RESUMEN
PURPOSE: Waveguide elastography (WGE) combines magnetic resonance elastography (MRE), diffusion tensor imaging (DTI), and anisotropic inversions for a determination of the elastic properties of white matter. Previously, the method evaluated the anisotropic elastic properties of the corticospinal tracts (CSTs) of healthy volunteers. Here, the sensitivity of WGE is tested for the detection of pathologic changes in a cohort of patients with Amyotrophic Lateral Sclerosis (ALS). METHODS: MRE and DTI were performed in 14 patients with ALS and 14 healthy, age-matched controls. A comparison was made between three components from WGE and the DTI metrics FA, MD, PD, and RD, for the detection of differences between patients and controls. It was hypothesized that the stiffness values in the CSTs of the patients would be significantly lower due to the known neurodegeneration associated with ALS. RESULTS: Two anisotropic shear moduli polarized parallel and perpendicular to the CSTs were significantly reduced in ALS patients (P < 0.0001), whereas the anisotropic longitudinal modulus polarized parallel to the CSTs showed no significant differences. CONCLUSION: The results of this study suggest a relatively high sensitivity of two anisotropic shear moduli as noninvasive metrics for the assessment of neuronal degeneration within the CSTs.
Asunto(s)
Esclerosis Amiotrófica Lateral/diagnóstico , Esclerosis Amiotrófica Lateral/fisiopatología , Encéfalo/fisiopatología , Imagen de Difusión Tensora/métodos , Diagnóstico por Imagen de Elasticidad/métodos , Interpretación de Imagen Asistida por Computador/métodos , Sustancia Blanca/fisiopatología , Anisotropía , Encéfalo/patología , Módulo de Elasticidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Imagen Multimodal/métodos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Resistencia al Corte , Estrés Mecánico , Sustancia Blanca/patologíaRESUMEN
Fiber type distribution within a skeletal muscle, i.e. the quantification of the relative amount of type 1 (slow-twitching) and type 2 (fast-twitching) muscle fibers, is of great interest for the monitoring of the effects of training or the treatment of muscle diseases. The purpose of this study was to determine the feasibility of diffusion tensor imaging (DTI) as a tool for noninvasive fiber type quantification in human skeletal muscle. The right calves of 12 healthy volunteers were examined using DTI at 1.5 T. Standard DTI parameters, including fractional anisotropy (FA), and mean, radial and parallel diffusivity (MD, RD and PD, respectively), were determined in the soleus muscle. Fiber type proportion and mean fiber diameter within the soleus muscle were quantified from tissue specimens obtained via a fine needle biopsy. Linear regression analysis tested for associations between DTI and biopsy results. FA values were correlated significantly with fiber type proportion, such that higher FA values indicated a higher proportion of type 1 fibers (R(2) = 0.5, p = 0.01). This was based on lower diffusivity perpendicular to the main axis of the fiber in subjects with a higher type 1 fiber proportion (RD: R(2) = 0.52, p = 0.008). MD was also correlated with the proportion of type 1 fibers (R(2) = 0.37, p = 0.037), whereas PD showed no significant correlation. DTI is a promising method for the noninvasive estimation of fiber type proportion in skeletal muscle. This technique may be used to monitor training effects or may be further developed as a biomarker in certain muscle diseases.