Name: in vivo morphometric analysis of human cranial nerves using magnetic resonance imaging in menière's disease ears and normal hearing ears
Uploaded: 2018-02-21T15:00:00.000+00:00
Duration: 10 min 27 s
Description: Watch this Scientific Journal Video about In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in MeniÃ¨re's Disease Ears and Normal Hearing Ears at JoVE.com

罗伯特 Gürkov 接受了拨款从德国研究和教育部 BMBF, 格兰特01号0901。

所有程序均经当地道德委员会批准 (慕尼黑大学/LMU 慕尼黑093-09 号议定书机构审查委员会)。所有患者都对所执行的程序给予知情同意。
1. 临床检查
<ol><li>识别患有疑似 MD 的患者, 与该部门合作进行耳鼻喉部的治疗。<ol>
<li>进行临床评估;眩晕, 耳鸣/耳铃, 听力损失 (可能波动) 需要评估。检查相关的恶心和呕吐。检查症状的持续时间。</li>
		<li>将临床和功能测试结果考虑到对 MD 的诊断: 检查听力、热量视频 oculography、前庭诱发肌电电位 (VEMP) 和 electrocochleography (ECoG) 在医院文件中的结果或电子病历系统。</li>
		<li>检查 MD 的典型发现: 测听可能显示纯音平均 (PTA) 听力水平受损, 热量灌溉可以揭示水平半圆麻痹, SP/AP 比可能在 ECoG 病理上高, VEMP 耳间振幅比可能是在 MD 患者中明显降低。</li>
	</ol>
</li>
</ol>2. MD 和健康控制患者的 MRI 图像采集
<ol><li>在患者组 MRI 扫描前应用鼓室钆注射液24小时。注射0.4 毫升的钆造影剂 intratympanically, (例如, Magnograf 稀释8倍的生理盐水), 24 小时之前的计划 MRI 扫描。</li>
	<li>为 MRI 检查准备病人: 检查金属植入物 (如果采取适当的预防措施, 则可以使用起搏器进行测试; 牙科植入通常是可行的), 幽闭恐惧症,等等使用降噪装置, 如减少噪音用于保护患者听觉的耳机。</li>
	<li>将病人充分定位到扫描仪中。将病人的头部伸直, 并合上并关闭 MR 头线圈。将病人的头部/颞骨放置在 MR 扫描仪的 isocenter。</li>
	<li>根据研究协议进行 MRI 扫描, 包括 3 d 型和3维-真实红外序列检测患者组淋巴积液和强 T2-weighted 3 d-连对患者组颅神经形态分析及健康的控制。</li>
	<li>为形态学扫描3维连设置序列参数, 如下所示: 重复时间 (TR) 5.79 毫秒, 回声时间 (TE) 2.58 毫秒, 翻转角度 34°, 视场 (FoV) 160 x 160 毫米2, 矩阵大小 320 x 320, 平均值 1, 切片厚度0.5 毫米 (表1).用9000毫秒的 TR 进行3维的扫描 TE 128 毫秒, 反转时间2500毫秒, 翻转角度的 180°, 基体尺寸 384 x 384, 切片厚度2毫米. 将3维 d 实际 IR 的参数设置为: TR 6000 毫秒, TE 155 毫秒, 反转时间1500毫秒, 翻转角度 180°, 基体尺寸 320 x 320, 片厚0.5 毫米。</li>
</ol>3. mri 对淋巴积液的 mri 质量检查和鉴定
<ol><li>检查 MRI 图像质量方面的工件, 如折叠工件, 脉动工件, 金属工件, 并采取特别帐户的评估目标, 在这种情况下, 脑神经七和八在整个过程中。</li>
	<li>评价患者组 MRI 扫描的淋巴积液。检查所获得的 3 d-天赋和3维-真实 IR 序列 (图 1) 检测到的耳蜗和迷宫淋巴积水的程度。</li>
</ol>4. 基于图像的颅神经测量
<ol><li>一般准备工作
	<ol>
<li>在评估工作站 (例如、OsiriX 或 Horos) 上安装图像评估和测量选择的 DICOM 查看器。</li>
		<li>通过双击应用程序的图标来运行 DICOM 查看器;将显示 "数据库" 窗口。</li>
		<li>通过鼠标左键单击上拉菜单上的 "文件" 导入患者图像数据, 然后选择 "导入" → "导入文件"。在文件选择器中, 选择患者图像数据;成功导入后, 患者姓名和数据将显示在 "数据库" 窗口中。 注意: 在上述 dicom 查看器中, 输入压缩文件 (例如、. zip) 或未压缩的 dicom 文件目录是可行的。</li>
		<li>在 "数据库" 窗口中, 通过左键单击患者姓名左侧的三角形符号, 展开 "病人图像" 文件夹。从这个文件夹选择序列 (这里连序列) 和双击它打开相应的图像数据。将显示患者图像数据。</li>
	</ol></li>
	<li>颅神经重建 注: 由于从脑干的神经通过桥小脑角 (CPA) 进入声道和进一步到内听觉管的眼底的时间长而不总是在平面过程中, 重建和评价神经的直径和在不同级别的 csa 是必要的。<ol>
<li>在颅神经整个过程中, 准备重建以下位置的横断面, 以避免在整个神经过程中从斜片中产生测量误差, 在 "3D 查看器" 下拉菜单中选择 "3D 平面"。在屏幕的顶部;将显示 "多平面" 窗口。</li>
		<li>调整缩放级别, 以适应要重建的结构 (这里脑神经 VII 和 VIII) 通过选择缩放工具 (放大镜) 从 "改变鼠标按钮功能" 区域在工具栏上左上半部分的多平面窗口。然后将鼠标光标移动到 "平面" 窗口中的3个平面中的每一个, 并通过向左单击并拖动鼠标来调整缩放级别 (鼠标光标将转换为放大镜)。</li>
		<li>重建中心 VIII 神经, 并将重建平面正交到神经过程中的 CPA。检查和适应所有3个平面/窗口中重建平面的方向 (应将其与神经交叉方向进行正交重建, 以避免在以下测量中产生局部体积效应)。<ol>
<li>检查是否有平面外遍历神经, 并分别校正平面方向。<ol>
<li>要纠正平面方向, 请将鼠标光标移动到多平面窗口中每面的轴十字线的中心 (当定位正确时, 鼠标光标将转换为手形符号)。</li>
				<li>用手形图标所指示的抓取工具单独抓取3个平面/窗口中的轴十字线, 并将轴近似地移动到3个平面中每一个内部的声波道。</li>
				<li>通过将鼠标移动到每个轴的侧面, 将3轴的方向调整到神经的路线上 (通过将鼠标光标更改为曲线图标, 可以描述正确的旋转函数)。然后按住鼠标左键按下并拖动鼠标调整平面方向。</li>
				<li>调整平面方向在所有3窗口的多平面化窗口。为了重建一个平面横向到八神经路线在中央的注册会计师, 转到左下窗在平面化窗口, 并移动鼠标到中间的轴十字线, 使鼠标光标将再次转换成一个手势符号。然后左键单击并拖动平面 (橙色线) 到所需位置 (这里, 到注册会计师中间)。</li>
				<li>如果需要缩放工具 (鼠标将通过左击和拖动将其图标更改为放大镜), 请调整缩放级别。</li>
				<li>左键单击到 "平面化" 窗口的右上窗, 选择此平面。选择 "文件" → "导出" → "导出到 DICOM 文件"。在 "DICOM 导出"-窗口选择 "序列:" → "仅当前图片" 由左击入毗邻圈子选择器。</li>
				<li>适当地重命名系列, 这里 "八注册会计师"。然后左键单击 DICOM 导出窗口右下半部分的 "确定" 按钮。 注: 这将关闭 DICOM 导出窗口, 将重建后的图像保存到患者数据库中, 并返回到 "平面图" 窗口。</li>
			</ol>
</li>
		</ol>
</li>
		<li>重建八神经分支的正交视图: 耳蜗神经 (CN), 前庭神经 (SVN) 和下前庭神经 (IVN) 在该科的道的水平, 其中代表性可视化通常是很可行的。检查是否有平面外遍历神经, 并分别校正平面方向。<ol>
<li>抓住3个平面/窗口中的轴十字线, 用手形图标表示的抓取工具, 将 axis 分别移动到 CN、SVN 和 IVN, 并将其方向调整为神经的航向, 使用旋转函数可在曲线图标所描述的每个轴的侧面进行, 如步骤 4.2. 3.1. 1-4.2. 3.1. 5。</li>
			<li>导出和重命名重建的飞机, 步骤 4.2. 3.1. 6-4.2. 3.1. 7。</li>
		</ol>
</li>
		<li>重建面神经 (颅神经 VII) 的正交视图, 在注册会计师的水平, 4.2.3 的道, 以及在《步骤》下所述的综合理事会的眼底。在每一级重建时, 检查神经的平面外遍历, 并分别校正平面方向。</li>
	</ol></li>
	<li>测量 注: 执行以下测量: 在重建的横向图像中, 测量 CSA, 长直径 (LD) 和垂直短直径 (SD) 面神经 (颅神经 VII) 和前庭蜗神经 (颅神经 VIII) (图4和图 5)。注意在扫描之间保持一致的窗口化水平, 以避免局部体积效应以非系统性方式影响定量测量。<ol>
<li>通过在 DICOM 查看器的 "数据库" 窗口中, 通过左键单击相应的图像文件 (以前命名为 "VIII 注册会计师"), 选择先前重建的颅神经八级图像。通过双击文件名打开它。重建后的图像将在一个窗口中打开。</li>
		<li>如有必要, 请按步骤4.2.2 中的指示放大图像结构。在屏幕顶部的工具栏上的 "更改鼠标按钮函数" 旁边的三角形符号上, 选择 "长度", 左键单击鼠标。左键单击并按住鼠标左键按下, 绘制一条线, 测量颅神经的最长直径八;这个测量是 LD。</li>
		<li>对 SD 测量进行垂直于 LD 的测量。 注意: 如果使用 OsiriX 或 Horos 作为 DCIOM 查看器, 测量将自动存储。<ol>
<li>重复这些测量的 LD 和 SD 也在重建的八神经在耳道的水平, 通过测量图像文件从图像数据库名为 "八道", 并在其眼底水平, 文件名为 "VIII。</li>
		</ol>
</li>
		<li>评估 CSA 最好使用封闭的多边形区域的兴趣 (ROI), 以考虑可能的不均匀性在颅神经的横断面轮廓。在屏幕上部的工具栏上, 按 "鼠标按钮函数" 区域右侧的三角形符号, 然后选择 "闭合多边形" (先前选定的线条符号将变为多边形)。</li>
		<li>通过左键在神经的边界上多次显示颅神经 VIII 的轮廓。在所需的点上关闭多边形双左键;将显示完整的轮廓。 注: 如果需要, 通过左键和移动来纠正多边形点的位置。</li>
		<li>打开先前在注册会计师级别上进行的面部神经重建 (图像文件名 "VII 注册会计师"), 并执行 4.3.1 4.3.5 后的颅神经 vii 的 LD、SD 和 CSA 的测量。</li>
		<li>在 IVN 的道上打开重建, 并对 CN、SVN、和颅神经七级的 LD、SD 和 CSA 进行测量, 步骤 4.3.1 4.3.5。</li>
		<li>在 IVN 的眼底层打开重建, 并对 CN、SVN、和颅神经七级的 LD、SD 和 CSA 进行测量, 步骤 4.3.1 4.3.5。</li>
	</ol></li>
</ol>

<ol>
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作者没有什么可透露的。

我们已经展示了一种可行的和可接近的方法评估颅神经的形态学变化, 因为它们可能发生在几个病理生理学的情况下, 这里在 MD 与正常听力控制。
修改和疑难解答:
对在这里报告的 7th和 8th颅神经的类似测量可以使用对不同级别的所有其他颅神经进行的3维连序列扫描, 只要它们仍然被脑液包围,否则, 与上述 MR 扫描序列技术可能产生对比问题。对于未被液体包围的颅神经的形态计量分析, MR 扫描协议的变化成为强制性的,例如, 应用静脉注射钆或使用 MRI 脂肪抑制技术。在整个神经过程中, 正交重建的测量仍然是强制性的。
mr 扫描不仅可以用于描述颅神经解剖变化, 而且还能帮助诊断 MD, 在淋巴积液的 mr 评价与形态学分析相结合的基础上。今后, 自动化的形态计量分析技术, 包括基于机器的学习和人工智能, 可以加快评估和提高测量和评价的一致性。
在对颅神经进行形态学分析的一般方法中, mri 检查可以 "本机" 进行, 而不使用静脉或鼓室磁共振造影剂的管理。在协议稀释鼓室造影剂已被应用, 以量化的严重性, 淋巴水肿发生在 MD, 相关的诊断疾病。本研究应用鼓室的微量和小浓度的钆造影剂, 在比较病变时不显示脑脊液或神经信号强度定量测量的效果。侧面和对侧侧在 MD 患者, 一个发现证实了其他研究。在将钆注入的患者的强 T2-weighted 图像与非注入控件的图像进行比较时, 信号强度、图像质量和对比度没有差异16。因此, 造影剂对形态学测量的影响并不起作用。直到今天, 没有证据发现钆可能在大脑或脑神经方面对体积的改变起到作用。然而, 以钆为基础的造影剂对颅神经的长期影响仍有待研究。鼓室在健康的控制中应用钆仍然是不道德的, 因此没有在正常的听力患者进行这项研究。
未来应用:
所描述的方法可以比较大的各种疾病和几种神经结构的颅神经形态学变化。评估颅神经形态学变化的方法的未来转移例如, 在慢性疼痛, 阿尔茨海默病, 或多发性硬化症 (MS) 和比较这些结果与健康的控制是可行的。
协议中的关键步骤和技术的局限性:
在使用所描述的技术评估形态学参数时, 请在整个扫描过程中设置一致的窗口化级别并/或让两个或更多的读取器执行测量。为了避免评分员之间的可变性, 让每个读者评估所有扫描。在整个神经过程中, 使用薄层厚度和垂直于脑神经过程的切片方向是强制性的。在比较不同的 mr 扫描仪进行的研究时, 必须考虑 mr 扫描参数的差异会导致部分体积效应的差异, 以及图像对比度和图像质量方面的差异。在比较研究时, 需要考虑在整个脑神经过程中进行形态学分析的水平。

磁共振成像 (MRI) 在人体解剖学和生理病理过程的可视化和分析中起着重要的作用。由于 Menière 疾病 (MD) 的临床和电生理诊断可能具有挑战性, 因此, 使用来自 MRI 的附加信息比帮助1、2、3、4更有用。采用体内方法, 通过 MRI 对 MD 淋巴积液和颅神经形态变化进行分析。采用这种联合方法, 对确定 MD 的诊断进行了验证, 并在整个神经过程中对颅神经的形态学变化进行了不同程度的研究。MD 的病因仍然不清楚5,6,7。有人建议, 神经细胞丧失可能涉及 MD, 但这还有待证实。
本研究分析了在 MD 中, 适合的颅神经用于形态学分析的7个th和8个th神经及其分支。只有少数研究可以被发现分析这些神经的形态学方面使用 MRI8,9,10。Henneberger et . 的研究分析了 7th和 8th脑神经在 MD 耳中的形态学变化, 与正常的听觉耳朵11相比。
这里提出的方法使在体内可视化和形态学分析的 7th和 8th脑神经在整个过程中从大脑到颞骨。使用这种方法, 我们发现 MD 患者组与健康耳有显著差异。我们建议在几种情况下使用的描述方法, 只要潜在的形态学变化的颅神经感兴趣。这种方法是否将建立在临床诊断资料仍有待评估的未来研究。实际的替代方法为在体内评估颅骨神经形态学变化, 而计算机断层扫描 (CT) 有它的优势, 如广泛的可用性, 速度和骨骼变化的描述, 它也表现出太低的组织对比, 以想象在脑颅和颞骨的颅神经微妙的变化。尸检后对 MD 患者颅神经变化的分析有待研究。以特殊的影像和评价技术为例, 可以分析 MD 患者颅神经的形态学变化和健康控制的 MRI。常规 MRI 检查的大脑往往不包括高分辨率, 强烈 T2-weighted 成像技术, 这是强制性的评估形态学变化的颅神经7和8。
所开发的方法可能进一步诊断的影响, 以评估不同程度的严重性在 MD, 以及发挥作用, 评估眩晕, 听力缺损, 和耳鸣。眩晕诊断和治疗检查专门中心在今天的医疗保健系统中起着重要作用, 我们的方法可以为专家提供诊断检查的可能工具12,13,14.眩晕是一种复杂的症状发生在一些疾病, 需要一个彻底的跨学科合作, 不同的专业, 如在诊断和治疗眩晕的专门中心显示12,13,14。
根据我们的知识, 在文献中没有任何方法可用于在医学和健康控制中对颅神经进行体内形态学分析。

<table><tbody><tr><td>&lt;strong&gt;MR-scanner&lt;/strong&gt;, e.g. Siemens Magnetom Verio, or appropriate &lt;strong&gt;MR-scans in DICOM format&lt;/strong&gt;, e.g. 3D-CISS</td><td>Siemens Healthcare GmbH, Erlangen, Germany, or MR scans by any other vendor</td><td>1</td><td>Instead of the MR scanner, appropriately acquired MR-scans can be used for morphometric analysis</td></tr><tr><td>Osirix or any other &lt;strong&gt;DICOM-Viewer&lt;/strong&gt; with appropriate evaluation tools</td><td>Pixmeo SARL, Geneva, Switzerland</td><td>2</td><td>Software for viewing and evaluating DICOM images</td></tr><tr><td>MedCalc or any other &lt;strong&gt;statistical analysis software&lt;/strong&gt;, e.g. SPSS&amp;nbsp;</td><td>MedCalc Software bvba, Ostend, Belgium</td><td>3</td><td>Software for statistical analysis</td></tr><tr><td>&lt;strong&gt;Computer&lt;/strong&gt; running Windows or MacOSX/macOS</td><td>e.g. Lenovo, Apple or anything selfmade</td><td>4</td><td>Hardware on which the above software can be employed</td></tr></tbody></table>

in vivo morphometric analysis of human cranial nerves using magnetic resonance imaging in meni&#232;re's disease ears and normal hearing ears

Menière 病 (MD) 的神经结构分析是非常重要的, 因为这种结构的损失以前已经提出给这个病人组, 但尚未证实。本协议描述了一种在体内评估神经变化的方法, 特别适用于磁共振成像 (MRI) 颅神经分析。使用扫描协议 (包括强 T2-weighted 3D 梯度-回声序列 (3 连), 在3吨 MR 扫描仪中检查 MD 患者和正常听力者。在患者组中, 通过 MRI 对淋巴积液的评估, 进一步证实了 MD。形态学分析是使用免费的 DICOM 查看器进行的。颅神经的评估包括测量不同级别神经的横截面积 (csa) 以及正交直径测量。

采用统计分析软件进行统计分析, 应用双侧独立样本t测试。图像评价由两个读者进行。患者组平均值 (n = 21) 和健康对照组 (n = 39) 之间的显著差异可用于测量面神经、CN、SVN 和 IVN (表 2) 的 CSA。csa 在患者组中的测量显示了显著较大的 csa 值 (图 2和图 3)。对 ld 和 sd 的测量结果进行了不同的评估, 根据测量地点的不同, 发现两组之间的 ld 和 sd 差异。例如, 在道的水平, SVN 的 SD 在病人组中明显大于健康对照组, 而 LD 被发现没有显著不同 (表 3和表 4)。基于中介的 MD 理论支持这些发现7,15。
<img alt="Figure 1" class="xfigimg" src="/files/ftp_upload/57091/57091fig1.jpg"> 图 1: MRI 扫描中的淋巴水肿。3 d 型 (A) 和 3 d 实红外 (B) 中的耳蜗 (直箭) 和前庭 (弯曲箭头) 的高等级淋巴水肿。<a href="//cloudflare.jove.com/files/ftp_upload/57091/57091fig1large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 2" class="xfigimg" src="/files/ftp_upload/57091/57091fig2.jpg"> 图 2: 耳蜗神经的形态计量学评价.与健康对照组相比, 耳蜗神经横截面积 (CSA) 的平均值和四分位范围存在显著差异。上、下绿色水平线描绘最小和最大值, 由晶须连接。紫星显示算术平均值。绿色中间线代表中值。蓝色误差线描述 1 SD.<a href="//cloudflare.jove.com/files/ftp_upload/57091/57091fig2large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 3" class="xfigimg" src="/files/ftp_upload/57091/57091fig3.jpg"> 图 3: 颅神经的形态学评估 vii.与健康对照组相比, 在桥小脑角 (CPA) 上, 面神经的横截面积 (CSA) 的差异显著。上、下绿色水平线描绘了晶须所连接的最小和最大值。紫星显示算术平均值。绿色中间线代表中值。蓝色误差线描述 1 SD.<a href="//cloudflare.jove.com/files/ftp_upload/57091/57091fig3large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 4" class="xfigimg" src="/files/ftp_upload/57091/57091fig4.jpg"> 图 4: 测量耳蜗神经的横截面积 (CSA).在垂直于神经过程的重建切片上的内道眼底进行的测量。<a href="//cloudflare.jove.com/files/ftp_upload/57091/57091fig4large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<img alt="Figure 5" class="xfigimg" src="/files/ftp_upload/57091/57091fig5.jpg"> 图 5: 测量耳蜗神经的长直径 (LD) 和垂直短直径 (SD).在垂直于神经过程的重建切片上的内道眼底进行的测量。<a href="//cloudflare.jove.com/files/ftp_upload/57091/57091fig5large.jpg" target="_blank">请单击此处查看此图的较大版本.</a>
<table fo:keep-together.within-page="1"><tbody>
<tr>
<td>Mr 序列参数</td>
			<td>3 d-连</td>
		</tr>
<tr>
<td>tr</td>
			<td>5.79 毫秒</td>
		</tr>
<tr>
<td>te</td>
			<td>2.58 毫秒</td>
		</tr>
<tr>
<td>翻转角度</td>
			<td>34°</td>
		</tr>
<tr>
<td>视野</td>
			<td>160 x 160 毫米2
</td>
		</tr>
<tr>
<td>矩阵大小</td>
			<td>320 x 320</td>
		</tr>
<tr>
<td>平均</td>
			<td>1</td>
		</tr>
<tr>
<td>切片厚度</td>
			<td>0.5 毫米</td>
		</tr>
</tbody></table>表 1: MRI 序列参数.设置 MRI 序列参数, 如所述, 使用稳态 (连) 的构造干涉-序列技术, 以达到强烈的 T2-weighted 图像对比, 以最佳描述的神经周围的脑脊液。
<img alt="Table 2" src="/files/ftp_upload/57091/57091table2.jpg"> 表 2: 横断面面积测量 (CSA) 的形态计量分析结果.比较患者与健康对照组, 测量 7th和 8th颅神经在不同水平上的 CSA。对单方受影响的患者、受双边影响的患者和健康控制包括平均值、标准偏差和p值的分析 (独立样本t测试, 患者组 n = 21, 健康控制 n = 39);在 Bonferroni 更正后, p < 0.000595 的显著结果标记为粗体。
<img alt="Table 3" src="/files/ftp_upload/57091/57091table3.jpg"> 表 3: 长直径 (LD) 的形态计量分析结果.比较患者与健康对照组在不同水平的 7th和 8th颅神经的测量。对单方受影响的患者、受双边影响的患者和健康控制包括平均值、标准偏差和p值的分析 (独立样本t测试, 患者组 n = 21, 健康控制 n = 39)。
<img alt="Table 4" src="/files/ftp_upload/57091/57091table4.jpg"> 表 4: 短直径 (SD) 的形态计量分析结果.比较患者与健康对照组, 测量 7th和 8th颅神经在不同水平上的 SD。对单方受影响的患者、受双边影响的患者和健康控制包括平均值、标准偏差和p值的分析 (独立样本t测试, 患者组 n = 21, 健康控制 n = 39)。

Watch this Scientific Journal Video about In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in MeniÃ¨re's Disease Ears and Normal Hearing Ears at JoVE.com

In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Meni&#232;re's Disease Ears and Normal Hearing Ears

目的评价颅神经的形态学变化, 如神经结构丧失或颅神经肿胀 (MD) 或健康人在体内, 采用磁共振成像 (MRI) 建立了 Menière 的评价协议。.另外还对 MD 进行了 MRI 诊断。

体内Menière 病耳和正常听觉的磁共振成像对人颅神经的形态学分析

Analysis of neural structures in Meni&#232;re's Disease (MD) is of importance, since a loss of such structures has previously been proposed for this ...

in-vivo-morphometric-analysis-human-cranial-nerves-using-magnetic

Nanyang Technological University

Research

JoVE Journal

Medicine

10.5K 次观看.  LMU Munich. 目的评价颅神经的形态学变化, 如神经结构丧失或颅神经肿胀 (MD) 或健康人在体内, 采用磁共振成像 (MRI) 建立了 Menière 的评价协议。.另外还对 MD 进行了 MRI 诊断。

视频: In Vivo Morphometric Analysis of Human Cranial Nerves Using Magnetic Resonance Imaging in Menière's Disease Ears and Normal Hearing Ears

High-resolution Functional Magnetic Resonance Imaging Methods for Human Midbrain

Functional MRI (fMRI) is a widely used tool for non-invasively measuring correlates of human brain activity. However, its use has mostly been focused upon measuring activity on the surface of cerebral cortex rather than in subcortical regions such as midbrain and brainstem. Subcortical fMRI must overcome two challenges: spatial resolution and physiological noise. Here we describe an optimized set of techniques developed to perform high-resolution fMRI in human SC, a structure on the dorsal surface of the midbrain; the methods can also be used to image other brainstem and subcortical structures.
High-resolution (1.2 mm voxels) fMRI of the SC requires a non-conventional approach. The desired spatial sampling is obtained using a multi-shot (interleaved) spiral acquisition1. Since, T2* of SC tissue is longer than in cortex, a correspondingly longer echo time (TE ~ 40 msec) is used to maximize functional contrast. To cover the full extent of the SC, 8-10 slices are obtained. For each session a structural anatomy with the same slice prescription as the fMRI is also obtained, which is used to align the functional data to a high-resolution reference volume.
In a separate session, for each subject, we create a high-resolution (0.7 mm sampling) reference volume using a T1-weighted sequence that gives good tissue contrast. In the reference volume, the midbrain region is segmented using the ITK-SNAP software application2. This segmentation is used to create a 3D surface representation of the midbrain that is both smooth and accurate3. The surface vertices and normals are used to create a map of depth from the midbrain surface within the tissue4.
Functional data is transformed into the coordinate system of the segmented reference volume. Depth associations of the voxels enable the averaging of fMRI time series data within specified depth ranges to improve signal quality. Data is rendered on the 3D surface for visualization.
In our lab we use this technique for measuring topographic maps of visual stimulation and covert and overt visual attention within the SC1. As an example, we demonstrate the topographic representation of polar angle to visual stimulation in SC.

This article describes techniques to perform high-resolution functional magnetic resonance imaging with 1.2 mm sampling in human midbrain and subcortical structures using a 3T scanner. Use of these techniques to resolve topographic maps of visual stimulation in the human superior colliculus (SC) is given as an example.

高分辨率人类中脑功能磁共振成像方法

Functional MRI (fMRI) is a widely used tool for non-invasively measuring correlates of human brain activity. However, its use has mostly been focused upon ...

科研

神经科学

Functional Neuroimaging Using Ultrasonic Blood-brain Barrier Disruption and Manganese-enhanced MRI

Although mice are the dominant model system for studying the genetic and molecular underpinnings of neuroscience, functional neuroimaging in mice remains technically challenging. One approach, Activation-Induced Manganese-enhanced MRI (AIM MRI), has been used successfully to map neuronal activity in rodents 1-5. In AIM MRI, Mn2+ acts a calcium analog and accumulates in depolarized neurons 6,7. Because Mn2+ shortens the T1 tissue property, regions of elevated neuronal activity will enhance in MRI. Furthermore, Mn2+ clears slowly from the activated regions; therefore, stimulation can be performed outside the magnet prior to imaging, enabling greater experimental flexibility. However, because Mn2+ does not readily cross the blood-brain barrier (BBB), the need to open the BBB has limited the use of AIM MRI, especially in mice.
One tool for opening the BBB is ultrasound. Though potentially damaging, if ultrasound is administered in combination with gas-filled microbubbles (i.e., ultrasound contrast agents), the acoustic pressure required for BBB opening is considerably lower. This combination of ultrasound and microbubbles can be used to reliably open the BBB without causing tissue damage 8-11.
Here, a method is presented for performing AIM MRI by using microbubbles and ultrasound to open the BBB. After an intravenous injection of perflutren microbubbles, an unfocused pulsed ultrasound beam is applied to the shaved mouse head for 3 minutes. For simplicity, we refer to this technique of BBB Opening with Microbubbles and UltraSound as BOMUS 12. Using BOMUS to open the BBB throughout both cerebral hemispheres, manganese is administered to the whole mouse brain. After experimental stimulation of the lightly sedated mice, AIM MRI is used to map the neuronal response.
To demonstrate this approach, herein BOMUS and AIM MRI are used to map unilateral mechanical stimulation of the vibrissae in lightly sedated mice 13. Because BOMUS can open the BBB throughout both hemispheres, the unstimulated side of the brain is used to control for nonspecific background stimulation. The resultant 3D activation map agrees well with published representations of the vibrissae regions of the barrel field cortex 14. The ultrasonic opening of the BBB is fast, noninvasive, and reversible; and thus this approach is suitable for high-throughput and/or longitudinal studies in awake mice.

A technique is described for broadly opening the blood-brain barrier in the mouse using microbubbles and ultrasound. Using this technique, manganese can be administered to the mouse brain. Because manganese is an MRI contrast agent that accumulates in depolarized neurons, this approach enables imaging of neuronal activity.

使用超声波血脑屏障破坏和锰增强MRI的脑功能成像

Although mice are the dominant model system for studying the genetic and molecular underpinnings of neuroscience, functional neuroimaging in mice remains ...

Three Dimensional Vestibular Ocular Reflex Testing Using a Six Degrees of Freedom Motion Platform

The vestibular organ is a sensor that measures angular and linear accelerations with six degrees of freedom (6DF). Complete or partial defects in the vestibular organ results in mild to severe equilibrium problems, such as vertigo, dizziness, oscillopsia, gait unsteadiness nausea and/or vomiting. A good and frequently used measure to quantify gaze stabilization is the gain, which is defined as the magnitude of compensatory eye movements with respect to imposed head movements. To test vestibular function more fully one has to realize that 3D VOR ideally generates compensatory ocular rotations not only with a magnitude (gain) equal and opposite to the head rotation but also about an axis that is co-linear with the head rotation axis (alignment). Abnormal vestibular function thus results in changes in gain and changes in alignment of the 3D VOR response.
Here we describe a method to measure 3D VOR using whole body rotation on a 6DF motion platform. Although the method also allows testing translation VOR responses 1, we limit ourselves to a discussion of the method to measure 3D angular VOR. In addition, we restrict ourselves here to description of data collected in healthy subjects in response to angular sinusoidal and impulse stimulation.
Subjects are sitting upright and receive whole-body small amplitude sinusoidal and constant acceleration impulses. Sinusoidal stimuli (f = 1 Hz, A = 4&deg;) were delivered about the vertical axis and about axes in the horizontal plane varying between roll and pitch at increments of 22.5&deg; in azimuth. Impulses were delivered in yaw, roll and pitch and in the vertical canal planes. Eye movements were measured using the scleral search coil technique 2. Search coil signals were sampled at a frequency of 1 kHz.
The input-output ratio (gain) and misalignment (co-linearity) of the 3D VOR were calculated from the eye coil signals 3.
Gain and co-linearity of 3D VOR depended on the orientation of the stimulus axis. Systematic deviations were found in particular during horizontal axis stimulation. In the light the eye rotation axis was properly aligned with the stimulus axis at orientations 0&deg; and 90&deg; azimuth, but gradually deviated more and more towards 45&deg; azimuth.
The systematic deviations in misalignment for intermediate axes can be explained by a low gain for torsion (X-axis or roll-axis rotation) and a high gain for vertical eye movements (Y-axis or pitch-axis rotation (see Figure 2). Because intermediate axis stimulation leads a compensatory response based on vector summation of the individual eye rotation components, the net response axis will deviate because the gain for X- and Y-axis are different.
In darkness the gain of all eye rotation components had lower values. The result was that the misalignment in darkness and for impulses had different peaks and troughs than in the light: its minimum value was reached for pitch axis stimulation and its maximum for roll axis stimulation.
Case Presentation
Nine subjects participated in the experiment. All subjects gave their informed consent. The experimental procedure was approved by the Medical Ethics Committee of Erasmus University Medical Center and adhered to the Declaration of Helsinki for research involving human subjects.
Six subjects served as controls. Three subjects had a unilateral vestibular impairment due to a vestibular schwannoma. The age of control subjects (six males and three females) ranged from 22 to 55 years. None of the controls had visual or vestibular complaints due to neurological, cardio vascular and ophthalmic disorders.
The age of the patients with schwannoma varied between 44 and 64 years (two males and one female). All schwannoma subjects were under medical surveillance and/or had received treatment by a multidisciplinary team consisting of an othorhinolaryngologist and a neurosurgeon of the Erasmus University Medical Center. Tested patients all had a right side vestibular schwannoma and underwent a wait and watch policy (Table 1; subjects N1-N3) after being diagnosed with vestibular schwannoma. Their tumors had been stabile for over 8-10 years on magnetic resonance imaging.

A method is described to measure three-dimensional vestibulo ocular reflexes (3D VOR) in humans using a six degrees of freedom (6DF) motion simulator. The gain and misalignment of the 3D angular VOR provide a direct measure of the quality of vestibular function. Representative data on healthy subjects are provided

三维前庭眼反射测试使用六度自由度运动平台

The vestibular organ is a sensor that measures angular and linear accelerations with six degrees of freedom (6DF). Complete or partial defects in the ...

In vivo Imaging of Optic Nerve Fiber Integrity by Contrast-Enhanced MRI in Mice

The rodent visual system encompasses retinal ganglion cells and their axons that form the optic nerve to enter thalamic and midbrain centers, and postsynaptic projections to the visual cortex. Based on its distinct anatomical structure and convenient accessibility, it has become the favored structure for studies on neuronal survival, axonal regeneration, and synaptic plasticity. Recent advancements in MR imaging have enabled the in vivo visualization of the retino-tectal part of this projection using manganese mediated contrast enhancement (MEMRI). Here, we present a MEMRI protocol for illustration of the visual projection in mice, by which resolutions of (200 &#181;m)3 can be achieved using common 3 Tesla scanners. We demonstrate how intravitreal injection of a single dosage of 15 nmol MnCl2 leads to a saturated enhancement of the intact projection within 24 hr. With exception of the retina, changes in signal intensity are independent of coincided visual stimulation or physiological aging. We further apply this technique to longitudinally monitor axonal degeneration in response to acute optic nerve injury, a paradigm by which Mn2+ transport completely arrests at the lesion site. Conversely, active Mn2+ transport is quantitatively proportionate to the viability, number, and electrical activity of axon fibers. For such an analysis, we exemplify Mn2+ transport kinetics along the visual path in a transgenic mouse model (NF-&#954;B p50KO) displaying spontaneous atrophy of sensory, including visual, projections. In these mice, MEMRI indicates reduced but not delayed Mn2+ transport as compared to wild type mice, thus revealing signs of structural and/or functional impairments by NF-&#954;B mutations.
In summary, MEMRI conveniently bridges in vivo assays and post mortem histology for the characterization of nerve fiber integrity and activity. It is highly useful for longitudinal studies on axonal degeneration and regeneration, and investigations of mutant mice for genuine or inducible phenotypes.

In vivo Imaging of Optic Nerve Fiber Integrity by Contrast-Enhanced MRI in Mice

This video illustrates a method, using a clinical 3 T scanner, for contrast-enhanced MR imaging of the na&#239;ve mouse visual projection and for repetitive and longitudinal in vivo studies of optic nerve degeneration associated with acute optic nerve crush injury and chronic optic nerve degeneration in knock-out mice (p50KO).

在视神经纤维通过诚信小鼠对比增强MRI 活体成像

The rodent visual system encompasses retinal ganglion cells and their axons that form the optic nerve to enter thalamic and midbrain centers, and ...

Optical Monitoring of Living Nerve Terminal Labeling in Hair Follicle Lanceolate Endings of the Ex Vivo Mouse Ear Skin

A novel dissection and recording technique is described for optical monitoring staining and de-staining of lanceolate terminals surrounding hair follicles in the skin of the mouse pinna. The preparation is simple and relatively fast, reliably yielding extensive regions of multiple labeled units of living nerve terminals to study uptake and release of styryl pyridinium dyes extensively used in studies of vesicle recycling. Subdividing the preparations before labeling allows test vs. control comparisons in the same ear from a single individual. Helpful tips are given for improving the quality of the preparation, the labeling and the imaging parameters. This new system is suitable for assaying pharmacologically and mechanically-induced uptake and release of these vital dyes in lanceolate terminals in both wild-type and genetically modified animals. Examples of modulatory influences on labeling intensity are given.

Optical Monitoring of Living Nerve Terminal Labeling in Hair Follicle Lanceolate Endings of the Ex Vivo Mouse Ear Skin

Here we describe a novel preparation for imaging live lanceolate sensory terminals of palisade endings that innervate mouse ear skin hair follicles during staining and destaining with styryl pyridinium dyes.

在毛囊披针形结局生活神经末端标记的光学监测<em&gt;离体</em&gt;鼠耳皮肤

A novel dissection and recording technique is described for optical monitoring staining and de-staining of lanceolate terminals surrounding hair follicles ...

Morphological and Functional Evaluation of Ribbon Synapses at Specific Frequency Regions of the Mouse Cochlea

Cochlear inner hair cells (IHCs) transmit acoustic signals to spiral ganglion neurons (SGNs) through ribbon synapses. Several experimental studies have indicated that hair cell synapses may be the initial targets in sensorineural hearing loss (SNHL). Such studies have proposed the concept of cochlear &#34;synaptopathy&#34;, which refers to alterations in ribbon synapse number, structure, or function that result in abnormal synaptic transmission between IHCs and SGNs. While cochlear synaptopathy is irreversible, it does not affect the hearing threshold. In noise-induced experimental models, restricted damage to IHC synapses in select frequency regions is employed to identify the environmental factors that specifically cause synaptopathy, as well as the physiological consequences of disturbing this inner ear circuit. Here, we present a protocol for analyzing cochlear synaptic morphology and function at a specific frequency region in adult mice. In this protocol, cochlear localization of specific frequency regions is performed using place-frequency maps in conjunction with cochleogram data, following which the morphological characteristics of ribbon synapses are evaluated via synaptic immunostaining. The functional status of ribbon synapses is then determined based on the amplitudes of auditory brainstem response (ABR) wave I. The present report demonstrates that this approach can be used to deepen our understanding of the pathogenesis and mechanisms of synaptic dysfunction in the cochlea, which may aid in the development of novel therapeutic interventions.

This manuscript describes an experimental protocol for evaluating the morphological characteristics and functional status of ribbon synapses in normal mice. The present model is also suitable for noise-induced and age-related cochlear synaptopathy-restricted models. The correlative results of previous mouse studies are also discussed.

小鼠耳蜗特定频率区域带状带突起的形态和功能评估

Cochlear inner hair cells (IHCs) transmit acoustic signals to spiral ganglion neurons (SGNs) through ribbon synapses. Several experimental studies have ...

Data Acquisition and Analysis In Brainstem Evoked Response Audiometry In Mice

Brainstem evoked response audiometry (BERA) is of central relevance in the clinical neurophysiology. As other evoked potential (EP) techniques, such as visually evoked potentials (VEPs) or somatosensory evoked potentials (SEPs), the auditory evoked potentials (AEPs) are triggered by the repetitive presentation of identical stimuli, the electroencephalographic (EEG) response of which is subsequently averaged resulting in distinct positive (p) and negative (n) deflections. In humans, both the amplitude and the latency of individual peaks can be used to characterize alterations in synchronization and conduction velocity in the underlying neuronal circuitries. Importantly, AEPs are also applied in basic and preclinical science to identify and characterize the auditory function in pharmacological and genetic animal models. Even more, animal models in combination with pharmacological testing are utilized to investigate for potential benefits in the treatment of sensorineural hearing loss (e.g., age- or noise-induced hearing deficits). Here we provide a detailed and integrative description of how to record auditory brainstem-evoked responses (ABRs) in mice using click and tone-burst application. A specific focus of this protocol is on pre-experimental animal housing, anesthesia, ABR recording, ABR filtering processes, automated wavelet-based amplitude growth function analysis, and latency detection.

Brainstem evoked response audiometry is an important tool in clinical neurophysiology. Nowadays, brainstem evoked response audiometry is also applied in the basic science and preclinical studies involving both pharmacological and genetic animal models. Here we provide a detailed description of how auditory brainstem responses can be successfully recorded and analyzed in mice.

脑干中的数据采集与分析 在小鼠中引发响应音频测量

Brainstem evoked response audiometry (BERA) is of central relevance in the clinical neurophysiology. As other evoked potential (EP) techniques, such as ...

Modified Experimental Conditions for Noise-Induced Hearing Loss in Mice and Assessment of Hearing Function and Outer Hair Cell Damage

An animal model of noise-induced hearing loss (NIHL) is useful for pathologists, therapists, pharmacologists, and hearing researchers to thoroughly understand the mechanism of NIHL, and subsequently optimize the corresponding treatment strategies. This study aims to create an improved protocol for developing a mouse model of NIHL. Male C57BL/6J mice were used in this study. Unanesthetized mice were exposed to loud noises (1 and 6 kHz, presented simultaneously at 115-125 dB SPL-A) continuously for 6 h per day for 5 consecutive days. Auditory function was assessed 1 day and 1 week after noise exposure, using auditory brainstem response (ABR). After the ABR measurement, the mice were sacrificed, and their organs of Corti were collected for immunofluorescence staining. From the auditory brainstem response (ABR) measurements, significant hearing loss was observed 1 day after noise exposure. After 1 week, the hearing thresholds of the experimental mice decreased to ~80 dB SPL, which was still a significantly higher level than the control mice (~40 dB SPL). From the results of immunofluorescence imaging, outer hair cells (OHCs) were shown to be damaged. In summary, we created a model of NIHL using male C57BL/6J mice. A new and simple device for generating and delivering pure-tone noise was developed and then employed. Quantitative measurements of hearing thresholds and morphological confirmation of OHC damage both demonstrated that the applied noise successfully induced an expected hearing loss.

Here, we present a protocol for a mouse model of noise-induced hearing loss (NIHL). To induce NIHL, we developed a new and simple device using corrugated plastic, a rat trap cage, and a speaker. Auditory brainstem response and immunofluorescence imaging were employed to assess the hearing function and outer hair cell damage, respectively.

改进小鼠噪声性听力损失的实验条件及听力功能和外毛细胞损伤的评估

An animal model of noise-induced hearing loss (NIHL) is useful for pathologists, therapists, pharmacologists, and hearing researchers to thoroughly ...

Measuring the Influence of Magnetic Vestibular Stimulation on Nystagmus, Self-Motion Perception, and Cognitive Performance in a 7T MRT

Strong magnetic fields induce dizziness, vertigo, and nystagmus due to Lorentz forces acting on the cupula in the semi-circular canals, an effect called magnetic vestibular stimulation (MVS). In this article, we present an experimental setup in a 7T MRT scanner (MRI scanner) that allows the investigation of the influence of strong magnetic fields on nystagmus as well as perceptual and cognitive responses. The strength of MVS is manipulated by altering the head positions of the participants. The orientation of the participants&#39; semicircular canals with respect to the static magnetic field is assessed by combining a 3D magnetometer and 3D constructive interference in steady-state (3D-CISS) images. This approach allows to account for intra- and inter-individual differences in participants&#8217; responses to MVS. In the future, MVS can be useful for clinical research, for example, in the investigation of compensatory processes in vestibular disorders. Furthermore, it could foster insights into the interplay between vestibular information and cognitive processes in terms of spatial cognition and the emergence of self-motion percepts under conflicting sensory information. In fMRI studies, MVS can elicit a possible confounding effect, especially in tasks influenced by vestibular information or in studies comparing vestibular patients with healthy controls.

In this article, we describe the experimental setup, material, and procedures to assess reflexive eye movements, self-motion perception, and cognitive tasks under magnetic vestibular stimulation, as well as the anatomical orientation of the vestibular organs, in a 7 Tesla Magnetic resonance tomography (7T-MRT) scanner.

测量磁前庭刺激对7T MRT眼球震颤、自我运动知觉和认知表现的影响

Strong magnetic fields induce dizziness, vertigo, and nystagmus due to Lorentz forces acting on the cupula in the semi-circular canals, an effect called ...

Quantification of Optic Nerve Cross Sectional Area on MRI: A Novel Protocol using Fiji Software

Optic nerve assessment is an important aspect of glaucoma diagnosis and follow-up. This project describes a protocol for a unified methodology of optic nerve cross-sectional assessment and quantification using 3 T MRI for image acquisition and ImageJ's Fiji software for image processing quantification. Image acquisition was performed using 3 T MRI, with proper instructions for the patient to ensure straight fixation during imaging. A T2-weighted fat suppressed sequence was used. A coronal cut taken 3 mm behind the globe and perpendicular to the optic nerve axis should be uploaded to the software. Using the threshold function, the white matter area of the optic nerve is selected and quantified, thus, eliminating inter-individual measurement bias. We also described the normal limits for the optic nerve cross-sectional area according to age, based on previously published literature. We used the described protocol to assess optic nerve of a suspected glaucoma patient. The optic nerve cross-sectional area was found to be within the normal limits, a finding further confirmed via optical coherence tomography of the optic nerve.

We provided a detailed protocol for a standardized method of optic nerve assessment and quantification using MRI, utilizing a widely available imaging sequence, and open access software for image analysis. Following this standardized protocol would provide meaningful data for comparison between different patients and different studies.

MRI 上光学神经横截面区域的量化:使用斐济软件的新协议

Optic nerve assessment is an important aspect of glaucoma diagnosis and follow-up. This project describes a protocol for a unified methodology of optic ...

体内Menière 病耳和正常听觉的磁共振成像对人颅神经的形态学分析

摘要

探索更多视频

此视频中的章节

高分辨率人类中脑功能磁共振成像方法

使用超声波血脑屏障破坏和锰增强MRI的脑功能成像

三维前庭眼反射测试使用六度自由度运动平台

在视神经纤维通过诚信小鼠对比增强MRI 活体成像

在毛囊披针形结局生活神经末端标记的光学监测

小鼠耳蜗特定频率区域带状带突起的形态和功能评估

脑干中的数据采集与分析在小鼠中引发响应音频测量

改进小鼠噪声性听力损失的实验条件及听力功能和外毛细胞损伤的评估

测量磁前庭刺激对7T MRT眼球震颤、自我运动知觉和认知表现的影响

MRI 上光学神经横截面区域的量化:使用斐济软件的新协议

体内Menière 病耳和正常听觉的磁共振成像对人颅神经的形态学分析

摘要

探索更多视频

此视频中的章节

高分辨率人类中脑功能磁共振成像方法

使用超声波血脑屏障破坏和锰增强MRI的脑功能成像

三维前庭眼反射测试使用六度自由度运动平台

在视神经纤维通过诚信小鼠对比增强MRI 活体成像

在毛囊披针形结局生活神经末端标记的光学监测

小鼠耳蜗特定频率区域带状带突起的形态和功能评估

脑干中的数据采集与分析 在小鼠中引发响应音频测量

改进小鼠噪声性听力损失的实验条件及听力功能和外毛细胞损伤的评估

测量磁前庭刺激对7T MRT眼球震颤、自我运动知觉和认知表现的影响

MRI 上光学神经横截面区域的量化:使用斐济软件的新协议

脑干中的数据采集与分析在小鼠中引发响应音频测量