Cerebral small vessel disease(CSVD)is a leading cause of age-related microvascular cognitive decline,resulting in significant morbidity and decreased quality of life.Despite a progress on its key pathophysiological ba...Cerebral small vessel disease(CSVD)is a leading cause of age-related microvascular cognitive decline,resulting in significant morbidity and decreased quality of life.Despite a progress on its key pathophysiological bases and general acceptance of key terms from neuroimaging findings as observed on the magnetic resonance imaging(MRI),key questions on CSVD remain elusive.Enhanced relationships and reliable lesion studies,such as white matter tractography using diffusion-based MRI(dMRI)are necessary in order to improve the assessment of white matter architecture and connectivity in CSVD.Diffusion tensor imaging(DTI)and tractography is an application of dMRI that provides data that can be used to non-invasively appraise the brain white matter connections via fiber tracking and enable visualization of individual patient-specific white matter fiber tracts to reflect the extent of CSVD-associated white matter damage.However,due to a lack of standardization on various sets of software or image pipeline processing utilized in this technique that driven mostly from research setting,interpreting the findings remain contentious,especially to inform an improved diagnosis and/or prognosis of CSVD for routine clinical use.In this minireview,we highlight the advances in DTI pipeline processing and the prospect of this DTI metrics as potential imaging biomarker for CSVD,even for subclinical CSVD in at-risk individuals.展开更多
脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔...脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔隙性脑梗死的分布位置、严重程度对各认知域产生不同影响,CSVD导致的认知功能障碍可能与炎症因子间接影响和脑组织纤维束破坏等机制相关。但CSVD影像学标志物与认知功能的关系及其相关机制还需要更进一步研究加以验证。展开更多
白质纤维束分割方法通过识别连接不同脑区的白质通路,为脑连接分析提供了重要的神经通路参考信息。然而,传统的白质纤维束分割方法主要依赖于弥散磁共振图像(Diffusion magnetic resonance imaging,dMRI),由于获取弥散磁共振图像比较耗...白质纤维束分割方法通过识别连接不同脑区的白质通路,为脑连接分析提供了重要的神经通路参考信息。然而,传统的白质纤维束分割方法主要依赖于弥散磁共振图像(Diffusion magnetic resonance imaging,dMRI),由于获取弥散磁共振图像比较耗时,这极大地限制了其在临床中的应用。为解决此问题,提出了一种基于T1加权图像的白质纤维束分割方法,通过计算T1加权图像的结构张量来提示可能的纤维走向,进而提高白质纤维束的分割精度。此外,本文在模型训练期间引入弥散磁共振图像的特权信息来指导模型学习,从而提升白质束分割模型性能,具有挑战性的束分割效果提升明显,其中左穹窿(Left fornix,FX_left)的Dice得分提高了5%,右穹窿(Right fornix,FX_right)的Dice得分提高了6%。。本研究弥补了在缺少弥散磁共振图像的场景下无法进行神经通路分析的不足,扩展了神经通路分析的应用场景。展开更多
文摘Cerebral small vessel disease(CSVD)is a leading cause of age-related microvascular cognitive decline,resulting in significant morbidity and decreased quality of life.Despite a progress on its key pathophysiological bases and general acceptance of key terms from neuroimaging findings as observed on the magnetic resonance imaging(MRI),key questions on CSVD remain elusive.Enhanced relationships and reliable lesion studies,such as white matter tractography using diffusion-based MRI(dMRI)are necessary in order to improve the assessment of white matter architecture and connectivity in CSVD.Diffusion tensor imaging(DTI)and tractography is an application of dMRI that provides data that can be used to non-invasively appraise the brain white matter connections via fiber tracking and enable visualization of individual patient-specific white matter fiber tracts to reflect the extent of CSVD-associated white matter damage.However,due to a lack of standardization on various sets of software or image pipeline processing utilized in this technique that driven mostly from research setting,interpreting the findings remain contentious,especially to inform an improved diagnosis and/or prognosis of CSVD for routine clinical use.In this minireview,we highlight the advances in DTI pipeline processing and the prospect of this DTI metrics as potential imaging biomarker for CSVD,even for subclinical CSVD in at-risk individuals.
文摘脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔隙性脑梗死的分布位置、严重程度对各认知域产生不同影响,CSVD导致的认知功能障碍可能与炎症因子间接影响和脑组织纤维束破坏等机制相关。但CSVD影像学标志物与认知功能的关系及其相关机制还需要更进一步研究加以验证。
文摘目的探讨线上导言、学习目标、预评估、参与式学习、后评估和总结(bridge-in,objective/outcome,pre-assessment,participatory learning,post-assessment,summary,BOPPPS)教学模式在放射科住院医师规范化培训中的应用效果,为促进放射影像学的教学改革提供参考。方法2021年9月—2022年9月,选取浙江大学医学院附属第二医院的放射科住院医师规范化培训(住培)学员48名,基于计算机程序随机分配为试验组(n=24)和对照组(n=24)。试验组使用线上BOPPPS教学模式,对照组采用传统线上教学。以脑小血管病(cerebral small vessel disease,CSVD)评估为教学内容,分析比较2组专业理论知识掌握程度和住培学员满意度。结果试验组住培学员在基础部分的脑室旁脑白质高信号评分低于对照组,并且在大多数与脑小血管病相关的高级问题上表现出色,包括半卵圆中心扩大的血管周围间隙、内侧颞叶萎缩和大脑微梗死得分,差异均有统计学意义(P<0.05)。试验组的基础部分总得分与对照组相似,但在高级问题部分以及理论考核总分上优于对照组[(5.38±1.10)分vs.(4.04±1.37)分],差异有统计学意义(P<0.05)。结论采用线上BOPPPS教学模式对放射科住院医师的规范化培训更为有效,相比传统线上教学有一定的优势。
