Poroelastic Mechanical Properties of the Brain Tissue of Normal Pressure Hydrocephalus Patients During Lumbar Drain Treatment Using Intrinsic Actuation MR Elastography.
Hydrocephalus
Intrinsic activation
Lumbar drain
Magnetic resonance elastography
Normal pressure hydrocephalus
Journal
Academic radiology
ISSN: 1878-4046
Titre abrégé: Acad Radiol
Pays: United States
ID NLM: 9440159
Informations de publication
Date de publication:
04 2021
04 2021
Historique:
received:
25
11
2019
revised:
05
03
2020
accepted:
07
03
2020
pubmed:
26
4
2020
medline:
16
4
2021
entrez:
26
4
2020
Statut:
ppublish
Résumé
Hydrocephalus (HC) is caused by accumulating cerebrospinal fluid resulting in enlarged ventricles and neurological symptoms. HC can be treated via a shunt in a subset of patients; identifying which individuals will respond through noninvasive imaging would avoid complications from unsuccessful treatments. This preliminary work is a longitudinal study applying MR Elastography (MRE) to HC patients with a focus on normal pressure hydrocephalus (NPH). Twenty-two ventriculomegaly patients were imaged and subsequently received a lumbar drain placement for cerebrospinal fluid (CSF) drainage. NPH lumbar drain responders and NPH syndrome nonresponders were categorized by clinical presentation. Displacement images were acquired using intrinsic activation (IA) MRE and poroelastic inversion recovered shear stiffness and hydraulic conductivity values. A stable IA-MRE inversion protocol was developed to produce unique solutions for both recovered properties, independent of initial estimates. Property images showed significantly increased shear modulus (p = 0.003 in periventricular region, p = 0.005 in remaining cerebral tissue) and hydraulic conductivity (p = 0.04 in periventricular region) in ventriculomegaly patients compared to healthy volunteers. Baseline MRE imaging did not detect significant differences between NPH lumbar drain responders and NPH syndrome nonresponders; however, MRE time series analysis demonstrated consistent trends in average poroelastic shear modulus values over the course of the lumbar drain process in responders (initial increase, followed by a later decrease) which did not occur in nonresponders. These findings are indicative of acute mechanical changes in the brain resulting from CSF drainage in NPH patients.
Identifiants
pubmed: 32331966
pii: S1076-6332(20)30150-1
doi: 10.1016/j.acra.2020.03.009
pmc: PMC7575616
mid: NIHMS1586732
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
457-466Subventions
Organisme : NIBIB NIH HHS
ID : R01 EB018230
Pays : United States
Organisme : NIBIB NIH HHS
ID : T32 EB004311
Pays : United States
Informations de copyright
Copyright © 2020 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
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