R Sky Jones, Jacqueline Chen, Doksu Moon, Mathias Nittka, Tiffany Ejikeme, Dan Ma, Mark Griswold, Sean Nagel, Stephen E Jones
{"title":"磁共振指纹技术预测常压脑积水腰椎脑脊液引流后步态改善。","authors":"R Sky Jones, Jacqueline Chen, Doksu Moon, Mathias Nittka, Tiffany Ejikeme, Dan Ma, Mark Griswold, Sean Nagel, Stephen E Jones","doi":"10.1002/jmri.29788","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Normal pressure hydrocephalus (NPH) results in gait disturbance, but clinical response to extended lumbar drainage (ELD) of cerebrospinal fluid varies. Noninvasive predictors of response are needed.</p><p><strong>Purpose: </strong>To determine whether MR fingerprinting (MRF) findings have potential as a quantifiable biomarker for predicting clinical response to ELD in patients with NPH.</p><p><strong>Study type: </strong>Prospective cohort.</p><p><strong>Population: </strong>Twenty individuals with NPH (mean age 77.7 years; 11 male sex).</p><p><strong>Field strength/sequence: </strong>3T; 2D T<sub>1</sub>,T<sub>1</sub>/T<sub>2</sub> MRF, 3D T<sub>1</sub>.</p><p><strong>Assessment: </strong>Patients with NPH referred for ELD between August 2020 and February 2023 were recruited and underwent brain MRI and 10 m walking test before and after ELD. Clinical response was defined as improvement in the walking test plus a positive neurosurgical assessment. Quantitative T<sub>1</sub> and T<sub>2</sub> values were obtained using MRF. Whole-brain T<sub>1</sub> and T<sub>2</sub> times were obtained for cerebral white matter (WM) and gray matter (GM). Brain volumetry was derived using a 3DT<sub>1</sub>-weighted sequence.</p><p><strong>Statistical tests: </strong>Linear discriminants to predict responder status were derived from logistic regression against T<sub>1</sub> and T<sub>2</sub> times; supplementary discriminants from visual inspection (manual delineation) were created as well. Fisher's exact test was applied to resulting contingency tables with significance at p < 0.05. Receiver operating characteristic curves were generated to assess predictors.</p><p><strong>Results: </strong>There were 11 responders and 9 nonresponders. Pretreatment MRF demonstrated an ability to distinguish responders from nonresponders (areas under the curve: WM T<sub>1</sub>, 0.83 ± 0.21; GM T<sub>1</sub>, 0.76 ± 0.23; WM T<sub>2</sub>, 0.81 ± 0.22; GM T<sub>2</sub>, 0.81 ± 0.22). Via logistic regression, GM measures significantly predicted responder status (OR = 14.0 [1.54, 130]) but WM measures did not (p = 0.37). Visual inspection yielded significance for GM (OR incalculable due to zero-valued contingency cell) and WM (OR = 18.7 [1.56, 222]).</p><p><strong>Data conclusion: </strong>Elevated whole-brain T<sub>1</sub> and T<sub>2</sub> relaxation times may serve as a noninvasive predictive biomarker of response to ELD in patients with NPH.</p><p><strong>Evidence level: </strong>2 TECHNICAL EFFICACY: Stage 2.</p>","PeriodicalId":16140,"journal":{"name":"Journal of Magnetic Resonance Imaging","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"MR Fingerprinting Predicts Gait Improvement After Lumbar Cerebrospinal Fluid Drainage for Normal Pressure Hydrocephalus.\",\"authors\":\"R Sky Jones, Jacqueline Chen, Doksu Moon, Mathias Nittka, Tiffany Ejikeme, Dan Ma, Mark Griswold, Sean Nagel, Stephen E Jones\",\"doi\":\"10.1002/jmri.29788\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Normal pressure hydrocephalus (NPH) results in gait disturbance, but clinical response to extended lumbar drainage (ELD) of cerebrospinal fluid varies. Noninvasive predictors of response are needed.</p><p><strong>Purpose: </strong>To determine whether MR fingerprinting (MRF) findings have potential as a quantifiable biomarker for predicting clinical response to ELD in patients with NPH.</p><p><strong>Study type: </strong>Prospective cohort.</p><p><strong>Population: </strong>Twenty individuals with NPH (mean age 77.7 years; 11 male sex).</p><p><strong>Field strength/sequence: </strong>3T; 2D T<sub>1</sub>,T<sub>1</sub>/T<sub>2</sub> MRF, 3D T<sub>1</sub>.</p><p><strong>Assessment: </strong>Patients with NPH referred for ELD between August 2020 and February 2023 were recruited and underwent brain MRI and 10 m walking test before and after ELD. Clinical response was defined as improvement in the walking test plus a positive neurosurgical assessment. Quantitative T<sub>1</sub> and T<sub>2</sub> values were obtained using MRF. Whole-brain T<sub>1</sub> and T<sub>2</sub> times were obtained for cerebral white matter (WM) and gray matter (GM). Brain volumetry was derived using a 3DT<sub>1</sub>-weighted sequence.</p><p><strong>Statistical tests: </strong>Linear discriminants to predict responder status were derived from logistic regression against T<sub>1</sub> and T<sub>2</sub> times; supplementary discriminants from visual inspection (manual delineation) were created as well. Fisher's exact test was applied to resulting contingency tables with significance at p < 0.05. Receiver operating characteristic curves were generated to assess predictors.</p><p><strong>Results: </strong>There were 11 responders and 9 nonresponders. Pretreatment MRF demonstrated an ability to distinguish responders from nonresponders (areas under the curve: WM T<sub>1</sub>, 0.83 ± 0.21; GM T<sub>1</sub>, 0.76 ± 0.23; WM T<sub>2</sub>, 0.81 ± 0.22; GM T<sub>2</sub>, 0.81 ± 0.22). Via logistic regression, GM measures significantly predicted responder status (OR = 14.0 [1.54, 130]) but WM measures did not (p = 0.37). Visual inspection yielded significance for GM (OR incalculable due to zero-valued contingency cell) and WM (OR = 18.7 [1.56, 222]).</p><p><strong>Data conclusion: </strong>Elevated whole-brain T<sub>1</sub> and T<sub>2</sub> relaxation times may serve as a noninvasive predictive biomarker of response to ELD in patients with NPH.</p><p><strong>Evidence level: </strong>2 TECHNICAL EFFICACY: Stage 2.</p>\",\"PeriodicalId\":16140,\"journal\":{\"name\":\"Journal of Magnetic Resonance Imaging\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-04-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Magnetic Resonance Imaging\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1002/jmri.29788\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Magnetic Resonance Imaging","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/jmri.29788","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
MR Fingerprinting Predicts Gait Improvement After Lumbar Cerebrospinal Fluid Drainage for Normal Pressure Hydrocephalus.
Background: Normal pressure hydrocephalus (NPH) results in gait disturbance, but clinical response to extended lumbar drainage (ELD) of cerebrospinal fluid varies. Noninvasive predictors of response are needed.
Purpose: To determine whether MR fingerprinting (MRF) findings have potential as a quantifiable biomarker for predicting clinical response to ELD in patients with NPH.
Study type: Prospective cohort.
Population: Twenty individuals with NPH (mean age 77.7 years; 11 male sex).
Field strength/sequence: 3T; 2D T1,T1/T2 MRF, 3D T1.
Assessment: Patients with NPH referred for ELD between August 2020 and February 2023 were recruited and underwent brain MRI and 10 m walking test before and after ELD. Clinical response was defined as improvement in the walking test plus a positive neurosurgical assessment. Quantitative T1 and T2 values were obtained using MRF. Whole-brain T1 and T2 times were obtained for cerebral white matter (WM) and gray matter (GM). Brain volumetry was derived using a 3DT1-weighted sequence.
Statistical tests: Linear discriminants to predict responder status were derived from logistic regression against T1 and T2 times; supplementary discriminants from visual inspection (manual delineation) were created as well. Fisher's exact test was applied to resulting contingency tables with significance at p < 0.05. Receiver operating characteristic curves were generated to assess predictors.
Results: There were 11 responders and 9 nonresponders. Pretreatment MRF demonstrated an ability to distinguish responders from nonresponders (areas under the curve: WM T1, 0.83 ± 0.21; GM T1, 0.76 ± 0.23; WM T2, 0.81 ± 0.22; GM T2, 0.81 ± 0.22). Via logistic regression, GM measures significantly predicted responder status (OR = 14.0 [1.54, 130]) but WM measures did not (p = 0.37). Visual inspection yielded significance for GM (OR incalculable due to zero-valued contingency cell) and WM (OR = 18.7 [1.56, 222]).
Data conclusion: Elevated whole-brain T1 and T2 relaxation times may serve as a noninvasive predictive biomarker of response to ELD in patients with NPH.
期刊介绍：
The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
