Reducing the hippocampus help. Method for predicting diseases in the hippocampus

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Question: Please decipher the conclusion of the mri

Conclusion.

Examination in standard pulse sequences SE, FSE and FLAIR in T1 and T2 weighted images in axial, coronal and sagittal projections,

On the presented MR images, the median structures are not displaced, the ventricular system is narrowed, symmetrical. Liquorodynamics is compensated. Subarachnoid spaces are narrowed, not visualized.

There is hypoplasia of the posterior corpus callosum.

The signal from the white matter corresponds to the normal state of myelin for a given age; in the temporo-parietal-occipital regions, periventricularly permissible areas of hypomyelination. The periventricular zones are intact.

Cortical plate without obvious disharmonic changes in the pattern of the cortex.

Hippocampi and parahippocampal regions without structural disturbances.

The hypothalamic-pituitary region without focal disturbances of the MR signal.

Convincing data for the presence of additional formations, focal and destructive changes were not revealed.

The cranio-vertebral junction is formed correctly.

The cerebellar vermis is hypoplastic. The large occipital cistern is reactively dilated.

In general, according to MRI, indirect signs of intracranial hypertension. Hypoplasia of the posterior parts of the corpus callosum. Hypoplasia of the cerebellar vermis.

Adenoids are enlarged, completely blocking the lumen of the nasopharynx. In the pyramids of the temporal bones, mucosal edema

Doctor's answer: Hello! You urgently need to see an ENT doctor. An adenectomy is required.

Medical services in Moscow:

Question: Hello! 3 years ago after the birth of a child, my weight was 72kg. after 2 years for 2 months, the weight became 56 kg (did not do anything to lose weight. For 2.5 years, headaches have been tormenting. The therapist does not see himself. ENT said that the mucous discharge is due to the vessels. The ophthalmologist narrowed the vessels, the fundus of the eye without pathologies.Three weeks ago, the headaches became unbearable (it was impossible to touch the head, it was painful to lie down).I went to the neurologist and was diagnosed with tension headaches and sent for an MRI. Here is the result: Lateral ventricles of normal size and configuration (up to 0.7 cm at the level of the foramina of Monro), the third ventricle is not dilated (up to 0.7 cm), the fourth ventricle is not changed, the basal cisterns are not dilated.

Chiasmal-sellar area without features. The pituitary gland has a normal shape, the vertical size in the central sections is 0.4 cm, the pituitary tissue has a normal signal. Siphons of both internal carotid arteries without features.

In the projection of the subcortical ganglia along the perforating vessels, the perivascular Virchow-Robin spaces are visualized.

The subarachnoid convexital space is diffusely unevenly moderately expanded, mainly in the area of ​​the frontal lobes. The hippocampi are quite symmetrical and structural.

Median structures are not displaced.

The optic nerves are symmetrical, the retrobulbar region is not changed.

The cerebellar tonsils are located above the entrance to the foramen magnum. Pathological formations in the region of the cerebellopontine angles were not visualized.

There is a slight parietal increase in the intensity of the signal according to T2 WI from the mucous membrane of single cells of the cribriform labyrinth

Before the examination, treatment with pantocalcin, nimesil, grandaxin, glycine was prescribed. At first, the pain went away, I continue to take the pills, and the pain again returns to the temporal pain, which sometimes goes over the upper part and nausea. Can you explain what is wrong with me and how to remove the pain?

Doctor's answer: Hello! Address to the endocrinologist examine a thyroid gland hand over hormones, make US.

Question: hello, I would like to know what the MRI protocol says - the median structures of the brain are not displaced. The cortex and white matter of the hemispheres of the cerebrum and cerebellum are differentiated, no focal changes were detected before and after Omniscan amplification. ) of the cerebral hemispheres, the peri-insular region and the hippocampus. The hippocampus region is quite symmetrical. The ventricles of the brain are usually located, their shape is not changed. The lateral ventricles are asymmetric S

Doctor's answer: Hello! MRI - no pathology. You need to lose weight. Then the pressure normalizes, etc.

Question: Hello, my daughter was diagnosed with Asperger's syndrome, but she has changes in the brain, here is the MR picture. There is a gaping of the lower horns of both lateral ventricles, due to a gross cystic-glial transformation of the temporal lobes poles and hippocampal atrophy on both sides.

Doctors say that this syndrome is not associated with these changes. Moreover, she does not smell. Please tell me what clinical picture these changes can give. Thank you

Doctor's answer: Hello! Asperger's Syndrome is a form of autism, which is a lifelong dysfunction that affects how a person perceives the world, processes information, and relates to other people. Autism is often described as a "spectrum disorder" as the condition affects people in different ways and to varying degrees.

Asperger's Syndrome is basically a hidden "latent dysfunction". This means that it is not possible to tell if someone has Asperger's Syndrome by their appearance. People with this disorder experience difficulty in three main areas. These include:

social communication.

social interaction

social imagination

A disturbance of smell is unrelated to this syndrome.

Question: Hello! I'm 28 years old. I recently had an MRI of the brain and cervical spine. Complaints of head tremor, pain and constant tension in the neck, it is difficult to turn the head to the sides. Please help me to decipher the results: sclerotic changes in the left hippocampus, cystic formation of the pineal region, venous angioma of the left frontal lobe. In the cervical region: a picture of degenerative dystrophic changes in the cervical spine, disc herniation C5C6. Tell me a medical institution where you can get treatment, if necessary, and also tell me, please, is it possible to seek help from a chiropractor? Thanks a lot!

Doctor's answer: Hello! You need to see a neurosurgeon.

A chiropractor will not help you, but only harm you.

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anonymous , Male, 12 years old

A 12-year-old boy (there were no epilepsy attacks. There were no fading, automatisms, convulsions against the background of high temperature. An appeal to a neurologist-epileptologist due to poor mastery of school material.) The diagnosis of an epileptologist was made for the first time on April 29, 2016: Cognitive epileptiform disintegration. 09/30/2016 Cognitive epileptiform disintegration. Hippocampal sclerosis. 12/29/2016 Epileptic encephalopathy (cognitive epileptiform disintegration). Consultation of other epileptologists 08.11.2016 ESES, cognitive epileptiform disintegration. 12/07/2016 Epilepsy with electrical sleep status epilepticus, symptomatic variant. MRI 1.5 Tl. dated 05/06/2016 There is a combination of expansion of the choroidal fissures and temporal horns of the lateral ventricles, accompanied by a significant loss of hippocampal volume. The internal architectonics of the right hippocampus is sharply disturbed, the differentiation of its structures is difficult, the vertical orientation of the collateral sulcus. The head of the left hippocampus is significantly reduced in volume, the internal architectonics is "erased" due to the violation of the longitudinal folding. The structural structure of the remaining parts of the left hippocampus is not disturbed. A picture of a pronounced decrease in the volume of the right hippocampus with gross violations of its structure, a decrease in the volume of the left hippocampus with signs of a violation of its structure in the projection of the head. Moderately expressed internal hydrocephalus. Repeated MRI on July 13, 2016 - malrotation of the hippocampus. Consultation A.A. Alikhanova confirmed. EEG 4 hours sleep 04/29/2016 Background EEG of passive wakefulness of a disorganized type with a predominance of alpha activity. Non-REM sleep is represented by stages I and II. During photostimulation before and after sleep, against the background of hyperventilation before sleep, as well as in the 1st stage of non-REM sleep, lateralized group complexes of an acute-slow wave in amplitude up to 300 µV are recorded in the left or right hemisphere, with periodic involvement of contralateral frontal leads. In the state of non-REM sleep, with an index of 70-80% in stage II of sleep, diffuse asynchronous acute-slow wave complexes are recorded in amplitude up to 400 μV. EEG 09/16/2016 - 09/17/2016 AED reception During the entire duration of non-REM sleep, the following is recorded: - in the right hemisphere, lateralized complexes of an acute-slow wave in amplitude up to 340 μV, with periodic involvement of contralateral frontal leads; - in the left hemisphere, lateralized complexes of an acute - slow wave in amplitude up to 340 μV with periodic involvement of contralateral frontal leads; - diffuse asynchronous complexes acute-slow wave in amplitude up to 450 μV; - in the frontal region of the left, less often the right hemisphere, acute-slow wave complexes in amplitude up to 360 μV, with periodic involvement of the ipsilateral central-temporal leads; - in the posterior temporo-parietal-occipital leads, polyphasic sharp waves, acute-slow wave complexes in amplitude up to 250 μV. The total index of pathological activity in the 2nd stage of non-REM sleep was 80-90%, slightly decreasing in delta sleep. EEG 12/17/2016 -12/18/2016 AED reception Background EEG of a disorganized type with a predominance of alpha activity. In the state of non-REM sleep, with an index of up to 80% in the first half of the night, in the parietal region of the left hemisphere, group complexes of an acute slow wave, DERD in amplitude up to 70 μV are recorded, with frequent spread to the vertex region along the parasagittal contour and periodic involvement of homologous contralateral leads, running up to 20 seconds. In the second half of the night, the index of epileptiform activity decreases, not exceeding 40% of the record. Functional loads did not provoke the appearance of pathological activity. Click here to Reply or Forward

A photo is attached to the question

Hello. No additional instrumental studies are needed. Most likely, consultations of a neuropsychologist and can be prescribed. With severe and / or progressive impairment of cognitive functions and speech, treatment can be prescribed in the form of antiepileptic drugs or hormones, which is more effective.

anonymously

Hello. Thanks a lot for your answer. Advise the center or the doctor who deals with such problem.

anonymously

Hello, Vasily Yurievich. Is it possible to stop epi activity with the help of AEP (Keppra)? Can the hippocampus regenerate with age? Malrotation of the hippocampus provokes epi activity, or epi activity has led to changes in the hippocampus. On MR images, the bilateral dysplastic organization of the cortex in the medial parts of both temporal lobes with the involvement of both hippocampus attracts attention. The structure of the latter is grossly distorted, folding is not traced, the presence of a normally formed dentate. The hypoplastic hippocampal phenotype dominates with thinning of the hippocampal bodies, their malrotation, and the absence of clear stratification. The described disorders are potentially epileptogenic and require EEG monitoring.

anonymously

Hello. Thanks a lot for your answer. Neuropsychological conclusion: The boy is contact. Provides personal information. Oriented in place, time, own state. Understands and follows instructions. During the study, increased anxiety was noted. Right-handed. Objectively: In the sphere of praxis, mirror reproduction of individual postures of spatial praxis with subsequent self-correction. In the field of self-sensory gnosis, on the left hand, it determines the localization of both single and two-handed touches less accurately. In the realm of visual gnosis, difficulty perceiving superimposed incomplete images. In the field of auditory gnosis, difficulty in reproducing complex rhythmic structures. In the sphere of spatial gnosis, the lack of projection representations. In the mystical sphere, pronounced violations of auditory-speech memory (according to the organic type). Reproduction curve: 6,8,8,9,9, retention - 5 words. There are perseverations, the introduction of a new word into retentions. Severe disturbances of voluntary processes of active attention. In the samples of Schulte, the excess of the age standard is not more than 25%. In the intellectual realm, the operation of elimination and generalization generally performs. Experiencing difficulties in establishing logical connections and relationships between concepts (simple analogues). Difficulties in performing arithmetic operations, with the transition through the category and in solving problems. Assessment: dysfunction of the first structural and functional block of the brain, the occipital regions predominantly on the left, the left temporal lobe and the frontal regions of the brain. The child is studying in a general education school, but there are difficulties. Very open and kind. There are no behavior problems, but there is no desire to learn either. Playing sports. At the moment the child is taking Keppra 500*2 Based on the above findings (MRI, EEG), can you give your opinion? What drugs are appropriate to take with such a problem?

The owners of the patent RU 2591543:

The invention relates to medicine, radiology and can be used to predict the course of diseases, the development of pathological conditions in the hippocampus. Using native magnetic resonance imaging (MRI), diffusion-weighted images (DWI), the absolute values ​​of the diffusion coefficient (ADC) are determined at three points: at the level of the head, body and tail of the hippocampus. Based on these ADC indicators, their trend value is calculated, which predicts the general direction of ADC changes. When the value of the calculated ADC trend is more than 0.950×10 -3 mm 2 /s, a conclusion is made about the possibility of gliosis changes as a result of reversible vasogenic edema and reversible hypoxic states of hippocampal cells. When the value of the calculated ADC trend is less than 0.590×10 -3 mm 2 /s, a conclusion is made about the possibility of ischemia with the transition of hippocampal cells to the anaerobic pathway of oxidation, followed by the development of cytotoxic edema and cell death. While maintaining the value of the calculated ADC trend in the range from 0.590×10 -3 mm 2 /s to 0.950×10 -3 mm 2 /s, it is concluded that the diffusion processes in the hippocampus are balanced. The method provides both an in-depth definition of existing pathological changes in the hippocampus, and a more accurate prediction of the dynamics of the development of these pathological changes for subsequent correction of therapeutic measures. 5 ill., 2 pr.

The invention relates to medicine, namely to radiation diagnostics, and can be used for objective and reliable prediction of diseases in the hippocampus, accurate determination of the direction of development of pathological changes in this area of ​​the brain by calculating a quantitative parameter: ADC (apparent diffusion coefficient) tendency values.

Diffusion coefficient - ADC (apparent diffusion coefficient, calculated diffusion coefficient - CDI) - a quantitative characteristic of diffusion processes in tissues. This is the average value of complex diffusion processes occurring in biological structures, that is, a quantitative characteristic of water diffusion in the intracellular and extracellular spaces, taking into account various sources of intravoxel uncoordinated and multidirectional movements, such as intravascular blood flow in small vessels, the movement of cerebrospinal fluid in the ventricles and subarachnoid spaces, etc. .d. The limits of ADC values ​​are normally known, in adults they range from 0.590×10 -3 mm 2 /s to 0.950×10 -3 mm 2 /s.

Moritani T., Ekholm S., Westesson P.-L. suggest using native magnetic resonance imaging (MRI) to study the brain with diffusion-weighted imaging (DWI) and calculation of diffusion coefficients (ADC) to detect cytotoxic and vasogenic cerebral edema.

According to this method, it is proposed to analyze the signal characteristics on the DWI and to determine the ADC in the same area. At the same time, cytotoxic edema is characterized by a hyperintense signal for DWI and is accompanied by a decrease in ADC values. Vasogenic edema can be manifested by various changes in DWI signal characteristics and be accompanied by an increase in ADC values. According to the authors, DWI is useful for understanding the MRI picture of disease variants with cytotoxic and vasogenic edema. Because DWI is more sensitive than conventional MRI in distinguishing between these pathological conditions.

The disadvantage of this method is the determination of A DC values ​​without calculating their prognostic characteristics.

Mascalchi M., Filippi M., Floris R., et al. show the high sensitivity of MRI-DWI in its ability to visualize the substance of the brain. This method, along with the use of native MRI, implies the construction of images, the so-called diffusion coefficient maps (ADC maps), which make it possible to more objectively assess areas of diagnostic interest by determining ADC values ​​or performing graphical analysis. This approach allows a quantitative and reproducible assessment of diffusion changes not only in areas of signal changes detected by native MRI, but also in areas that have a normal signal in native MRI. In this method, ADC of gray and white matter is increased in patients with neurodystrophic changes, which correlates with cognitive deficits. However, this method does not calculate the ADC of the hippocampus, and therefore cannot be used as a method for predicting hippocampal disease.

Closest to the claimed is the method described by A. Förster M. Griebe A. Gass R. et al. The authors compare clinical data and MRI data, suggest using in combination the results of native MRI, DWI in the hippocampus, and calculated diffusion coefficients (ADC) to distinguish between diseases in the hippocampus. This method is carried out by determining typical visual symptoms on each type of image and for each disease, summarizing the data obtained, highlighting the so-called visual syndromes for the main groups of diseases in the hippocampus. The authors believe that this approach will provide additional diagnostic information that will make the clinical diagnosis more accurate and justified.

The disadvantage of this method is the lack of quantitative prognostic criteria for assessing ADC performance in various pathological conditions in the hippocampus.

The objective of the proposed method is to implement an objective and reliable prediction of diseases in the hippocampus, to accurately determine the direction of development of pathological changes in this area of ​​the brain by calculating a quantitative parameter: the trend value of ADC indicators.

The problem is solved by determining the absolute values ​​of the diffusion coefficient (ADC) at the level of the head, body and tail of the hippocampus, based on these ADC indicators, the value of their trend is calculated, according to which the general direction of ADC changes is predicted: when the value of the calculated ADC trend is more than 0.950 ×10 -3 mm 2 /s make a conclusion about the possibility of gliosis changes as a result of reversible vasogenic edema and reversible hypoxic states of hippocampal cells: if the calculated ADC trend value is less than 0.590×10 -3 mm 2 /s, it is concluded that ischemia with cell transition is possible hippocampus to the anaerobic oxidation pathway with subsequent development of cytotoxic edema and cell death; while maintaining the value of the calculated ADC trend in the range from 0.590×10 -3 mm 2 /s to 0.950×10 -3 mm 2 /s, it is concluded that the diffusion processes in the hippocampus are balanced.

The method is carried out as follows: native MRI of the brain is performed according to the generally accepted scheme to obtain a series of T1-weighted images (T1WI), T2-weighted images (T2WI) in three standard planes, diffusion-weighted images (DWI) (b 0 =1000 s/ mm 2) in the axial (transverse) plane; analyze the data obtained during MRI on T1WI, T2WI, DWI, visually determine the location of the hippocampus, evaluate their signal characteristics. Then, for each hippocampus on both sides, the absolute values ​​of ADC are determined in three areas: at level 1 - head (h), 2 - body (b) and 3 - tail (t). T1WI, T2WI, DWI of the brain were obtained on a Brivo-355 MP tomograph (GE USA), 1.5 T. Absolute ADC values ​​were determined using the Viewer-Functool image processing program of the Brivo-355 MP tomograph (Fig. 1). . On fig. 1 shows the determination of the absolute values ​​of ADC on both sides, in three areas at the level 1 - head (h), 2 - body (b) and 3 - tail (t) of each hippocampus, where I is the right hippocampus, II is the left hippocampus.

Absolute ADC values ​​are used to calculate the ADC trend value separately for the right and left hippocampus. Why create an Excel table consisting of two columns - "x" and "y". In the column "y" enter line by line the absolute values ​​of ADC, calculated in three areas: h, b, t; in the column "x" - the numbers 1, 2, 3, respectively, denoting the areas h, b, t (Fig. 1). Below the table data rows, clicking the cursor will activate any cell. From the standard package of statistical functions of Excel-2010, the function "TREND" is selected, in the window that opens, in the line "known values ​​of y", the cursor is placed, in the Excel table the cells of the column "y" with absolute values ​​of ADC are selected, after which in the line "known values ​​y” will display the addresses of the data cells. The cursor is moved to the line “known x values”, the cells of the “x” column of the Excel table are selected, with the numbers 1, 2, 3, after which the addresses of the data cells will appear in the line “known x values”. The "new x values" and "constant" lines of the TREND tab are blank. Press the "OK" button. The calculated ADC trend value will appear in the activated cell. Thus, the ADC trend value for each hippocampus is calculated. According to the value of the calculated ADC trend, the direction of ADC changes in the hippocampus is predicted: when the calculated ADC trend value is more than 0.950×10 -3 mm 2 /s, a conclusion is made about predicting gliosis changes as a result of reversible vasogenic edema and reversible hypoxic states of hippocampal cells; when the value of the calculated ADC trend is less than 0.590×10 -3 mm 2 /s, a conclusion is made about the possibility of ischemia with the transition of hippocampal cells to the anaerobic pathway of oxidation, followed by the development of cytotoxic edema and cell death; while maintaining the value of the calculated ADC trend in the range from 0.590×10 -3 mm 2 /s to 0.950×10 -3 mm 2 /s, it is concluded that the diffusion processes in the hippocampus are balanced.

The analysis of the absolute values ​​of ADC with the calculation of the value of their trend makes it possible to objectively and accurately determine the general direction of changes in ADC values ​​by quantitative characteristics, to reliably predict the development of pathological conditions in the region of each hippocampus.

The proposed method for predicting diseases in the hippocampus allows quantitatively, that is, more objectively and accurately, to predict the development of pathological conditions, to reliably determine their qualitative characteristics. For example, the development of dystrophic, sclerotic or ischemic changes for each specific patient, in each specific case. So, when the value of the calculated trend ADC more than 0.950×10 -3 mm 2 /s make a conclusion about the possibility of gliosis changes as a result of reversible vasogenic edema and reversible hypoxic states of the hippocampal cells; when the value of the calculated ADC trend is less than 0.590×10 -3 mm 2 /s, a conclusion is made about the possibility of ischemia with the transition of hippocampal cells to the anaerobic pathway of oxidation, followed by the development of cytotoxic edema and cell death; while maintaining the value of the calculated ADC trend in the range from 0.590×10 -3 mm 2 /s to 0.950×10 -3 mm 2 /s, it is concluded that the diffusion processes in the hippocampus are balanced.

The proposed method for predicting diseases in the hippocampus can be used by doctors of MRI rooms, departments of radiation diagnostics, neurology, and neurosurgery. The data obtained using this method will make it possible to objectively, accurately and reliably predict the development of diseases in the hippocampus, select an adequate set of therapeutic and preventive measures, these data can be used to develop new technologies for the diagnosis and treatment of diseases in the hippocampus.

In our studies of patients (n=9) with unilateral expansion of the temporal horn of one of the lateral ventricles and a decrease in the size of the corresponding hippocampus, the mean ADC value was determined: mean ADC value ± standard deviation - (1.036±0.161)×10 -3 mm 2 /s (95 % confidence interval: (1.142-0.930)×10 -3 mm 2 /s, compared with the mean ADC value of unchanged hippocampus on the opposite side: ADC ± standard deviation - (0.974±0.135)×10 -3 mm 2 /s ( 95% confidence interval: (1.062-0.886)×10 -3 mm 2 /s) For an objective, accurate prediction of diseases in the hippocampus, accurate and reliable determination of the direction of development of pathological changes in diffusion in this area of ​​the brain, a quantitative indicator was calculated: value calculated ADC trend.

Example 1. Patient Sh., 21 years old. Native MRI revealed an expansion of the temporal horn of the right lateral ventricle, including as a result of a decrease in the size of the hippocampus, a small-focal increase in the T2WI signal in the hippocampus on both sides. When analyzing absolute hippocampal ADC values, taking into account the standard deviation, a higher mean ADC value and a wider 95% confidence interval of ADC values ​​were found on the right, on the side of the reduced hippocampus. At the same time, some of the mean ADC values ​​for both the right and left hippocampus were within the normal range, and some were outside it. This made it impossible to determine the main direction of development of diffusion changes in this area of ​​the brain. Determining the value of the calculated ADC trend made it possible to designate such a direction and for each hippocampus to draw a conclusion about possible pathological changes or their absence:

Right hippocampus: ADC values ​​at the level of the head, body, tail: h=1,220×10 -3 mm 2 /s; b=0.971×10 -3 mm 2 /s; t=0.838×10 -3 mm2/s. Mean value of ADC ± standard deviation: (1.01±0.19)×10 -3 mm 2 /s; 95% confidence interval ADC: (1.229-0.791)×10 -3 mm 2 /s; calculated trend value ADC=1.201×10 3 mm 2 /s.

Left hippocampus: ADC values ​​at the level of the head, body, tail: h=0.959×10 -3 mm 2 /s; b=0.944×10 -3 mm 2 /s; t=1.030×10 -3 mm2/s. Mean value of ADC ± standard deviation: (0.978±0.0459)×10 -3 mm 2 /s; 95% confidence interval of ADC values: (1.030-0.926)×10 -3 mm 2 /s; the value of the calculated trend ADC=0,942×10 -3 mm 2 /s.

The value of the calculated trend ADC=1,201×10 -3 mm 2 /s (greater than 0.950×10 -3 mm 2 /s) allows us to conclude the possibility of gliosis changes in the right hippocampus; the value of the calculated trend ADC=0.942×10 -3 mm 2 /s (ranging from 0.59×10 -3 mm 2 /s to 0.95×10 -3 mm 2 /s) allows us to conclude that diffusion processes are balanced in the left hippocampus.

Example 2. Patient K., 58 years old. Native MRI revealed subatrophic changes in the right temporal lobe and expansion of the temporal horn of the right lateral ventricle. Adjusted for standard deviation, the mean ADC values ​​on both sides were about the same, but a wider 95% confidence interval for ADC values ​​was found in the right hippocampus. Determining the value of the calculated ADC trend showed the main direction of diffusion changes in both the right hippocampus and the left hippocampus, helped to predict the development of pathological conditions in these areas of the brain.

Right hippocampus: ADC values ​​at the level of the head (h), body (b), tail (t): h=1.060×10 -3 mm 2 /s; b=0.859×10 -3 mm 2 /s; t=1.03×10 -3 mm2/s. Mean value of ADC ± standard deviation: (0.983±0.108)×10 -3 mm 2 /s; 95% confidence interval: (1.106-0.860)×10 -3 mm 2 /s; the value of the calculated trend ADC=0,998×10 -3 mm 2 /s.

Left hippocampus: ADC values ​​at the level of the head (h), body (b), tail (t): h=1.010×10 -3 mm 2 /s; b=0.968×10 -3 mm 2 /s; t=0.987×10 -3 mm2/s. Average ADC value ± standard deviation: (0.988±0.021)×10 -3 mm 2 /s; 95% confidence interval: (1.012-0.964)×10 -3 mm 2 /s; the value of the calculated trend ADC=1,000×10 -3 mm 2 /s.

In this case, the value of the calculated ADC trend of 0.998×10 -3 mm 2 /s - in the right hippocampus and 1.000×10 -3 mm 2 /s - in the left hippocampus exceeds the value of 0.95×10 -3 mm 2 /s, which allows to draw a conclusion about the possibility of gliosis changes in these areas of the brain.

Thus, as follows from examples 1 and 2, with a similar picture obtained with native MRI and DWI, the analysis of the absolute values ​​of ADC with the determination of the value of the calculated ADC trend allows not only to study in depth the existing pathological changes in the hippocampus. It also makes it possible to objectively, accurately, reliably and confidently predict the direction of development of these pathological changes and, of course, to adjust therapeutic measures accordingly.

Sources of information

1. Förster A., ​​Griebe M., Gass A., Kern R., Hennerici M.G., Szabo K. (2012) Diffusion-Weighted Imaging for the Differential Diagnosis of Disorders Affecting the Hippocampus. Cerebrovasc Dis 33: 104-115.

2. Mascalchi M, Filippi M, Floris R, Fonda C, Gasparotti R, Villari N. (2005) Diffusion-weighted MR of the brain: methodology and clinical application. Radiol Med 109(3): 155-97.

3. Moritani T., Ekholm S., Westesson P.-L. Diffusion-Weighted MR Imaging of the Brain, - Springer-Verlag Berlin Heidelberg, 2005, 229 p.

A method for predicting diseases in the hippocampal region, including the use of native magnetic resonance imaging (MRI), diffusion-weighted images (DWI), determination of the absolute values ​​of the diffusion coefficient (ADC) at the level of the head, body and tail of the hippocampus, based on these indicators, the ADC value is calculated their trends, according to which the general direction of ADC changes is predicted: when the value of the calculated ADC trend is more than 0.950×10 -3 mm 2 /s, a conclusion is made about the possibility of gliosis changes as a result of reversible vasogenic edema and reversible hypoxic states of hippocampal cells; when the value of the calculated ADC trend is less than 0.590×10 -3 mm 2 /s, a conclusion is made about the possibility of ischemia with the transition of hippocampal cells to the anaerobic pathway of oxidation, followed by the development of cytotoxic edema and cell death; while maintaining the value of the calculated ADC trend in the range from 0.590×10 -3 mm 2 /s to 0.950×10 -3 mm 2 /s, it is concluded that the diffusion processes in the hippocampus are balanced.

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The invention relates to medicine, oncology, gynecology, radiology. Magnetic resonance imaging (MRI) of the small pelvis is performed using T1-spin echo with suppression of the signal from adipose tissue FATSAT in the axial plane with a slice thickness of 2.5 mm and a scanning step of 0.3 mm before the introduction of a contrast agent (CP) and at 30, 60, 90 , 120, 150 s after its introduction.

SUBSTANCE: group of inventions relates to medical equipment, namely to magnetic resonance imaging systems. The medical device includes a magnetic resonance imaging system that includes a magnet, a clinical device, and a slip ring assembly capable of supplying power to the clinical device. The slip ring assembly comprises a cylindrical body, a rotary element on which the clinical device is mounted, the first cylindrical conductor and the second cylindrical conductor, which partially overlap. The second cylindrical conductor is connected to the cylindrical body, the first cylindrical conductor and the second cylindrical conductor are electrically isolated. The slip ring assembly also comprises a first set of conductive elements, each of the set of conductive elements being connected to a second cylindrical conductor, and a brush holder assembly comprising a first brush and a second brush, wherein the first brush is configured to contact the first cylindrical conductor when the rotary element rotates. around the axis of symmetry. The second brush is configured to make contact with the set of conductive elements when the rotary element rotates around the axis of symmetry. EFFECT: inventions make it possible to weaken the magnetic field generated by the slip ring assembly. 2 n. and 13 z.p. f-ly, 7 ill.

SUBSTANCE: group of inventions relates to medical equipment, namely to radiation dosimetry. The dosimeter for measuring the exposure dose of a subject during a radiation therapy session under the control of magnetic resonance imaging contains a housing, the outer surface of which is made with the possibility of placing a subject, in which each of the individual cells contains shells filled with a magnetic resonance radiation dosimeter. The therapeutic apparatus comprises a magnetic resonance imaging system, an ionizing radiation source capable of directing an ionizing radiation beam towards a target zone inside a subject, a computer system with a processor, a computer-readable storage medium, and a dosimeter. The execution of the instructions instructs the processor to perform the steps of determining the position of the target zone, directing the beam of ionizing radiation into the target zone, and ionizing radiation is directed so that the ionizing radiation passes through the dosimeter, obtaining a set of magnetic resonance data from the dosimeter, while the dosimeter is at least partially located inside the zone imaging, calculating the dosage of ionizing radiation of the subject in accordance with the data set of magnetic resonance. The use of the inventions makes it possible to increase the reproducibility of radiation dose measurements. 3 n. and 12 z.p. f-ly, 7 ill.

The invention relates to medicine, namely to neurosurgery. Differential diagnosis of small and vegetative states of consciousness is carried out. At the same time, search stimulation is carried out by the method of navigational brain stimulation (NBS). The motor centers of the brain are identified and activated by verbally instructing the patient to perform movements. When a myographic response recorded from the muscles is detected, a state of consciousness above the vegetative one is diagnosed. EFFECT: method allows to increase the reliability of assessment of impaired consciousness and restoration of the patient's intellect, which is achieved by identifying the preservation of the pyramidal tract and the functional activity of the cortical centers of the brain. 27 ill., 7 tab., 3 pr.

The invention relates to medicine, namely to medical diagnostic equipment and can be used to determine the density of biological tissue in a pathological focus. Using a positron emission tomograph containing a device that measures the frequency difference of γ-quanta, simultaneously arriving at the detectors of γ-radiation, measure the maximum frequency difference of these γ-quanta. Based on this frequency difference, on the basis of the Doppler effect, the positron velocity and the biotissue density proportional to it in the pathological focus are found. The method allows to measure the density of biological tissue in the pathological focus by using a device that allows you to measure the frequency difference of γ-quanta, simultaneously arriving at the detectors of γ-radiation. 3 ill.

The invention relates to medical equipment, magnetic resonance imaging (MRI) devices. The magnetic resonance tomograph includes a constant magnetic field source, a gradient magnetic field generation unit, a radio frequency pulse generator, a receiver, and an electromagnetic field amplifier made of a metamaterial located near the receiver. The metamaterial includes a set of extended predominantly oriented conductors isolated from each other, each of which is characterized by a length li, the average value of which is equal to L, located at distances si from each other, the average value of which is equal to S, having transverse dimensions di, the average value of which is equal to D, and the average value of the conductor lengths satisfies the condition 0.4λ

The invention relates to means for extracting information from a detected characteristic signal. The technical result is to increase the accuracy of information extraction. A data stream (26) extracted from the electromagnetic radiation (14) emitted or reflected by the object (12) is received. The data stream (26) contains a continuous or discrete time-controlled characteristic signal (p; 98) containing at least two main components (92a, 92b, 92c) associated with the respective complementary channels (90a, 90b, 90c) of the signal space ( 88). The characteristic signal (p; 98) is mapped to a given component representation (b, h, s, c; T, c) given a substantially linear algebraic model of signal composition to define a linear algebraic equation. The linear algebraic equation is at least partially solved given at least an approximate estimate of the given parts of the signal (b, h, s). Therefore, from a linear algebraic equation, an expression can be derived that is highly indicative of at least one, at least partially periodic vital signal (20). 3 n. and 12 z.p. f-ly, 6 ill.

SUBSTANCE: group of inventions relates to medical equipment, namely to means for forming a magnetic resonance image. A method for forming a magnetic resonance (MR) image comprises the steps of obtaining a first set of signal data limited by a central region of k-space, in which magnetic resonance is excited by means of RF pulses having a deflection angle α1, obtaining a second set of signal data limited by a central region of k-space and RF pulses have deflection angle α2, obtain the third set of signal data from the peripheral portion of k-space, and RF pulses have deflection angle α3, deflection angles are related as α1>α3>α2, reconstruct the first MR image from the combination of the first signal data set and the third signal data set, a second MR image is reconstructed from the combination of the second signal data set and the third signal data set. The magnetic resonance device contains a main solenoid, a plurality of gradient coils, an RF coil, a control unit, a reconstruction unit, and an imaging unit. The storage medium stores a computer program which contains instructions for carrying out the method. The use of the inventions makes it possible to reduce the time of data collection. 3 n. and 9 z.p. f-ly, 3 ill.

The invention relates to medicine, otorhinolaryngology and magnetic resonance imaging (MRI). MRI is performed in T2 Drive (Fiesta) and B_TFE modes and 3D phase contrast angiography (3D PCA) with a flow rate of 35 cm/s. For all studies, the same slice geometry, slice thickness, and slice pitch are used. The plane in all studies is also the same and is set according to the anatomical points: the Chamberlain line in the sagittal plane and the centers of the snails in the coronal plane. A summary image is obtained in one plane by superimposing the images obtained during the indicated studies on each other, visualizing the vestibulocochlear nerve and the anterior-inferior cerebellar artery on the summary image. In this case, the display of the nerve is identified by a hypointense signal - black, arteries - by a hyperintense signal - white. Next, the measurement of the linear distance of the intersection of the vessel with the nerve relative to the control point on the lateral surface of the brain stem - at the exit point of the vestibulocochlear nerve from the lateral surface of the brain stem. If the nerves and vessels do not intersect, the norm is stated. If there is a point contact between the artery and the nerve, compression is diagnosed, the localization of which is determined by the distance from the control point, which is located on the lateral surface of the brainstem at the exit point of the vestibulocochlear nerve from the lateral surface of the brainstem. EFFECT: method provides high accuracy, detail of non-invasive diagnostics in patients with cochlear and vestibular disorders by determining the exact correlation of the conflict site with the anatomical feature of the course of the vestibular and cochlear portions of the nerve, which makes it possible to conclude that the zone of this conflict affects the clinical picture. 1 ave.

SUBSTANCE: group of inventions relates to medical equipment, namely to magnetic resonance imaging. A motion compensated magnetic resonance imaging (MRI) method comprises receiving motion indication signals from a plurality of markers that include a resonant material and at least one of an inductive-capacitive (LC) loop or an RF microcoil, located near resonant material, wherein the marker includes a controller that tunes and detunes the LC circuit or RF microcoil, scans the patient using MRI scan parameters to generate MRI resonance data, generates motion signals such that at least , one of the frequency and phase of signals indicating movement indicates the relative position of markers during scanning of patients, reconstructing MRI resonance data into an image using MRI scanning parameters, determining the relative position of at least the volume of interest of the patient from signals indicating movement, and modify scan parameters to compensate for certain relative motion of the patient, detuning the LC loop or RF microcoil during image acquisition, and adjusting the LC loop or RF microcoil during relative position acquisition. The system for correcting the expected movement contains a magnetic resonance imaging scanner, a plurality of markers and a data processing device. EFFECT: use of the inventions makes it possible to expand the arsenal of means for determining the position of the patient and correcting movement during MRI. 2 n. and 6 z.p. f-ly, 6 ill.

The invention relates to medicine, namely to oncourology. The average cubic value of the neoplasm is determined by magnetic resonance imaging. The concentration of biomarkers in urine and blood serum is determined by enzyme immunoassay - vascular endothelial growth factor (VEGF, in ng/ml), matrix metalloproteinase 9 (MMP9, in ng/ml) and monocytic chemotoxic protein 1 (MCP1, in ng/ml). Then the obtained values ​​are entered into expressions C1-C6. The condition of the patient's kidney is assessed according to the largest of the obtained C1-C6 values. EFFECT: method allows operatively, high-tech, non-invasive way to select from the group of urological patients patients with kidney cancer by evaluating the most significant indicators. 5 Ave.

The invention relates to medicine, radiology and can be used to predict the course of diseases, the development of pathological conditions in the hippocampus. Using native magnetic resonance imaging, diffusion-weighted images, the absolute values ​​of the diffusion coefficient are determined at three points: at the level of the head, body and tail of the hippocampus. Based on these ADC indicators, their trend value is calculated, which predicts the general direction of ADC changes. When the value of the calculated ADC trend is more than 0.950×10-3 mm2s, a conclusion is made about the possibility of gliosis changes as a result of reversible vasogenic edema and reversible hypoxic states of hippocampal cells. When the value of the calculated ADC trend is less than 0.590×10-3 mm2s, it is concluded that ischemia may occur with the transition of hippocampal cells to the anaerobic pathway of oxidation, followed by the development of cytotoxic edema and cell death. While maintaining the value of the calculated ADC trend in the range from 0.590×10-3 mm2s to 0.950×10-3 mm2s, a conclusion is made about the equilibrium of diffusion processes in the hippocampus. The method provides both an in-depth definition of existing pathological changes in the hippocampus, and a more accurate prediction of the dynamics of the development of these pathological changes for subsequent correction of therapeutic measures. 5 ill., 2 pr.

Hippocampal sclerosis is the most "fashionable trend" in neurology and radiology now, by the way. We are competing with each other, who was the first to "saw the hippocampus", but the public is indifferent ... And in the West there are entire official communities of "hippocampus lovers" ...

I think it's epileptic

I think that this is status epilepticus, but dynamics is needed after 2-3 non-epileptic weeks

and the case that you have indicated that and this one and the same person or what?

IT, and a variant of herpetic

IT, can't there be a variant of herpetic encephalitis here? With sclerosis, the hypocampus should have a volume decrease, but here it seems to be symmetrical, or does it take more time? For my understanding, this is a complex topic, but interesting and relevant, because. Several times on CT I saw asymmetry of these parts of the brain and there was a clinic of epilepsy, the hippocampus was small, the furrows were expanded and the temporal horn was deepened, she regarded this as medial temporal sclerosis.

You are looking only at the heads of the hippocampus (this area is mainly represented, where the masses and the focus of accumulation are), but there are a couple of sections at the level of the bodies more caudally - it is not symmetrical there. Plus: hippocampal sclerosis is manifested not only by a volumetric decrease in the hippocampus. Some points on CT cannot be technically clarified, CT in epilepsy, unfortunately, ((((((. If only the changes are pronounced, then yes. This is my individual opinion.

I think you are right

It seems to me that you correctly put in a differential series PKD and DNR, I would even put DNR in the first place, contrasting can be regarded as a neuroradiological marker DNR, this formation contains dysplastic cells and neuroglia and the more dysplastic cells the less it is capable of contrast amplification, maybe this is the same case, and according to the literature data, DNET can outwardly almost completely mimic the PKD. Regarding other reasons, these can be ganglogliomas, oligodendrogliomas, but there the cystic component still prevails in the structure, which is not the case in this case. They also describe it as a variant of astrocytoma I II, but I don’t know about this, maybe in last place in the differential. diagnosis and can be made, although there should be at least a small mass effect and perifocal edema. Against encephalitis, a long history of detectable changes, because they were on MRI before, even if they were not contrasted. For the tumor nature of the lesion, there may be a clinic of steadily progressive epilepsy and poor response to treatment, but this is relative.

Thank you for your comment.

Thank you for your comment. There is a small mass effect, though, and you can compare the medial contours of the structures in the coronal view. And what is your opinion about not only FKD OR DNET, but FKD AND Dnet? It's a shame that there is no verification for the first case - I would like to start from personal experience already with morphology ...

In the book of prof. Alikhanov

In the book of prof. Alikhanova found: associated FCDs are isolated, i.e. various variants of cortical dysgenesis coexisting in close topographic relationship (and sometimes losing a clear histological separation among themselves), most often classical Taylor or balloon-cell FCD are combined with gliomamia and hippocampal gliosis, forming FCD associates.

Researchers at Harvard Medical School in Boston, Massachusetts, studying the pathophysiology of psychiatric disorders, have found that patients with such disorders have a smaller hippocampus. Previous research has suggested that changes in the medial temporal lobe (MTL), hippocampus, parahippocampal gyrus, and entorhinal cortex are hallmarks of schizophrenia. Attempts to identify the degree of difference in patients with other mental disorders have been unsuccessful, however, for example, in bipolar disorders, changes in the medial temporal lobe are insignificant or absent. Other studies have also failed to show any reduction in hippocampal volume in patients with bipolar disorder treated with lithium.

Harvard scientists have done research using neuroimaging in healthy volunteers and patients with schizophrenia, schizoaffective disorder, and psychotic bipolar disorder. According to the results obtained, the medial temporal lobe decreases in volume in patients with schizophrenia and schizoaffective disorder, but not in patients with psychotic bipolar disorder. In addition, a decrease in hippocampal volume was found in all three groups of patients with mental disorders, compared with healthy volunteers. Each violation in mental work is accompanied by certain changes characteristic of this state. The researchers also found that the degree of hippocampal shrinkage depends on the severity of the psychosis, memory status, and overall cognitive performance.

But despite the correlation between symptoms and volume reduction in different areas of the hippocampus, the authors acknowledge that it is too early to say anything concrete. The patients in this study were treated with antipsychotics, and the researchers plan to further study the problem to investigate changes in the brain before and after the start of the use of pharmacological agents. In addition, patients with non-psychotic bipolar disorder were not included in the sample in this study, so the investigators cannot expect their findings to be generalizable to patients with this diagnosis.

In this study, the most modern technologies were used to analyze the work of the hippocampus to date. This made it possible to study small substructures in the hippocampus in a large sample of individuals with certain mental disorders, including schizophrenia and psychotic bipolar disorders. Observations of scientists show that changes in the hippocampus, a key brain region responsible for the formation, storage, processing and retrieval of memories, cannot be caused only by schizophrenia, but occur in connection with a whole spectrum of psychotic disorders.