磁共振针刺成像技术研究.ppt

Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,磁共振针刺成像技术研究,邱本胜,中国科学技术大学医学影像中心,传统中医理论,神经调节,生物医学成像,fMRI,，,PET,器官,针刺的机理研究,穴位,手针,电针,激光,超声,毫米波,磁共振兼容针刺针,Acupuncture needles in this study.(a)Standard stainless needle;(b)Gold needle;(c)Austenitic stainless steel needle.,conventional metal needle gold acupuncture needle Austenitic stainless steel needle,BOLD Imaging,磁共振兼容针刺针,BOLD Imaging,针刺针在磁共振成像中的温度变化,BOLD Imaging,针刺磁共振成像,The coronal MRI of acupuncture at shank using a gold needle and a Austenitic stainless steel needle,BOLD Imaging,针刺磁共振成像,The transversal MRI of acupuncture at shank using a gold needle and a Austenitic stainless steel needle.,BOLD Imaging,电针灸仪,2,个输出通道，可以同时用于,4,个治疗部位。,经皮刺激方式：通过皮肤刺激皮下穴位。,恒流输出，治疗过程中电流恒定，避免电流不稳定引起的皮肤刺痛感。,正负双向对称脉冲波，两个电极刺激量完全相同，没有正负极性。,9,种波形，用户可根据治疗需要选择不同波形。,波宽自动调节：频率升高时脉冲变窄，频率降低时脉冲变宽，避免刺激强度时强时弱引起的不舒适感。,参数精确：电流范围,0-40mA,，精确到,1mA,；频率范围：,2Hz-100Hz;,定时功能：用户可根据需要设置治疗时间，设定时间到后自动停机,.,BOLD Imaging,磁共振成像中的电针连接,1,、安全性考虑：发热和烫伤,?,2,、磁共振和电针灸仪的相互干扰,;,3,、铜双绞线；,4,、屏蔽层；,5,、接地；,BOLD Imaging,Ultrasound Acupuncture Machine,1,、磁共振和超声针灸仪的相互干扰,2,、同轴电缆；,3,、双屏蔽层和接地；,BOLD Imaging,聚焦超声针灸仪,聚焦超声换能器,磁共振温度成像；,不宜受磁共振成像干扰；,完成简单超声针灸电路系统的设计和调试,BOLD Imaging,聚焦超声针灸仪,超声针灸电路系统的设计和调试,BOLD Imaging,激光针灸仪,1,、无电磁干扰,;,2,、需要系统研究,:,波段；,脉冲宽度；,强度；,MRI of Acupuncture,Anatomical Localization:,High-resolution T1-weighted anatomical,volumes:Spin Echo&Spoiled Grass series,Extraction of cortical surface,BOLD(,blood-oxygen level,dependent),T2*-weighted functional volumes,Echo-planer imaging series,speed of acquisition,Signal intensity depends on blood oxygenation changes,ASL(Arterial Spin Labeling),DTI/Connectom,?,Molecular MRI?,Data processing,AFNI,操作面板,预处理一般流程,数据分析,个体激活图的获得,相关分析,AFNI,3dfim,线性和非线性时间序列回归分析,3dDeconvolve,3dNLfim,多个被试结果的组分析,逐个体素,t,检验,3dttest,逐个体素的,1-,2-,3-,元方差分析,Fixed and random effects 3dANOVA,二次分析,感兴趣区（,ROI,）分析,AFNI,相关分析方法,模型的构建即用,waver,来生成,1D,文件（实验刺激函数）,预测血流动力学反应的文件用来和真实的血流动力学反应,(,实验获得的体素的时间序列,),进行相关分析,线性回归分析,主要用,afni,里的,3dDeconvolve,（反卷积）,线性回归分析后获得理想的反应函数,线性回归分析,多被试组分析,为每个数据集进行图像校正和时,间校正,;,对,3D+time,数据集进行平滑,;,对数据进行标准化,计算信号改变百分比,;,对多个数据进行,t-test,ROI,的选择和分析,ROI,的选择,ROI,信号分析,fMRI,二维可视化,fMRI,三维可视化,fMRI view of SUMA,SUMA,和,AFNI,交互使用能够将脑沟和脑回展开,Interactive use of SUMA,and AFNI,Principle of ASL,Generalized principles:,Tag inflowing arterial blood by magnetic inversion.,Acquire the tag image.,Repeat experiment without tag.,Acquire the control image.,Subtraction:control Image-tag image,Advantages and Drawbacks,Advantages:,No contrast injection needed,Quantitative measurement of CBF,Promising clinical applications,Drawbacks:,Low SNR,Artifacts,Other limitations,Introduction to PASL,PASL uses short(5,-,20ms),r,adio,-,frequency(RF)pulses to invert a thick slab of spins in the tagging plane proximal to the imaging region.,PASL pulses,EPISTAR(Echo Planar Imaging and Signal Targeting with Alternating Radiofrequency)and its,variations,:,PICORE(Proximal Inversion with Control for Off-Resonance Effects),TILT(Transfer Insensitive Labeling Technique),FAIR(Flow-sensitive Adiabatic Inversion Recovery)and its,variations,:,UNFAIR(Uninverted FAIR),BASE(unprepared basis(BA)and selective(SE)inversion prepared images),FAIRER(FAIR with an extra RF pulse),PASL pulses:FAIR,A FAIR(Flow-sensitive Alternating Inversion Recovery)pulse sequence,Introduction:CASL,CASL uses long and continuous RF pulses(1-2seconds)along with a constant gradient field to induce a flow-driven adiabatic inversion in a narrow plane of spins,usually just below the imaging plane,.,CASL pulses,Comparisons:CASL and PASL,ASL Types,Advantages,Disadvantages,CASL,Higher SNR than PASL;Shorter transit delay;,Lower tagging efficiency;Continuous RF transmit hardware required;Higher SAR;Magnetization Transfer effects;,PASL,Higher tagging efficiency;Lower SAR;Improved transit time effects;,Lower SNR;Increased transit delay;,Other types of ASL,pCASL(pseudo CASL),pCASL was introduced to match the inversion efficiency of CASL while reducing the RF power deposition,without special hardware.,Higher SNR than PASL and higher tagging efficiency than CASL;Susceptible to B0 inhomogeneity;,Limited clinical availability;,VS-ASL(Velocity Selective ASL),VS-ASL saturates the blood that is moving at a faster velocity than a specific cutoff value.,Ability to measure low blood flow,such as stroke;,Lower SNR;difficult to determine the optimal cutoff value;,BOLD Imaging,MA,和,EA,的,fMRI,对比研究,BOLD Imaging,MA,和,EA,的,fMRI,对比研究,Psychophysical,Deqi,sensation during manual and EA.No statistical significance was found between modalities of MA and EA with respect to the sensations of numbness,fullness,and warm(P0.05).However,the sensing of soreness and dull pain was prominently stronger in EA(P0.05),Hemodynamic response during needle manipulation(a),post-acupuncture session I(b),and post-acupuncture session II of MA(c).Red-Yellow:activation;Blue-Cyan:deactivation.,BOLD Imaging,Brain response of MA,BOLD Imaging,Brain Response of EA,Hemodynamic response during electrical stimulation(a),post-acupuncture session I(b),and post-acupuncture session II(c)of EA.Red-Yellow:activation;Blue-Cyan:deactivation.,Time-varied responses of representative brain regions in different sessions of MA at ST-36.The midbrain(i),left caudate(ii),and left ACC(iii)retained their activated/deactivated status from the stimulation session to the post-acupuncture session II.The BOLD signal in the left hippocampus gradually increased and finally reached a statistical significance in post-acupuncture session II(iv).,BOLD Imaging,Time-varied responses of MA,BOLD Imaging,Time-varied responses of EA,Time-varied responses of representative brain regions in different sessions of EA at ST-36.The left insula(i),left putamen(ii)maintained activated from stimulation session to post-acupuncture session II.However,the left caudate(iii)and right PCC(iv)gradually lost significance as stimulation was terminated.,The brain activity areas were located in the limbic structures in EA,while deactivation dominated in the same area in MA.,Most regions with long-lasting activation presented a strong-weak-strong fluctuation from both EA and MA acupuncture stimulation to the early phase of post-acupuncture session,which may indicate an action mode of the sustained acupuncture effect.,BOLD Imaging,MA,和,EA,的效应,fMRI,对比研究,手针和超声刺激的,fMRI,对比研究,The location of acupoint ST36(left)and the experimental paradigm(right)was shown.The fMRI scanning began with an 8-minutes resting session(R0).Then the needle was inserted into the acupoint ST_36 or ultrasound transducer was attached to the acupoint.“Deqi”sensation without sharp pain was achieved in MA.During task-state scanning,three cycles of stimulation(S1,S2,S3)and resting(R1,R2,R3)were performed,which totally took 9 minutes.After scanning,the needle or the ultrasonic transducer was removed from the acupoint.,fMRI of MA at ST-36,fMRI of UA at ST-36,Intergroup differences on brain response,Intergroup comparison showed that MA produced stronger brain response in ipsilateral hemisphere,including cerebellum,caudate,and frontal gyri.UA induced stronger response in part of the frontal,temporal and parietal lobes,ventral DC,and PAG.,Experiment 1:Unilateral acoustic stimulation was alternately conducted to the left and right ears for 30 seconds separated by intervals of 30-second resting.,Experiment 2:Acupuncture needle was inserted and manipulation was periodically conducted for 30 seconds and separated by intervals of 30-second resting.,手针和声刺激的,fMRI,研究,Brain Map,Brain Map,Data Processing,fMRI of acupuncture simulation,Comparison of BOLD and ASL,Hemodynamic responses of EA at ST-36 using BOLD and pASL,Summary,Multi-modality acupuncture:MA,UA,and LA;,MRI compatible device;,BOLD and ASL for acupuncture;,we will like to collaborate,data storage and processing for our collaborators;,technique support;,MRI compatible needles,UA machines etc.;,MRI pulse sequence;,谢谢大家！,该刺激相关部位时会激活机体内源性阿片系统,促使释放内源阿片肽,以代替外源性吗啡的功能,发挥全身性的镇痛作用,并且有改善微循环,缓解肌肉痉挛,发挥免疫调节的作用,.,BOLD Imaging,Acupuncture on pain relieve,6,个输出通道，用于多个治疗部位。,经皮,/,经针两种治疗模式。,恒流输出，治疗过程中电流恒定,;,正负双向对称脉冲波，两个电极刺激量完全相同，没有正负极性。,15,种波形：用户可根据治疗需要选择,;,波宽自动调节：频率升高时脉冲变窄，频率降低时脉冲变宽，避免刺激强度时强时弱引起的不舒适感。,参数精确：经皮模式电流范围,0-50mA,，电流精确到,1mA,；经针模式电流范围,0-9.9mA,，精确到,0.1mA,；频率范围：,2Hz-100Hz,。,开机自动复位,;,可根据需要设置治疗时间,;,BOLD Imaging,电针灸仪,