Книги по МРТ КТ на английском языке / MR Imaging in White Matter Diseases of the Brain and Spinal Cord - K Sartor Massimo Filippi Nicola De Stefano Vincent Dou
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Contents |
I |
MEDICAL RADIOLOGY
Diagnostic Imaging
Editors:
A. L. Baert, Leuven
K. Sartor, Heidelberg
Contents |
III |
M. Filippi · N. De Stefano · V. Dousset
J.C. McGowan (Eds.)
MR Imaging in
White Matter Diseases
of the Brain
and Spinal Cord
With Contributions by
R.Bammer · A.Bertolino · A.Bizzi · L.R.Caplan · M.Castillo · N.De Stefano · V.Dousset
B.J.Emmer · F.Fazekas · M.Filippi · K.W.Fishbein · G.B.Frisoni · J.L.Go · J.A.Gomes
S.J.Hickman · M.A.Horsfield · T.W.J.Huizinga · P.Jezzard · A.Kangarlu · P.E.Kim
B.K.Kleinschmidt-DeMasters · M.Knauth · I.Kovanlikaya · D.L.Kraitchman · R.Lenkinski D.K.B.Li · C.Marras · M.Maya · M.Mascalchi · J.C.McGowan · D.H.Miller · S.Mori
M.Mortilla · L.Nagae-Poetscher · D.T.Okuda · D.W.Paty · B.Pollo · C.Raybaud · M.A.Rocca M.Rovaris · F.Salvi · F.Sambataro · S.Schwarz · J.H.Simon · R.G.Spencer · S.Strasser-Fuchs S.D.Swanson · A.Toosy · A.Traboulsee · M.A.van Buchem · P.C.M.van Zijl · T.L.Vollmer
G.Zhao · C-S.Zee
Foreword by
K. Sartor
With 247 Figures in 601 Separate Illustrations, 41 in Color and 23 Tables
123
IV Contents
Massimo Filippi, MD |
Vincent Dousset, MD, PhD |
Director, Neuroimaging Research Unit |
Professor, Service de Neuroradiologie |
Department of Neurology |
Diagnostique et Thérapeutique |
Scientific Institute and |
CHU Bordeaux Pellegrin and Laboratoire de |
University Ospedale San Raffaele |
Neurobiologie des Affections de la Myéline |
Via Olgettina, 60 |
Université Victor Segalen Bourdeaux 2 |
20132 Milan |
33076 Bordeaux |
Italy |
France |
Nicola De Stefano, MD, PhD |
Joseph C. McGowan, PhD |
Associate Professor |
Associate Professor of Electrical Engineering |
Department of Neurology & Behavioral Sciences |
Department of Electrical Engineering |
University of Siena |
Maury Hall 227 |
Viale Bracci 2 |
United States Naval Academy |
53100 Siena |
Annapolis, MD 21402-5025 |
Italy |
USA |
Medical Radiology · Diagnostic Imaging and Radiation Oncology
Series Editors: A. L. Baert · L. W. Brady · H.-P. Heilmann · M. Molls · K. Sartor
Continuation of Handbuch der medizinischen Radiologie
Encyclopedia of Medical Radiology
Library of Congress Control Number: 2004103353
ISBN 3-540-40230-6 Springer-Verlag Berlin Heidelberg New York
This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitations, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law.
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Contents |
V |
Foreword
When magnetic resonance imaging (MRI) started to be used clinically in the early 1980s it rapidly became clear how little information had been provided hitherto by computed tomography (CT) on the various diseases that involve the cerebral (and spinal) white matter. For the first time many white matter abnormalities with too little effect on tissue electron density to render them visible on CT could be shown in vivo. Also, as there was no ionizing radiation involved, these abnormalities could be studied over time (“monitored”) with essentially no risk to the patient. Along with the evolution of the new imaging modality, such as the steady improvement of MRI hardand software and the increasing usage of paramagnetic agents to enhance tissue contrast, radiologists and their clinical colleagues gained insight into both the natural history and the course under therapy of many white matter diseases. It was soon recognized, though, that some white matter diseases had a fairly characteristic or even diagnostic pattern on MRI, while others did not; morphologically there was much overlap between diseases differing in etiology and pathogenesis. Despite this limitation of standard structural (conventional) imaging techniques, MRI eventually gained a decisive role in clinical diagnosis and research of the most important white matter disease, multiple sclerosis (MS).
As the quest for advanced MRI methods to obtain more fundamental information on the various disease processes and to improve differential diagnosis continued, any promising new imaging or measuring technique was tested for its usefulness to study normal and abnormal white matter. Some of the presently available techniques allow us to study crucial aspects of neurometabolism in a quantitative way (magnetization transfer MRI, diffusionweighted MRI, proton MR spectroscopy), while others provide insight into neurovascular physiology and brain and spinal cord function (perfusion-weighted MRI, functional MRI). The ultimate aim, however, is to develop methods suitable to study white matter structure, metabolism, physiology and function at the cellular and even molecular level, an endeavor likely to be successful only at field strengths above 1.5 T.
In this book, conceived and edited by M.Filippi, N.De Stefano,V. Dousset and J.C.McGowan, an impressive number of world-renowned experts have set new standards of compact information regarding white matter disease. The book deals first with the principles of pertinent modern MRI techniques and then covers in depth the disorders of myelination, including normal brain development, demyelinating diseases, immune-mediated disorders of white matter including vasculitides, white matter disorders related to aging, and white matter disorders secondary to other pathologic conditions.
In this state-of-the-art compendium, I am quite sure, interested (neuro)radiologists, neuroclinicians, and neuroresearchers can find practically everything worthwhile knowing on the in vivo imaging of white matter diseases of the brain and spinal cord. Convinced that the book will be a success, I wish to laud the editors and authors for their joint effort and timely work.
Heidelberg |
K. Sartor |
Contents |
VII |
Preface
The application of magnetic resonance imaging (MRI) to the study of the central nervous system (CNS) has greatly improved our ability to diagnose numerous pathological conditions affecting the brain and the spinal cord, as well as to monitor their evolution. This is particularly true for multiple sclerosis (MS), where the sensitivity of T2-weighted MRI in the detection of white matter lesions, together with the ability of post-contrast T1-weighted images to reflect the presence of acute inflammatory activity, may allow us to demonstrate the dissemination of MS pathology in space and time earlier than the clinical assessment, thus leading to an earlier and more confident diagnosis. However, the whole spectrum of white matter diseases, ranging from inherited and acquired disorders of myelination to neurodegenerative conditions related to aging, has been the focus of many MRI studies since the earliest clinical application of this technology.
In the past few years, in parallel with the advancement of MRI technology, the many limitations of conventional MRI have become evident, both in the diagnostic work-up and in the research setting. Conventional MRI patterns of white matter pathology may, on the one hand, overlap among different CNS diseases, while, on the other, they provide only limited pieces of information on the underlying pathological changes in terms of both accuracy and specificity. As regards this latter issue, conventional MRI has three major limitations. First, T2-weighted signal abnormalities just reflect the presence of increased water content, which may range from transient edema to irreversible demyelination and axonal loss. Secondly, the presence of contrast enhancement indicates that blood-brain barrier permeability is increased and associated with ongoing inflammation, but it does not provide any information about the nature and extent of associated tissue damage. Thirdly, conventional MRI is unable to detect and quantify the presence of damage occurring in the normal-appearing CNS tissues, which have been shown to be diffusely and sometimes severely damaged in many white matter disorders.
Structural and metabolic quantitative MRI techniques, such as magnetization transfer (MT) MRI, diffusion-weighted (DW) MRI and proton MR spectroscopy (1H-MRS), are increasingly being applied to the study of white matter diseases. Other non-conventional MRI techniques, such as functional MRI (fMRI), cell-specific MRI, perfusion MRI, molecular MRI and microscopic imaging with ultra-high-field MRI, are emerging as additional promising tools for improving our understanding of many of these conditions. These MRI techniques represent an extraordinary set of powerful instruments to gain in vivo fundamental insights into the pathogenesis and evolution of white matter damage. MT MRI and DW MRI enable us to quantify the extent of structural changes occurring in T2-visible lesions and in the white matter that appears normal on conventional MR images.1H-MRS can add information on the biochemical nature of white matter changes, with the potential to improve significantly our ability to monitor inflammatory demyelination and axonal injury. Structural and metabolic MR-based quantitative techniques are also contributing to the understanding of the reparative mechanisms occurring after injury to the CNS. This latter aspect is likely to have a central role in determining the final clinical outcome of all neurological condi-
VIII |
Contents |
tions. In this context, fMRI holds substantial promise to elucidate the mechanisms of cortical adaptive reorganization following brain injury, and eventually to achieve a more accurate picture of the balance between tissue damage and repair in various CNS conditions. Cellular MRI, molecular MRI and perfusion MRI have the potential to provide additional pieces of information on the heterogeneous aspects of white matter damage, which might be central for the understanding of the pathogenesis of new lesion formation and evolution. High-field MRI will affect dramatically anatomical visualization, proton and nonproton MRS, fMRI and nonproton imaging and, as a consequence, our ability to image the critical components of white matter diseases. This aspect of MRI technology is progressing rapidly, and the time for a more extensive clinical application of high-field MRI will probably come soon.
The present book aims at providing a complete and updated review of the “state of the art” of the application of conventional, quantitative and functional MRI techniques to the study of white matter disorders of the brain and spinal cord. In the first, extensive section, each chapter examines in details the basic principles, advantages and disadvantages of all the aforementioned MRI techniques. The subsequent sections are clinically driven and focused on the various disorders that can affect the human CNS white matter. The role of MRI in the diagnosis and in monitoring the efficacy of experimental treatment is reviewed extensively, as well as the novel insights provided by quantitative MR techniques into the pathophysiology of all these conditions.We hope that this book will represent a valuable tool for clinicians and researchers who wish to gain a deeper understanding of the complex issues related to diagnosis, work-up and treatment of patients with diseased white matter, as well as a reservoir for new ideas and a stimulus for further investigations.
Milan |
Massimo Filippi |
Siena |
Nicola De Stefano |
Bordeaux |
Vincent Dousset |
Annapolis |
Joseph C. McGowan |
Contents |
IX |
Contents
MR Techniques: Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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Basis of MR Contrast |
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Mark A. Horsfield . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
3 |
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Hardware for Magnetic Resonance Imaging |
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Kenneth W. Fishbein, Joseph C. McGowan, and Richard G. Spencer . . . . . . . |
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3 |
Spinand Gradient Echo Imaging |
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Dara L. Kraitchman . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
29 |
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Fast Imaging with an Introduction to k-Space |
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Joseph C. McGowan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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Magnetization Transfer |
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Joseph C. McGowan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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Quantitative Diffusion Imaging |
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Peter C.M. van Zijl, Lidia Nagae-Poetscher and Susumu Mori . . . . . . . . . . . |
63 |
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MR Methods to Measure Cerebral Perfusion |
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Scott D. Swanson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
83 |
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Functional MRI |
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Peter Jezzard and Ahmed Toosy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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MR Spectroscopy |
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Robert E. Lenkinski . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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Molecular Imaging and High-Field MRI in Multiple Sclerosis |
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Alayar Kangarlu . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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Disorders of Myelination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
11 MR Imaging of Brain Development
Charles Raybaud . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
12 Imaging of Inherited and Acquired Metabolic Brain Disorders
Mauricio Castillo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177
13 Proton MR Spectroscopy in Metabolic Disorders of the Central Nervous System
Nicola De Stefano and Marzia Mortilla. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
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Contents |
Demyelinating Diseases. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
14 Conventional MRI Techniques in Multiple Sclerosis
Anthony Traboulsee, David K.B. Li, Guojun Zhao, and Donald W. Paty . . . 211
15 Multiple Sclerosis: Other MR Techniques
Massimo Filippi and Maria A. Rocca . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225
16 Variants of Multiple Sclerosis
Jack H. Simon and Bette K. Kleinschmidt-DeMasters . . . . . . . . . . . . . . . . . . . . 241
17 Acute Disseminated Encephalomyelitis
Stefan Schwarz and Michael Knauth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
18 Demyelinating Diseases of the Spinal Cord
Roland Bammer, Franz Fazekas, and Siegrid Strasser-Fuchs . . . . . . . . . . . . . . 269
19 Demyelinating Diseases of the Optic Nerve
Simon J. Hickman and David H. Miller . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
Immune-Mediated Disorders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
20 Primary Angiitis of the Central Nervous System
Darin T. Okuda and Timothy L.Vollmer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
21 Neuro-Psychiatric Systemic Lupus Erythematosus
Bart J. Emmer, Tom W. J. Huizinga, and Mark A. van Buchem . . . . . . . . . . . . . . . . 311
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Non-MS Inflammatory Diseases of the CNS: |
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MR Features in Addition to the White Matter |
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Mario Mascalchi and Fabrizio Salvi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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White Matter Pathology in Systemic Immune-Mediated Diseases |
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Marco Rovaris and Massimo Filippi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . |
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White Matter Disorders Related with Aging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353
24 Neuroimaging of Normal Brain Aging
Giovanni B. Frisoni . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 355
25 White Matter Abnormalities in Patients with Cerebrovascular Disease
Joao A. Gomes and Louis R. Caplan. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363
26 Neurodegenerative Diseases with Associated White Matter Pathology
Mario Mascalchi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377
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XI |
White Matter Changes Secondary to Other Conditions . . . . . . . . . . . . . . . . . . . . . . . . . 389
27Viral and Non-Viral Infections in Immunocompetent and Immunocompromised Patients
Vincent Dousset. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391
28 Neoplastic Disorders
Alberto Bizzi, Bianca Pollo, and Carlo Marras . . . . . . . . . . . . . . . . . . . . . . . . . 411
29Head Trauma
Chi-Shing Zee, Marcel Maya, John L. Go, Paul E. Kim,
and Ilhami Kovanlikaya . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441
29 Psychiatric Disorders
Fabio Sambataro and Alessandro Bertolino . . . . . . . . . . . . . . . . . . . . . . . . . . . . 453
Subject Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
List of Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 475