Biomedical subjects

J P Armspach

Publications and source records attributed to J P Armspach.

At least 19 recordsLinked to original sources

PubMed2002

Contribution of SISCOM imaging in the presurgical evaluation of temporal lobe epilepsy related to dysembryoplastic neuroepithelial tumors.

PURPOSE: Dysembryoplastic neuroepithelial tumors (DNTs) are a group of glioneuronal supratentorial and intracortical lesions often associated with the early onset of intractable and crippling partial seizures. They are characterized by their location, multinodular architecture, and heterogeneous cell composition, with a specific glioneuronal element in the specific form. Foci of cortical dysplasia may be associated with the tumoral lesion, and identifying the presence and the extent of cortical dysplasia is not always easy on magnetic resonance images (MRIs). The purpose of this article is to evaluate, retrospectively, the usefulness of ictal single-photon emission computed tomography (SPECT) imaging to assess the presence and the extent of cortical dysplasia associated with DNTs in nine patients with intractable temporal lobe epilepsy related to histopathologically confirmed DNTs. METHODS: The results of the subtraction of ictal and interictal SPECT coregistered to MRI (SISCOM) were compared with the results of the examinations of pathological material after surgery. RESULTS: SISCOM showed a strongly hyperperfused area corresponding anatomically to electroclinical abnormalities and to the location of DNTs on MRI. A circumscribed hyperperfusion was present in DNTs without cortical dysplasia, limited to the location of the tumor on MRI. In cases of associated cortical dysplasia, a widespread hyperperfusion including areas corresponding to normal perilesional regions on MRI was found. CONCLUSIONS: SISCOM, used among presurgical investigations, contributes to detecting cortical dysplasia associated with DNTs. Concordance between the symptomatogenic zone (defined from the medical history and electroclinical data), MRI scans, SISCOM pattern, and complete resection of the epileptic zone was predictive of a good postsurgical outcome.

Adolescent↗

PubMed2001

Three-dimensional segmentation of anatomical structures in MR images on large data bases.

In this paper an image-based method founded on mathematical morphology is presented in order to facilitate the segmentation of cerebral structures over large data bases of 3D magnetic resonance images (MRIs). The segmentation is described as an immersion simulation, applied to the modified gradient image, modeled by a generated 3D-region adjacency graph (RAG). The segmentation relies on two main processes: homotopy modification and contour decision. The first one is achieved by a marker extraction stage where homogeneous 3D-regions are identified. This stage uses contrasted regions from morphological reconstruction and labeled flat regions constrained by the RAG. Then, the decision stage intends to precisely locate the contours of regions detected by the marker extraction. This decision is performed by a 3D extension of the watershed transform. The method has been applied on a data base of 3D brain MRIs composed of fifty patients. Results are illustrated by segmenting the ventricles, corpus callosum, cerebellum, hippocampus, pons, medulla and midbrain on our data base and the approach is validated on two phantom 3D MRIs.

Databases as Topic↗

PubMed2001

Determination of vessel cross section for flow rate quantification.

This study was motivated by the interest of measuring different cardiac parameters for which changes in the flow rate during a cardiac cycle needs to be determined at different positions along a vessel segment. These measurements result in a great number of images for which automatic contour detection is very helpful. A model-based algorithm for intraluminal contour detection has been developed in order to allow an accurate quantitative image analysis. The algorithm permits to select contours automatically on all the frames and slices of an imaging study. Images obtained on a flow phantom simulating the effects of blood circulation in large arteries have been used to validate the method. They were acquired with a specially designed interleaved multi slice and phase sequence, using a standard whole-body 2 Tesla NMR scanner. A potential in vivo application of the algorithm has been demonstrated on abdominal aorta images.

Algorithms↗

PubMed2001

A joint physics-based statistical deformable model for multimodal brain image analysis.

A probabilistic deformable model for the representation of multiple brain structures is described. The statistically learned deformable model represents the relative location of different anatomical surfaces in brain magnetic resonance images (MRIs) and accommodates their significant variability across different individuals. The surfaces of each anatomical structure are parameterized by the amplitudes of the vibration modes of a deformable spherical mesh. For a given MRI in the training set, a vector containing the largest vibration modes describing the different deformable surfaces is created. This random vector is statistically constrained by retaining the most significant variation modes of its Karhunen-Loève expansion on the training population. By these means, the conjunction of surfaces are deformed according to the anatomical variability observed in the training set. Two applications of the joint probabilistic deformable model are presented: isolation of the brain from MRI using the probabilistic constraints embedded in the model and deformable model-based registration of three-dimensional multimodal (magnetic resonance/single photon emission computed tomography) brain images without removing nonbrain structures. The multi-object deformable model may be considered as a first step toward the development of a general purpose probabilistic anatomical atlas of the brain.

Anatomy, Cross-Sectional↗

PubMed2000

Language functional neuro-imaging changes following focal left thalamic infarction.

The involvement of the left thalamus in language function has been largely demonstrated through the effects of thalamic lesion and/or stimulation upon language. However, the pathophysiological mechanisms underlying thalamic aphasias remain a matter of debate. We report here on changes in the pattern of brain activity in auditory word processing, verb generation and visual lexical decision in a patient who sustained left thalamic infarct following the surgery of intractable mesio-temporal epilepsy with left hippocampal sclerosis. To some extent, our findings exemplify the way the left thalamus brings on line the cortical networks involved in language processing, suggested in the term 'selective engagement'.

Aphasia↗

PubMed1998

Contribution of T2 relaxation time mapping in the evaluation of cryptogenic temporal lobe epilepsy.

In this study we compared the results of visual analysis of MR imaging with T2 relaxation time mapping of the mesial structures in a group of 97 patients with cryptogenic temporal lobe epilepsy. All patients underwent a clinical neurological examination, neuropsychological investigation, prolonged video-EEG monitoring, SPECT imaging, MR imaging, and T2 relaxation time mapping. T2 relaxation times were estimated with a Carr-Purcell-Meiboom-Gill pulse sequence with 48 echoes (15 to 720 ms). The mean T2 relaxation time value was 118.5 +/- 2 ms in the hippocampi and 120.3 +/- 1.9 ms in the amygdala of 21 healthy subjects used as controls. T2 relaxation mapping revealed mesial temporal sclerosis in 91.8% of the patients (often involving both the hippocampus and the amygdala) and evidenced bilateral involvement in 44.6% of the patients against 72.2 and 6.2%, respectively, for MR imaging. The ipsilateral and contralateral hippocampal T2 relaxation time values did significantly correlate with seizure frequency and the contralateral hippocampal T2 relaxation time value with the duration of epilepsy. In conclusion, this quantitative method is highly sensitive for the detection of mesial temporal sclerosis and permits a better evaluation of the apparently normal contralateral mesial structures.

Adolescent↗

PubMed1998

Registration of MR/MR and MR/SPECT brain images by fast stochastic optimization of robust voxel similarity measures.

This paper describes a robust, fully automated algorithm to register intrasubject 3D single and multimodal images of the human brain. The proposed technique accounts for the major limitations of the existing voxel similarity-based methods: sensitivity of the registration to local minima of the similarity function and inability to cope with gross dissimilarities in the two images to be registered. Local minima are avoided by the implementation of a stochastic iterative optimization technique (fast simulated annealing). In addition, robust estimation is applied to reject outliers in case the images show significant differences (due to lesion evolution, incomplete acquisition, non-Gaussian noise, etc.). In order to evaluate the performance of this technique, 2D and 3D MR and SPECT human brain images were artificially rotated, translated, and corrupted by noise. A test object was acquired under different angles and positions for evaluating the accuracy of the registration. The approach has also been validated on real multiple sclerosis MR images of the same patient taken at different times. Furthermore, robust MR/SPECT image registration has permitted the representation of functional features for patients with partially complex seizures. The fast simulated annealing algorithm combined with robust estimation yields registration errors that are less than 1 degree in rotation and less than 1 voxel in translation (image dimensions of 128(3)). It compares favorably with other standard voxel similarity-based approaches.

Algorithms↗

PubMed1998

Data-driven curvilinear reconstructions of 3D MR images: application to cryptogenic extratemporal epilepsy.

This paper presents a data-driven method for the reconstruction and visualisation of curvilinear slices from three-dimensional (3D) magnetic resonance (MR) scans of the head. Visualisation of curvilinear slices, rather than standard planar slices, produces symmetrical views of the cortex and allows small abnormalities to be detected by comparing the two hemispheres of the brain. In our method, the surface defined by the upper half of the brain is used as a reference shape for curvilinear reconstructions. The brain is first segmented from the 3D scan using a 3D region growing method associated to an unsupervised threshold selection technique. The upper half of the segmented brain is then extracted and fitted by a deformable surface model. This surface is finally interactively moved by the operator in the 3D scan, to visualise the desired curvilinear slice, which is projected on the screen as a two-dimensional image. We show an application of this visualisation technique to the localisation of cerebral epileptogenic lesions. The procedure has proven efficient and handy in clinical use.

Algorithms↗

PubMed1996

Biological assessment and MRI monitoring of the therapeutic efficacy of a monoclonal anti-T CD4 antibody in multiple sclerosis patients.

An initial group of 21 patients plus a second group of 14 patients with active multiple sclerosis (MS) (18 progressive and 17 relapsing-remitting forms) were treated with a murine monoclonal anti-T CD4/BF5 antibody as part of a phase I open trial. Tolerance was relatively good: minor general side-effects occurred in 22 patients only upon the first mAb infusion. One year later, functional disability was stabilised in only six of the 35 patients and after 2 years in two patients only (among 21). One year after treatment, nine of the 17 relapsing-remitting patients were relapse-free. CD4 counts decreased dramatically 2 h after treatment. These counts were back to baseline counts at 3 months. A transient increase was found in IL-6 and TNF alpha levels 2 h after treatment, which probably accounts for the observed side effects. Cell adhesion molecule levels were not modified. Serial MRI scans were performed in the second group of 14 patients. In all of these patients, lesion modifications were observed in the three scans performed prior to treatment. Yet, no changes in the lesions were noted on the MRI scans performed over the following 3 months. These findings demonstrate the feasibility of this treatment insofar as it induced a marked CD4 lymphocyte depletion. However, it did not seem to stabilise the evolution of the disease--although one must be careful in drawing such conclusions in a phase I trial--or to curb the evolution of MRI-documented lesions.

Antibodies, Monoclonal↗

PubMed1994

Hyperbaric oxygen treatment in acute experimental allergic encephalomyelitis. Contribution of magnetic resonance imaging study.

Magnetic resonance imaging (MRI) has been performed to determine the efficacy of hyperbaric oxygen treatment (HBO) on experimental allergic encephalomyelitis (EAE) in Lewis rats. The animals were exposed for 2 x 3 h in a 24-h period at 2 ATA pure O2. Three HBO treatment protocols were used: a 10-day preventive treatment (beginning on the 1st day postimmunization), a 3-day preventive treatment (beginning on the 1st day postimmunization), and a 10-day symptomatic treatment (beginning on the 11th day postimmunization). Based on clinical and MRI observations, this study demonstrates: (i) that HBO treatment does not reduce the blood-brain barrier (BBB) disturbance and cerebral edema in EAE, (ii) that in an opposite way, it provokes reversible BBB breakdown, and (iii) that preventive HBO treatments results in modification of the course of EAE, possibly by immunosuppression effect during the initial sensitization step.

Animals↗

PubMed1994

[Magnetic Resonance Imaging study of the role of the blood-brain barrier in the pathogenesis of experimental allergic encephalomyelitis: application to multiple sclerosis].

Nuclear magnetic resonance imaging (MRI) proved to be, from the first, a very sensitive method, allowing the visualisation of multiple sclerosis lesions, yet which never permitted to establish a non equivocal relationship between the semeiology of such lesions and the clinical signs. The multifocal aspect of disseminated multiple sclerosis lesions is probably one of several factors accounting for this discrepancy. The study of an autoimmune disease, experimental allergic encephalomyelitis (EAE), regarded as a suitable model for multiple sclerosis in humans, has been performed using MRI in order to unravel the pathogenesis of the disease and apprehend the mechanisms responsible for the formation of multiple sclerosis lesions. The study focused on the part played by the blood-brain barrier (BBB) in the induction process of an autoimmune disease, since the central nervous system is normally screened from immunological supervision, by this barrier. Models both of acute EAE, induced by active or passive transfer of the antigen (myelin basic protein-MBP)--and chronic EAE, induced by passive transfer of MBP-specific T cells and myelin glycoproteins or MOG-specific monoclonal antibodies, have been reproduced, and their evolution followed up using high field MRI. Every time, the crucial role of the BBB was evidenced by the synchronism existing between the clinical signs, the appearance of lesions, preferentially in the most sensitive or permeable areas, and the BBB breakdown encouraged by the action of adjuvants. The physiopathological study of EAE using MRI is suggestive of the concept of systemic disease for multiple sclerosis, according to a two-step process, involving, in a first stage some primary viral or bacterial infection, causing T-cells to be sensitized to the host's own proteins by molecular mimicry, and in a second stage some bacterial infection or accidental circumstances which, resulting in a BBB breakdown, would provide immunocompetent cells with an opportunity to reach their target.

Animals↗

PubMed1993

Quantitative cerebral magnetic resonance imaging during ACTH treatment of multiple sclerosis.

Serial MR scans were performed with the 2DFT imaging method and the filtered backprojection imaging method on 12 patients with multiple sclerosis in acute phase, 4 in a relapsing/remitting form, and 8 in a progressive form, before, during and after ACTH treatment. Both T1 and T2mono relaxation times, obtained by fitting transverse magnetization decay curves with a monoexponential function within the apparently normal white matter and the areas of increased signal, were measured. With the backprojection method it was possible to fit the transverse magnetization decay curve with a biexponential function and obtain T2long and T2short relaxation times. The T2mono and T1 relaxation times of the apparently normal white matter were significantly different from those obtained for volunteers, but no significant differences were found before, during, or after treatment. The transverse magnetization decay curves of the areas of increased signal were better fitted by a biexponential function. No significant changes in these relaxation times were observed after ACTH treatment. These results argue against an anti-oedematous action of ACTH and may suggest that it has an immunosuppressant effect.

Adrenocorticotropic Hormone↗

PubMed1993

Blood-brain barrier breakdown in MBP-specific T cell induced experimental allergic encephalomyelitis. A quantitative in vivo MRI study.

Blood--brain barrier permeability in myelin basic protein (MBP)-specific T cell induced experimental allergic encephalomyelitis (EAE) was studied by magnetic resonance imaging (MRI) in Lewis rats. Myelin basic protein-specific T cells of different specificity and/or purified protein derivative (PPD)-specific T cells were used. During the course of EAE, the volume of the lesions and the T1 and T2 relaxation times were recorded and evaluated with respect to the clinical signs. The results showed that the severity of abnormalities seen on MRI, corresponding to the blood--brain barrier breakdown and cerebral oedema depended on the following two factors: (i) the specificity of the MBP-specific T cells used; (ii) the number of MBP-specific T cells transferred. It was also shown that the more specific the cells were, the less severe the cerebral blood--brain barrier rupture. Moreover, the blood--brain barrier breakdown increased when the number of cells increased. Our results demonstrated that a synergy exists between MBP and PPD-specific T cells which seems to result in an increase in central nervous system inflammation. This helps to explain the role of Mycobacterium tuberculosis in the induction of EAE.

Animals↗

PubMed1992

In vivo dynamic MR imaging of MBP-induced acute experimental allergic encephalomyelitis in Lewis rat.

A dynamic in vivo study by MRI consisting of the measurement of relaxation times and in the visualization of the BBB permeability by Gd-DOTA was performed in an MBP-induced acute EAE model of Lewis rat. Fourteen rats were immunized with an MBP/CFA mixture, eight by CFA alone, and three control rats were used to test the harmless effect of repeatedly performed MRI examinations. Beginning on the 8th or 9th days and in parallel with the emergence of clinical signs, rats immunized by the MBP/CFA mixture showed slight increases of relaxation times and of the BBB permeability. These abnormalities, which always remain localized in the periventricular regions, become more pronounced toward the 10th and 11th days, just before (or at the same time) as paraplegia manifestations. After a plateau of a few days, they diminish with the clinical signs. This close correlation found in vivo establishes the essential role of BBB in the pathogenesis of clinical signs of this EAE model.

Animals↗

PubMed1991

Nuclear magnetic resonance T2 relaxation times in multiple sclerosis.

An original method was used to carry out the mathematical analysis of T2 transverse magnetization decay curves and the measure of T2 relaxation times on multiple sclerosis (MS) patients. The presumably normal white matter (WM) of these patients presented higher T2 relaxation times (98.6 msec), in comparison with that found in a population sample (88 msec). In this case, magnetization decay curves remain mostly monoexponential and are characterized by a single T2. On the other hand, areas of increased signal (AIS) curves are always better fitted by a biexponential function characterized by a short (82 msec) and a long (greater than 200 msec) T2. The spreading out of long T2 varies from one AIS to another in the same patient and among different patients; values of long T2 also vary with time, but without any correlation with the clinical state. In fact, no correlation was been established between relaxation times and clinical parameters. Quantitative MRI therefore enables a different approach to interpret MRI images; results suggest that several histobiochemical parameters play a role in the pathogenesis of an AIS and that MS is a dynamic and constantly evolving disease.

Adult↗

PubMed1991

In vivo determination of multiexponential T2 relaxation in the brain of patients with multiple sclerosis.

In vivo measurement of T2 relaxation times in multiple sclerosis (MS) lesions by magnetic resonance imaging (MRI) is potentially useful for the evaluation of the disease activity. Seven patients with definite MS were investigated over a period of three years (19 examinations), using a whole-body MRI scanner operating at 0.15 T with a specially designed high-power radio-frequency head coil. A modified CPMG sequence with a 180 degree pulse interval of TE = 6 msec and 128 echoes was used for the T2 relaxation measurement of the areas of increased signal (AIS) and white matter (WM). A biexponential T2 analysis of each pixel of the spin-echo images was computed. The T2 relaxation processes were found to be a monoexponential function in WM. The T2 relaxation times of apparently normal white matter in MS patients was significantly longer than in control subjects. The T2 relaxation curves of the AIS were found in most cases to fit a biexponential function characterized by a short and a long T2. T2 long relaxation times of AIS were spread out over a wide range (150-560 msec). The study of T2 long histograms shows that some AIS can be divided into two or three parts depending on the T2 long values. Each of these parts may correspond to a pathological process such as edema, demyelination and gliosis. Evolution of T2 relaxation times over a period of time cannot as yet be correlated with modifications in the clinical state.

Adult↗

PubMed1987

Multiple sclerosis diagnosis: magnetic resonance imaging compared with other instrumental examinations.

Examination by magnetic resonance imaging (MRI), evoked potentials (EP) and cerebrospinal fluid (CSF) analyses was carried out on 97 definite, 20 probable and 40 possible multiple sclerosis (MS) patients (McAlpine's clinical criteria). MRI of only 4 transverse brain sections at the level of the ventricles and the analysis of the first 4 echoes showed periventricular or parenchymal lesions, or both, in 114 of the 117 definite and probable MS, and in 25 of the possible MS. MRI was more sensitive than the CSF analyses or EP; abnormalities more frequently appeared in known MS, and clinically asymptomatic lesions were seen. The MRI abnormalities were not, however, MS-specific; they were present in other neurological patients; none posed a question of differential diagnosis from MS. Complementary examinations, and especially MRI, should be a valuable adjunct for MS diagnosis, as long as the findings are viewed in the clinical context.

Adolescent↗

PubMedDate not supplied

Filtered backprojection and spectral width of MR signal.

Reconstructed images obtained by filtered backprojection are altered when the projections are distorted by an attenuation of the high frequency components of the demodulated magnetic resonance (MR) signal. This attenuation occurs if the spectral width of the MR signal is reduced by the bandwidth of the receiver radiofrequency coil as well as by the use of imperfect refocusing pulses. This signal spectrum has to be wide when the sampling bandwidth is wide, because the sampling time is very short, for instance in the case of very short interpulse delay such as 6 ms. A short interpulse delay is needed when many images are required, to enable the transverse magnetization decay of each pixel to be recorded accurately. This paper presents an analysis of backprojection reconstruction for such a case and demonstrates a contamination of each pixel by surrounding pixels. The consequence on the results of T2 measurement and biexponential decomposition of transverse magnetization decay curves are discussed. A method for correction of such artifacts is described.

Image Enhancement↗