Purpose: Magnetic resonance imaging (MRI) is the gold standard in visualizing brain tumors and their effects on adjacent structures. However, no reliable information concerning different tumor components and borders b...Purpose: Magnetic resonance imaging (MRI) is the gold standard in visualizing brain tumors and their effects on adjacent structures. However, no reliable information concerning different tumor components and borders between perifocal edema and infiltration areas can be received. The aim of the study was to establish and evaluate a multimodal imaging concept, in order to differentiate different biological tumor components and to determine tumor borders. Materials and Methods: 12 patients with cerebral gliomas (four low and eight high grade) received a “morphological” MRI, a 3D MR spectroscopy and a T2* MR perfusion examination prior to surgery. Data was evaluated by defining different tumor components, which were entitled based upon their multimodal characteristics and histological data. Results: In high grade gliomas different components can be differentiated, which were described as: “true edema”, “cellular proliferation”, “vascular proliferation”, “cellular infiltration”, “tumor” and “necrosis”. In low grade gliomas, four different tumor components were found: “true edema”, “cellular infiltration”, “cellular proliferation” and “tumor”. Conclusion: With the applied multimodal imaging and a novel evaluation concept, it was possible to detect different tumor components, which could be helpful in detecting the optimal sites for tumor biopsy. Especially in morphological “edema appearing” sites, this knowledge could be important for the adaption of tumor resection borders and the planning of radiation therapy. Further studies with more patients and histological correlation are needed.展开更多
Objectives: The anterior cingulate is thought to be essentially involved in impulsivity and affect regulation and in the pathogenesis of depression as well as of attention deficit/hyperactivity disorder. At the same t...Objectives: The anterior cingulate is thought to be essentially involved in impulsivity and affect regulation and in the pathogenesis of depression as well as of attention deficit/hyperactivity disorder. At the same time alterations in glutamatergic neurotransmission in the frontal forebrain have been found in imaging studies in Attention Deficit Hyperactivity Disorder (ADHD) and in depressive patients. Therefore we hypothesized that glutamate/glutamine (Glx) signals in the anterior cingulate cortex (ACC) of depressed ADHD patients might differ from that in non-depressed patients. Methods: Fourteen male adult patients with ADHD were included into the study. Chemical Shift Imaging of ACC was performed. Subgroups were defined based on scores on the Beck Depression Inventory (BDI) and ratios of metabolites were compared between groups. Additionally correlation analyses of BDI scores with metabolite ratios were calculated. Results: Significantly lower Glx signals and N-acetyl-aspartate (NAA) signals were found in the left anterior cingulate cortex of depressed ADHD patients. The Glx/Cr and NAAX/Cr ratios in the left ACC correlated significantly with BDI-scores. Conclusions: To our knowledge this is the first report about a relationship between depressive symptoms and metabolite disturbances in ACC of adult patients with ADHD. Our preliminary data produce first evidence for a putative link between neurochemical alterations in the ACC and depressive symptoms. They should be controlled for in further studies.展开更多
文摘Purpose: Magnetic resonance imaging (MRI) is the gold standard in visualizing brain tumors and their effects on adjacent structures. However, no reliable information concerning different tumor components and borders between perifocal edema and infiltration areas can be received. The aim of the study was to establish and evaluate a multimodal imaging concept, in order to differentiate different biological tumor components and to determine tumor borders. Materials and Methods: 12 patients with cerebral gliomas (four low and eight high grade) received a “morphological” MRI, a 3D MR spectroscopy and a T2* MR perfusion examination prior to surgery. Data was evaluated by defining different tumor components, which were entitled based upon their multimodal characteristics and histological data. Results: In high grade gliomas different components can be differentiated, which were described as: “true edema”, “cellular proliferation”, “vascular proliferation”, “cellular infiltration”, “tumor” and “necrosis”. In low grade gliomas, four different tumor components were found: “true edema”, “cellular infiltration”, “cellular proliferation” and “tumor”. Conclusion: With the applied multimodal imaging and a novel evaluation concept, it was possible to detect different tumor components, which could be helpful in detecting the optimal sites for tumor biopsy. Especially in morphological “edema appearing” sites, this knowledge could be important for the adaption of tumor resection borders and the planning of radiation therapy. Further studies with more patients and histological correlation are needed.
文摘Objectives: The anterior cingulate is thought to be essentially involved in impulsivity and affect regulation and in the pathogenesis of depression as well as of attention deficit/hyperactivity disorder. At the same time alterations in glutamatergic neurotransmission in the frontal forebrain have been found in imaging studies in Attention Deficit Hyperactivity Disorder (ADHD) and in depressive patients. Therefore we hypothesized that glutamate/glutamine (Glx) signals in the anterior cingulate cortex (ACC) of depressed ADHD patients might differ from that in non-depressed patients. Methods: Fourteen male adult patients with ADHD were included into the study. Chemical Shift Imaging of ACC was performed. Subgroups were defined based on scores on the Beck Depression Inventory (BDI) and ratios of metabolites were compared between groups. Additionally correlation analyses of BDI scores with metabolite ratios were calculated. Results: Significantly lower Glx signals and N-acetyl-aspartate (NAA) signals were found in the left anterior cingulate cortex of depressed ADHD patients. The Glx/Cr and NAAX/Cr ratios in the left ACC correlated significantly with BDI-scores. Conclusions: To our knowledge this is the first report about a relationship between depressive symptoms and metabolite disturbances in ACC of adult patients with ADHD. Our preliminary data produce first evidence for a putative link between neurochemical alterations in the ACC and depressive symptoms. They should be controlled for in further studies.
