Regional volume changes of the brain in migraine chronification

The pathophysiology of migraine is complex.Neuroimaging studies reveal functional and structural changes in the brains of migraine patients.We sought to explore regional volume differences in intracranial structures in patients with episodic and chronic migraine.Sixteen episodic migraine patients,16 chronic migraine patients,and 24 normal controls were recruited and underwent 3.0 T MRI scanning.The volumes of 142 brain regions were calculated by an automatic volumetric algorithm and compared with clinical variables.Results demonstrated that the volumes of specific regions in the frontal and occipital lobes,and the right putamen,were increased and the volume of the fourth ventricle was decreased in the episodic migraine patients compared with controls.The volumes of the left basal forebrain,optic chiasm,and,the fourth ventricle were decreased in the chronic migraine patients,while the occipital cortex and the right putamen were larger.Compared to episodic migraine patiants,chronic migraine patients displayed larger left thalamus and smaller frontal regions.Correlation analysis showed that headache frequency was negatively correlated with the volume of the right frontal pole,right lateral orbital gyrus,and medial frontal lobes and positively correlated with the volume of the left thalamus.The sleep disturbance score was negatively correlated with the volume of the left basal forebrain.This suggests that migraine patients have structural changes in regions associated with pain processing and modulation,affective and cognitive processing,and visual perception.The remodeling of selective intracranial structures may be involved in migraine attacks.This study was approved by the Ethics Committee of Chinese PLA General Hospital(approval No.S2018-027-02)on May 31,2018.

Hyperperfusion of Multiple Sclerosis Plaques Characterized by 3D FSE Arterial Spin Labelling

MULTIPLE sclerosis(MS)is a common inflammatory demyelinating disorder of central nervous system,and the disease burder could be well evaluated by conventional magnetic resonance imaging(MRI),1 including T2-weighted,fluid-attenuatd inversion recovery,and postcontrast T1-weighted sequences.2 We

MRI Evaluation of Lateral Geniculate Body in Normal Aging Brain Using Quantitative Susceptibility Mapping

Objective To investigate the changes of lateral geniculate body(LGB) in the normal aging brain using quantitative susceptibility mapping(QSM) technique. Methods Magnetic resonance(MR) phase and magnitude images were acquired from enhanced gradient echo T2 star weighted angiography sequence with 16 echoes on 3.0T MR system using the head coil with 32 channels. Morphology Enabled Dipole Inversion(MEDI) method was applied for QSM, and the susceptibility value of LGB was measured by region of interest(ROI) drawn manually on three orthogonal planes. Results LGB of the middle-aged group had a higher susceptibility value(0.16±0.05 ppm) than that of the youth group(0.12±0.05 ppm) and elderly group(0.13±0.03 ppm)(all P<0.05). Partial correlation analysis demonstrated that there was significantly positive correlation between susceptibility value and age in the youth group(r=0.71, P<0.05). Conclusion LGB could clearly be identified on QSM in the brain in vivo.

Striated Enhancement Sign in Invasive Cerebral Fungal Granuloma by Aspergillus:a Case Report

CEREBRAL aspergillosis is a rare and severe disorder with rapid progressive pathogenesis,and commonly seen in immunocompromised patients.1Typical cerebral aspergillosis presents abscess with ring enhancement or cortical or subcortical infactions on magnetic resonance(MR)images.In this communication,we describe a rare cerebral aspergillosis with relative characteristic MR imaging findings.

Prevalence of coronary artery ectasia in older adults and the relationship with epicardial fat volume by cardiac computed tomography angiography

Objective Coronary artery ectasia (CAE) refers to abnormal dilation of coronary artery segments to 1.5 times of adjacent normal ones. Epicardial fat is associated with cardiovascular risk factors. The relationship between CAE and epicardial fat has not yet been investigated. This study aimed to assess the relationship between CAE and epicardial fat volume (EFV) in older people by dual-source computed tomography coronary angiography (CTCA). Methods We prospectively enrolled 1400 older adults who were scheduled for dual-source CTCA. Under reconstruction protocols, patients with abnormal segments 1.5 times larger than the adjacent segments were accepted as CAE. EFV was measured by semi-automated software. Traditional risk factors in CAE patients, as well as the extent of EFV, were analyzed and compared to non-CAE group. Results A total of 885 male and 515 female older patients were enrolled. CAE was identified by univariable analysis in 131 patients and significantly correlated to hypertension, smoking, hyperlipidemia, prior percutaneous coronary intervention and ascending aorta aneurysm. EFV was shown to be significantly higher inCAE patients than patients without ectasia. Inmultivariable analyses, EFV (P = 0.018), hypertension (P < 0.001) and hyperlipidemia (P < 0.001) were significantly correlated to CAE. There was a significant negative correlation between EFV and Markis classification. Conclusions CAE can be reliably recognized by dual-source CTCA. Epicardial fatmight play a role in etiopathogenesis and progression of CAE, providing a newtarget for treating ectasia.

Functional changes of the lateral pterygoid muscle in patients with temporomandibular disorders:a pilot magnetic resonance images texture study

Background:Texture features were the intrinsic properties of the human tissues and could efficiently detect the subtle functional changes of involved tissue.The pathologic changes of the lateral pterygoid muscle(LPM)were significantly correlated with the temporomandibular disc displacement.However,the occult functional changes of LPM could not be detected by the naked eye on the medical images.The current study was aimed to evaluate the functional changes of the LPM in the patients with temporomandibular disorders(TMDs)using texture analysis.Methods:Twenty-nine patients with TMD were performed with magnetic resonance(MR)imaging on a 3.0T MR scanner,who were consecutively recruited from the TMD clinic of Hainan Hospital of Chinese People’s Liberation Army General Hospital from February 2019 to September 2019.The patients were classified into three groups according to the disc displacement:disc without displacement(DWoD),disc displacement with reduction(DDWR)and disc displacement without reduction(DDWoR).The graylevel co-occurrence matrix method was applied with the texture analysis of LPM on the axial T2-weighted imaging.The texture features included angular second moment,contrast,correlation,inverse different moment,and entropy.One-way analysis of variance was used for grouped comparisons and receiver operating characteristics(ROC)curve analysis was applied to evaluate the diagnostic efficacy of the texture parameters.Results:Texture contrast of LPM presented significantly lower in DDWoR(46.30[35.03,94.48])than that in DWoD(123.85[105.06,143.23];test statistic=23.05;P<0.001).Texture entropy of LPM showed significant differences among DWoD(7.62±0.33),DDWR(6.76±0.35),and DDWoR(6.46±0.39)(PDWoD-DDWR<0.001,PDWoD-DDWoR<0.001,and PDDWR-DDWoR=0.014).Area under the ROC curve(AUC)demonstrated that texture entropy had an excellent diagnostic accuracy for DWoD-DDWR(AUC=0.96)and DWoD-DDWoR(AUC=0.98).Conclusion:The texture contrast and entropy could identify the altered functional status of LPM in patients withTMDand could be considered as the effective imaging biomarker to evaluate the functional changes of LPM in TMD.

Impact of Clinical Guideline Recommendations on the Application of Coronary Computed Tomographic Angiography in Patients with Suspected Stable Coronary Artery Disease

Background： Coronary computed tomographic angiography （CCTA） has been widely used in patients who are at intemaediate risk for having stable coronary artery disease （SCAD）, and 2013 European Society of Cardiology Guidelines on the Management of SCAD （2013G） recommended the appropriate application of CCTA. However, 2013G has not been subjected to systematic analyses for subsequent impact on clinical practice. Methods： A total of 5320 patients suspected with SCAD were enrolled and scheduled for CCTA from March 2013 to September 2014. For each patient, pretest probability of SCAD was calculated according to updated Diamond-Forrester model （UDFM）. Appropriate CCTA or appropriate stress test was determined as described in the 2013G. A generalized estimating equation model was used to determine the trends in the half-monthly rate of appropriate CCTA. Results： Overall, only 61.37% of patients received appropriate CCTA, and there was insignificant change over time （P = 0.8701）. The application of CCTA in patients who should have had a stress test accounted for most of the inappropriate CCTA before （22.29%） or after （19.98%） the publication of the 2013G. In all patients or any subgroup, no significant change in the adjusted half-monthly rate of appropriate CCTA was found after the publication of the 2013G （odds ratio, 1.002; 95% confidence interval, 0.982-1.021; P = 0.8678）. Conclusions： These findings suggest that the 2013G have not, to date, been fully incorporated into clinical practice, and the clinical utilization of CCTA remains unreasonable to some extent.

Multimodal Magnetic Resonance Imaging Studies of Migraines Related to Increasing Risk Factors for Brain Lesions Would Be an Optimal Research Focus： A Pilot Literature Citation Analysis

To the Editor： Migraine is the third most prevalent headache disorder and the seventh leading cause of disability worldwide.The first magnetic resonance imaging （MRI） migraine study was reported in 1995, with many subsequent MRI migraine studies appearing after the development of structural brain and functional MRIs. Advanced MRI techniques such as voxel-based morphometry, advanced brain structure segment.