Biomedical subjects

Weili Lin

Publications and source records attributed to Weili Lin.

25 records · Page 2Linked to original sources

PubMed2003

Alterations of brain activity associated with resolution of emotional distress and pain in a case of severe irritable bowel syndrome.

BACKGROUND & AIMS: The association of psychosocial disturbances with more severe irritable bowel syndrome (IBS) is well recognized. However, there is no evidence as to how these associations might be mediated. Functional magnetic resonance imaging (fMRI) offers an opportunity to study whether activation of the cingulate cortex, an area involved with the affective and pain intensity coding might be linked to poorer clinical status with IBS. In this case report, we found an association between the severity of a patient's clinical symptoms and psychosocial state, with activation of the cingulate cortex. We also found that clinical and psychosocial improvement was associated with reduced cingulate activation. METHODS: Observational case report of a young woman observed for 16 years with a history of sexual abuse, psychosocial distress, and functional GI complaints. Psychosocial, clinical, and fMRI assessment was performed when the patient experienced severe symptoms and again 8 months later when clinically improved. RESULTS: During severe illness, the patient had major psychosocial impairment, high life stress, a low visceral pain threshold, and activation of the midcingulate cortex (MCC), prefrontal area 6/44, and the somatosensory cortex, areas associated with pain intensity encoding. When clinically improved, there was resolution in activation of these 3 areas, and this was associated with psychosocial improvement and an increased threshold to rectal distention. CONCLUSIONS: Activation of the MCC and related areas involved with visceral pain encoding are associated with poor clinical status in patients with severe IBS and psychosocial distress and appear to be responsive to clinical improvement.

Affective Symptoms↗

PubMed2003

Measuring tortuosity of the intracerebral vasculature from MRA images.

The clinical recognition of abnormal vascular tortuosity, or excessive bending, twisting, and winding, is important to the diagnosis of many diseases. Automated detection and quantitation of abnormal vascular tortuosity from three-dimensional (3-D) medical image data would, therefore, be of value. However, previous research has centered primarily upon two-dimensional (2-D) analysis of the special subset of vessels whose paths are normally close to straight. This report provides the first 3-D tortuosity analysis of clusters of vessels within the normally tortuous intracerebral circulation. We define three different clinical patterns of abnormal tortuosity. We extend into 3-D two tortuosity metrics previously reported as useful in analyzing 2-D images and describe a new metric that incorporates counts of minima of total curvature. We extract vessels from MRA data, map corresponding anatomical regions between sets of normal patients and patients with known pathology, and evaluate the three tortuosity metrics for ability to detect each type of abnormality within the region of interest. We conclude that the new tortuosity metric appears to be the most effective in detecting several types of abnormalities. However, one of the other metrics, based on a sum of curvature magnitudes, may be more effective in recognizing tightly coiled, "corkscrew" vessels associated with malignant tumors.

Brain↗

PubMed2003

Comparisons of regional white matter diffusion in healthy neonates and adults performed with a 3.0-T head-only MR imaging unit.

PURPOSE: To evaluate the normal brains of adults and neonates for regional and age-related differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA). MATERIALS AND METHODS: Eight healthy adults and 20 healthy neonates were examined with a 3.0-T head-only magnetic resonance (MR) imaging unit by using a single-shot diffusion-tensor sequence. Trace ADC maps, FA maps, directional maps of the putative directions of white matter (WM) tracts, and fiber-tracking maps were obtained. Regions of interest-eight in WM and one in gray matter (GM)-were predefined for the ADC and FA measurements. The Student t test was used to compare FA and ADC between adults and neonates, whereas the Tukey multiple-comparison test was used to compare FA and ADC in different brain regions in the adult and neonate groups. RESULTS: A global elevation in ADC (P <.001) in both GM and WM and a reduction in FA (P <.001) in WM were observed in neonates as compared with these values in adults. In addition, significant regional variations in FA and ADC were observed in both groups. Regional variations in FA and ADC were less remarkable in adults, whereas neonates had consistently higher FA values and lower ADC values in the central WM as compared with these values in the peripheral WM. Fiber tracking revealed only major WM tracts in the neonates but fibers extending to the peripheral WM in the adults. CONCLUSION: There were regional differences in FA and ADC values in the neonates; such variations were less remarkable in the adults.

Adult↗

PubMed2003

Temporal relationship between apparent diffusion coefficient and absolute measurements of cerebral blood flow in acute stroke patients.

BACKGROUND AND PURPOSE: Diffusion-weighted imaging (DWI) has been established as a marker of acute ischemic brain injury. We sought to determine the relationship between cerebral blood flow (CBF) and apparent diffusion coefficient (ADC) and to explore whether the elapsed time between MRI acquisition and symptom onset alters this relation in acute stroke patients. METHODS: Sixteen acute stroke patients were studied with DWI and perfusion-weighted imaging, from which ADC and CBF were calculated. ADC values were normalized (nADC) to the contralateral, nonischemic hemisphere and then correlated pixel by pixel with CBF within a region of interest defined by abnormal transit time. To explore potential temporal effects on the relationship between CBF and nADC, patients were divided into 2 groups based on the duration between symptom onset and MR imaging for data analysis: group A, 2 to 4 hours (n=8), and group B, 4.5 to 6.5 hours (n=8). RESULTS: nADC was plotted against CBF for each pixel in all 16 subjects, and a composite relationship was derived. After a gradual decline, an abrupt drop in nADC occurred below a CBF threshold value of 21 mL x min(-1) x 100 g(-1). When subjects were divided into early and late imaging groups, the group of patients imaged earlier (group A) had a lower threshold (15 mL x min(-1) x 100 g(-1)) than the group imaged later (group B, 24 mL x min(-1) x 100 g(-1)). CONCLUSIONS: Our results demonstrate that a relationship between nADC and CBF exists in the ischemic brain and that ADC values alone may provide useful information in predicting perfusion status. However, this relationship may change with elapsing time between stroke onset and imaging.

Adult↗

PubMed2003

MR imaging enhancement patterns as predictors of hemorrhagic transformation in acute ischemic stroke.

BACKGROUND AND PURPOSE: Early parenchymal gadolinium enhancement on T1-weighted MR images is predictive of hemorrhagic transformation (HT) in rodent focal ischemia models, but its value in humans is unknown. We sought to investigate gadolinium enhancement in acute ischemic stroke patients to determine their association with subsequent HT. METHODS: We retrospectively examined 22 patients with ischemic stroke who underwent MR imaging within 4.9 hours (+/-1.4) of symptom onset. Patients receiving intravenous tissue plasminogen activator (tPA) (n = 6) were included. Twenty-one patients underwent repeat MR studies at 48 hours, 13 underwent additional MR imaging at 1 week, and one underwent follow-up head CT at 24 hours. Initial images were analyzed for enhancement patterns (vascular, meningeal, parenchymal). Follow-up T2- and T2*-weighted images were evaluated for hemorrhage. RESULTS: In all patients, initial MR images showed vascular enhancement in the vascular territory of the stroke lesion: 19 with vascular enhancement alone and three with vascular and parenchymal enhancement. All three patients with both enhancement patterns had HT: two large and symptomatic, and one asymptomatic (petechial hemorrhage). They received tPA before MR imaging. None of the patients without early parenchymal enhancement developed symptomatic hemorrhage. Six (32%) patients with vascular enhancement alone had petechial hemorrhage at follow-up imaging. In this limited sample, initial mean volumes on diffusion-weighted images, National Institute of Health Stroke Scale scores, and intervals from stroke onset to imaging did not differ between patients with vascular and parenchymal enhancement versus those with vascular enhancement alone. CONCLUSION: Early parenchymal enhancement of stroke lesions may be a good predictor of subsequent symptomatic HT may help identify patients at risk, especially after thrombolytic therapy.

Aged↗

PubMed2002

Cerebral oxygen extraction fraction and cerebral venous blood volume measurements using MRI: effects of magnetic field variation.

The presence of magnetic background field inhomogeneity (DeltaB) may confound quantitative measures of cerebral venous blood volume (vCBV) and cerebral oxygen extraction fraction (MR_OEF) with T2*-based methods. The goal of this study was to correct its effect and obtain more accurate estimates of vCBV and MR_OEF. A 3D high-resolution gradient echo sequence was employed to obtain DeltaB maps by two algorithms. The DeltaB maps were then used to recover the signal loss in images acquired by a 2D multiecho gradient echo / spin echo sequence. Finally, both quantitative estimates of MR_OEF and vCBV were obtained from the DeltaB- corrected 2D multiecho gradient echo / spin echo images. A total of 12 normal subjects were studied. An overestimated vCBV was observed in the brain (4.29 +/- 0.78%) prior to DeltaB correction, while the measured vCBV was substantially reduced after DeltaB correction. Whole brain vCBV of 2.97 +/- 0.44% and 2.68 +/- 0.47% were obtained by the two different DeltaB correction methods, in excellent agreement with the reported results in the literature. Furthermore, when MR_OEF was compared with and without DeltaB correction, no significant differences (P = 0.467) were observed. The ability to simultaneously obtain vCBV and MR_OEF noninvasively may have profound clinical implications for the studies of cerebrovascular disease.

Algorithms↗

PubMed2002

Cerebral venous and arterial blood volumes can be estimated separately in humans using magnetic resonance imaging.

Approaches to obtain quantitative, noninvasive estimates of total cerebral blood volume (tCBV) and cerebral venous blood volume (vCBV) separately in humans are proposed. Two sequences were utilized, including a 3D high-resolution gradient-echo (GE) sequence and a 2D multi-echo GE/spin-echo (MEGESE) sequence. Images acquired by the former sequence provided an estimate of background magnetic field variations (DeltaB), while images obtained by the latter sequence were utilized to obtain separate measures of tCBV and vCBV with and without contrast agent. Prior to the calculation of vCBV and tCBV, the acquired images were corrected for signal loss induced by the presence of DeltaB. vCBV and tCBV were estimated to be 2.46% +/- 0.28% and 3.20% +/- 0.41%, respectively, after the DeltaB correction, which in turn provided a vCBV/tCBV ratio of 0.77 +/- 0.04, in excellent agreement with results reported in the literature. Our results demonstrate that quantitative estimates of vCBV and tCBV can be obtained in vivo.

Blood Volume↗