated with measurable neurometabolic abnormalities that can contribute new information on the neurobiological underpinnings of the disorder. Methods Study participants consisted of 34 children with AS (2-12 years old; mean age 5.2 (±2.0); 28 boys) and 19 typically developed children (2-11 years old; mean age 5.6 (±2.6); 12 boys) who served as the normal control group. The 1H MRS data were obtained from two regions of interest: the anterior cingulate cortex (ACC) and left cerebellum. Results In the ACC, levels of N-acetylaspartate (NAA), total creatine (tCr), total choline-containing compounds (tCho) and myo-Inositol (mI) were significantly decreased in children with AS compared to controls. On the other hand, no significant group differences in any of the metabolites were found in the left cerebellum. Neither age nor sex accounted for the metabolic findings in the regions. Conclusion The finding of decreased levels of NAA, tCr, tCho, and mI in the ACC but not in left cerebellar voxels in the AS, suggests a lower ACC neuronal density in the present AS cohort compared to controls

Clinical efficacy and problems with CT lymphography in identifying the sentinel node in breast cancer

Abstract Background Combining a radioisotope with a dye-guided method is the best method for identification of the sentinel lymph nodes (SNs) in breast cancer. However, some institutions are limited to use of a dye-guided method alone. Recently, computed tomographic lymphography (CTLG) employing a nonionic contrast medium has achieved SN identification. Patients and methods 218 patients with primary breast cancer and no clinical evidence of lymph node metastasis were studied. SN identification was performed by CTLG and a dye-guided method. The SN identification rate was analyzed for correlations with the clinicopathological findings. Results The SN identification rates were 96% with CTLG, 92% with the dye-guided method and 99% with both methods combined. The identification rates with CTLG and the combined method were significantly lower in node-positive patients compared to node-negative patients, and significantly lower with the combined method in vascular invasion-positive patients compared to negative patients. In addition, the SN identification rate with the dye-guided method was significantly lower in patients with a body mass index (BMI) of ≥ 25, whereas the BMI did not affect the identification rate with CTLG or the combined method. Multiple SNs were detected in approximately 20% of the patients. Conclusion Combined performance of CTLG and a dye-guided method enables identification of SNs prior to breast cancer surgery. That SN identification is easier compared with by the dye-guided method alone, and the identification rate is improved compared with either method alone. The combination of methods was especially useful in obese patients. For patients with multiple SNs, the combination has the further advantage of enabling accurate SN biopsy. CTLG may yield false-negative findings in node-positive patients and patients with lymph vessel obstruction.</p