TY - JOUR
T1 - Spectral Diffusion Analysis of Intravoxel Incoherent Motion MRI in Cerebral Small Vessel Disease
AU - Wong, Sau May
AU - Backes, Walter H.
AU - Drenthen, Gerhard S.
AU - Zhang, C. Eleana
AU - Voorter, Paulien H. M.
AU - Staals, Julie
AU - van Oostenbrugge, Robert J.
AU - Jansen, Jacobus F. A.
N1 - Funding Information:
Contract grant sponsor: European Union's Horizon 2020 research and innovation programme; Contract grant number: 666881; Contract grant sponsor: SVDs@target, NWO (Netherlands Organization for Scientific Research); Contract grant number: 017.009.048; Contract grant sponsor: Hersenstichting; Contract grant number: 2013(1)-195; Contract grant sponsor: Stichting de Weijerhorst Foundation. These funds did not have a role in the study process and did not contribute to the article.
Publisher Copyright:
© 2019 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.
PY - 2020/4
Y1 - 2020/4
N2 - Background Cerebral intravoxel incoherent motion (IVIM) imaging assumes two components. However, more compartments are likely present in pathologic tissue. We hypothesized that spectral analysis using a nonnegative least-squares (NNLS) approach can detect an additional, intermediate diffusion component, distinct from the parenchymal and microvascular components, in lesion-prone regions. Purpose To investigate the presence of this intermediate diffusion component and its relation with cerebral small vessel disease (cSVD)-related lesions. Study Type Prospective cross-sectional study. Population Patients with cSVD (n = 69, median age 69.8) and controls (n = 39, median age 68.9). Field Strength/Sequence Whole-brain inversion recovery IVIM acquisition at 3.0T. Assessment Enlarged perivascular spaces (PVS) were rated by three raters. White matter hyperintensities (WMH) were identified on a fluid attenuated inversion recovery (FLAIR) image using a semiautomated algorithm. Statistical Tests Relations between IVIM measures and cSVD-related lesions were studied using the Spearman's rank order correlation. Results NNLS yielded diffusion spectra from which the intermediate volume fraction f(int) was apparent between parenchymal diffusion and microvasular pseudodiffusion. WMH volume and the extent of MRI-visible enlarged PVS in the basal ganglia (BG) and centrum semiovale (CSO) were correlated with f(int) in the WMHs, BG, and CSO, respectively. f(int) was 4.2 +/- 1.7%, 7.0 +/- 4.1% and 13.6 +/- 7.7% in BG and 3.9 +/- 1.3%, 4.4 +/- 1.4% and 4.5 +/- 1.2% in CSO for the groups with low, moderate, and high number of enlarged PVS, respectively, and increased with the extent of enlarged PVS (BG: r = 0.49, P <0.01; CSO: r = 0.23, P = 0.02). f(int) in the WMHs was 27.1 +/- 13.1%, and increased with the WMH volume (r = 0.57, P <0.01). Data Conclusion We revealed the presence of an intermediate diffusion component in lesion-prone regions of cSVD and demonstrated its relation with enlarged PVS and WMHs. In tissue with these lesions, tissue degeneration or perivascular edema can lead to more freely diffusing interstitial fluid contributing to f(int). Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019.
AB - Background Cerebral intravoxel incoherent motion (IVIM) imaging assumes two components. However, more compartments are likely present in pathologic tissue. We hypothesized that spectral analysis using a nonnegative least-squares (NNLS) approach can detect an additional, intermediate diffusion component, distinct from the parenchymal and microvascular components, in lesion-prone regions. Purpose To investigate the presence of this intermediate diffusion component and its relation with cerebral small vessel disease (cSVD)-related lesions. Study Type Prospective cross-sectional study. Population Patients with cSVD (n = 69, median age 69.8) and controls (n = 39, median age 68.9). Field Strength/Sequence Whole-brain inversion recovery IVIM acquisition at 3.0T. Assessment Enlarged perivascular spaces (PVS) were rated by three raters. White matter hyperintensities (WMH) were identified on a fluid attenuated inversion recovery (FLAIR) image using a semiautomated algorithm. Statistical Tests Relations between IVIM measures and cSVD-related lesions were studied using the Spearman's rank order correlation. Results NNLS yielded diffusion spectra from which the intermediate volume fraction f(int) was apparent between parenchymal diffusion and microvasular pseudodiffusion. WMH volume and the extent of MRI-visible enlarged PVS in the basal ganglia (BG) and centrum semiovale (CSO) were correlated with f(int) in the WMHs, BG, and CSO, respectively. f(int) was 4.2 +/- 1.7%, 7.0 +/- 4.1% and 13.6 +/- 7.7% in BG and 3.9 +/- 1.3%, 4.4 +/- 1.4% and 4.5 +/- 1.2% in CSO for the groups with low, moderate, and high number of enlarged PVS, respectively, and increased with the extent of enlarged PVS (BG: r = 0.49, P <0.01; CSO: r = 0.23, P = 0.02). f(int) in the WMHs was 27.1 +/- 13.1%, and increased with the WMH volume (r = 0.57, P <0.01). Data Conclusion We revealed the presence of an intermediate diffusion component in lesion-prone regions of cSVD and demonstrated its relation with enlarged PVS and WMHs. In tissue with these lesions, tissue degeneration or perivascular edema can lead to more freely diffusing interstitial fluid contributing to f(int). Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019.
KW - cerebral small vessel disease
KW - MRI
KW - glymphatic system
KW - diffusion magnetic resonance imaging
KW - ENLARGED PERIVASCULAR SPACES
KW - FREE-WATER ELIMINATION
KW - BRAIN
KW - BLOOD
KW - MATTER
KW - PERFUSION
KW - SEGMENTATION
KW - FRACTION
KW - MODEL
U2 - 10.1002/jmri.26920
DO - 10.1002/jmri.26920
M3 - Article
C2 - 31486211
SN - 1053-1807
VL - 51
SP - 1170
EP - 1180
JO - Journal of Magnetic Resonance Imaging
JF - Journal of Magnetic Resonance Imaging
IS - 4
ER -