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Brain Swelling and Loss of Gray and White Matter Differentiation in Human Postmortem Cases by Computed Tomography.

Shirota G, Gonoi W, Ishida M, Okuma H, Shintani Y, Abe H, Takazawa Y, Ikemura M, Fukayama M, Ohtomo K - PLoS ONE (2015)

Bottom Line: WM attenuation significantly increased after death at all levels (P<0.0001).GM/WM ratio of attenuation was significantly lower by PMCT than by AMCT at all levels (P<0.0001).PMCT showed an increase in WM attenuation, loss of GM-WM differentiation, and brain swelling, evidenced by a decrease in the size of ventricles and sulci.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

ABSTRACT
The purpose of this study was to evaluate the brain by postmortem computed tomography (PMCT) versus antemortem computed tomography (AMCT) using brains from the same patients. We studied 36 nontraumatic subjects who underwent AMCT, PMCT, and pathological autopsy in our hospital between April 2009 and December 2013. PMCT was performed within 20 h after death, followed by pathological autopsy including the brain. Autopsy confirmed the absence of intracranial disorders that might be related to the cause of death or might affect measurements in our study. Width of the third ventricle, width of the central sulcus, and attenuation in gray matter (GM) and white matter (WM) from the same area of the basal ganglia, centrum semiovale, and high convexity were statistically compared between AMCT and PMCT. Both the width of the third ventricle and the central sulcus were significantly shorter in PMCT than in AMCT (P < 0.0001). GM attenuation increased after death at the level of the centrum semiovale and high convexity, but the differences were not statistically significant considering the differences in attenuation among the different computed tomography scanners. WM attenuation significantly increased after death at all levels (P<0.0001). The differences were larger than the differences in scanners. GM/WM ratio of attenuation was significantly lower by PMCT than by AMCT at all levels (P<0.0001). PMCT showed an increase in WM attenuation, loss of GM-WM differentiation, and brain swelling, evidenced by a decrease in the size of ventricles and sulci.

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Related in: MedlinePlus

Region of interest (ROI) at each level.The three ROIs that were analyzed in our study include the basal ganglia level, defined as the image in which the caudate nucleus, internal capsule, third ventricle, and sylvian fissures were visualized (A), centrum semiovale level defined as the image one slice above the lateral ventricular system (B), and high convexity level defined as the next image above the centrum semiovale level (C). In each case, cursor 1 is on the GM and cursor 2 is on the WM. The size of each ROI is 10 mm2.
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pone.0143848.g001: Region of interest (ROI) at each level.The three ROIs that were analyzed in our study include the basal ganglia level, defined as the image in which the caudate nucleus, internal capsule, third ventricle, and sylvian fissures were visualized (A), centrum semiovale level defined as the image one slice above the lateral ventricular system (B), and high convexity level defined as the next image above the centrum semiovale level (C). In each case, cursor 1 is on the GM and cursor 2 is on the WM. The size of each ROI is 10 mm2.

Mentions: To test for brain swelling we measured the width (length of the minor axis) of the third ventricle at the same level of the basal ganglia, and the width of the central sulcus at the level of the high convexity. We measured attenuation (Hounsfield units, HUs) in the GM and WM that were obtained from the same area of the basal ganglia, centrum semiovale, and high convexity level in AMCT and PMCT. These three regions of interest were defined according to the method by Torbey et al. 2000 [15], which was adopted in another previous study [17], as shown in Fig 1. To quantify the loss of GM–WM differentiation, we compared GM/WM ratios of attenuation in HUs between PMCT and AMCT.


Brain Swelling and Loss of Gray and White Matter Differentiation in Human Postmortem Cases by Computed Tomography.

Shirota G, Gonoi W, Ishida M, Okuma H, Shintani Y, Abe H, Takazawa Y, Ikemura M, Fukayama M, Ohtomo K - PLoS ONE (2015)

Region of interest (ROI) at each level.The three ROIs that were analyzed in our study include the basal ganglia level, defined as the image in which the caudate nucleus, internal capsule, third ventricle, and sylvian fissures were visualized (A), centrum semiovale level defined as the image one slice above the lateral ventricular system (B), and high convexity level defined as the next image above the centrum semiovale level (C). In each case, cursor 1 is on the GM and cursor 2 is on the WM. The size of each ROI is 10 mm2.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664263&req=5

pone.0143848.g001: Region of interest (ROI) at each level.The three ROIs that were analyzed in our study include the basal ganglia level, defined as the image in which the caudate nucleus, internal capsule, third ventricle, and sylvian fissures were visualized (A), centrum semiovale level defined as the image one slice above the lateral ventricular system (B), and high convexity level defined as the next image above the centrum semiovale level (C). In each case, cursor 1 is on the GM and cursor 2 is on the WM. The size of each ROI is 10 mm2.
Mentions: To test for brain swelling we measured the width (length of the minor axis) of the third ventricle at the same level of the basal ganglia, and the width of the central sulcus at the level of the high convexity. We measured attenuation (Hounsfield units, HUs) in the GM and WM that were obtained from the same area of the basal ganglia, centrum semiovale, and high convexity level in AMCT and PMCT. These three regions of interest were defined according to the method by Torbey et al. 2000 [15], which was adopted in another previous study [17], as shown in Fig 1. To quantify the loss of GM–WM differentiation, we compared GM/WM ratios of attenuation in HUs between PMCT and AMCT.

Bottom Line: WM attenuation significantly increased after death at all levels (P<0.0001).GM/WM ratio of attenuation was significantly lower by PMCT than by AMCT at all levels (P<0.0001).PMCT showed an increase in WM attenuation, loss of GM-WM differentiation, and brain swelling, evidenced by a decrease in the size of ventricles and sulci.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.

ABSTRACT
The purpose of this study was to evaluate the brain by postmortem computed tomography (PMCT) versus antemortem computed tomography (AMCT) using brains from the same patients. We studied 36 nontraumatic subjects who underwent AMCT, PMCT, and pathological autopsy in our hospital between April 2009 and December 2013. PMCT was performed within 20 h after death, followed by pathological autopsy including the brain. Autopsy confirmed the absence of intracranial disorders that might be related to the cause of death or might affect measurements in our study. Width of the third ventricle, width of the central sulcus, and attenuation in gray matter (GM) and white matter (WM) from the same area of the basal ganglia, centrum semiovale, and high convexity were statistically compared between AMCT and PMCT. Both the width of the third ventricle and the central sulcus were significantly shorter in PMCT than in AMCT (P < 0.0001). GM attenuation increased after death at the level of the centrum semiovale and high convexity, but the differences were not statistically significant considering the differences in attenuation among the different computed tomography scanners. WM attenuation significantly increased after death at all levels (P<0.0001). The differences were larger than the differences in scanners. GM/WM ratio of attenuation was significantly lower by PMCT than by AMCT at all levels (P<0.0001). PMCT showed an increase in WM attenuation, loss of GM-WM differentiation, and brain swelling, evidenced by a decrease in the size of ventricles and sulci.

Show MeSH
Related in: MedlinePlus