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<meta name="DC.Title" content="Longitudinal White Matter Changes following Carbon Monoxide Poisoning: A 9-Month Follow-Up Voxelwise Diffusional Kurtosis Imaging Study" />
<meta name="DC.Identifier" content="10.3174/ajnr.A5979" />
<meta name="DC.Date" content="2019-03-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2019 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Patients with carbon monoxide (CO) intoxication exhibit progressive WM changes that are not well-understood. The purpose of this study was to detect longitudinal WM changes using voxelwise diffusional kurtosis imaging in patients with CO intoxication from the acute-to-chronic stage after CO intoxication.

MATERIALS AND METHODS: Twenty-four patients with CO intoxication and 21 age- and sex-matched healthy controls were enrolled in this study. Diffusional kurtosis imaging was performed on all subjects and was conducted repeatedly in patients at 1 week and 1, 3, and 9 months after CO intoxication. Voxelwise diffusional kurtosis imaging analysis was performed to detect global WM changes in the patients with and without WM lesions. Receiver operating characteristic analysis was performed to compare the performance of diffusional indices in differentiating patients with delayed neuropsychiatric sequelae from patients without them.

RESULTS: In voxelwise analysis, progressive WM changes were detected in patients with WM lesions. In the acute phase, WM injuries were found mainly in the dopaminergic pathways at 1 week, whereas in the chronic stage, WM injuries extended toward subcortical areas from 1 to 9 months. However, no significant WM change was noted in patients without WM lesions during the 9 months after CO intoxication. Moreover, receiver operating characteristic analysis demonstrated that axial kurtosis and mean kurtosis values had better performance than other diffusional indices in differentiating patients with delayed neuropsychiatric sequelae from patients without them at 1 week after CO intoxication.

CONCLUSIONS: Voxelwise diffusional kurtosis imaging analysis was helpful to longitudinally investigate WM changes and predict the prognosis of patients after CO intoxication.

AD
:   axial diffusivity
AK
:   axial kurtosis
CO
:   carbon monoxide
CP
:   cerebral peduncle
DKI
:   diffusional kurtosis imaging
DNS
:   delayed neuropsychiatric sequelae
FA
:   fractional anisotropy
FWM
:   frontal white matter
GP
:   globus pallidus
IC
:   internal capsule
MD
:   mean diffusivity
MK
:   mean kurtosis
RD
:   radial diffusivity
RK
:   radial kurtosis
WML
:   white matter lesion" />
<meta name="DC.Contributor" content="M.-C. Chou" />
<meta name="DC.Contributor" content="J.-Y. Li" />
<meta name="DC.Contributor" content="P.-H. Lai" />
<meta name="article:published_time" content="2019-03-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Longitudinal White Matter Changes following Carbon Monoxide Poisoning: A 9-Month Follow-Up Voxelwise Diffusional Kurtosis Imaging Study" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Patients with carbon monoxide (CO) intoxication exhibit progressive WM changes that are not well-understood. The purpose of this study was to detect longitudinal WM changes using voxelwise diffusional kurtosis imaging in patients with CO intoxication from the acute-to-chronic stage after CO intoxication.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Twenty-four patients with CO intoxication and 21 age- and sex-matched healthy controls were enrolled in this study. Diffusional kurtosis imaging was performed on all subjects and was conducted repeatedly in patients at 1 week and 1, 3, and 9 months after CO intoxication. Voxelwise diffusional kurtosis imaging analysis was performed to detect global WM changes in the patients with and without WM lesions. Receiver operating characteristic analysis was performed to compare the performance of diffusional indices in differentiating patients with delayed neuropsychiatric sequelae from patients without them.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;In voxelwise analysis, progressive WM changes were detected in patients with WM lesions. In the acute phase, WM injuries were found mainly in the dopaminergic pathways at 1 week, whereas in the chronic stage, WM injuries extended toward subcortical areas from 1 to 9 months. However, no significant WM change was noted in patients without WM lesions during the 9 months after CO intoxication. Moreover, receiver operating characteristic analysis demonstrated that axial kurtosis and mean kurtosis values had better performance than other diffusional indices in differentiating patients with delayed neuropsychiatric sequelae from patients without them at 1 week after CO intoxication.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Voxelwise diffusional kurtosis imaging analysis was helpful to longitudinally investigate WM changes and predict the prognosis of patients after CO intoxication.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2019/03/01" />
<meta name="citation_mjid" content="ajnr;40/3/478" />
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<meta name="citation_issn" content="0195-6108" />
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<meta name="citation_doi" content="10.3174/ajnr.A5979" />
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<meta name="citation_firstpage" content="478" />
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<meta name="citation_author" content="M.-C. Chou" />
<meta name="citation_author_institution" content="aFrom the Departments of Medical Imaging and Radiological Sciences (M.-C.C.)" />
<meta name="citation_author_institution" content="bHealthcare Administration and Medical Informatics (M.-C.C.), Kaohsiung Medical University, Kaohsiung, Taiwan" />
<meta name="citation_author_institution" content="cMedical Research (M.-C.C.), Kaohsiung Medical University Hospital, Kaohsiung, Taiwan" />
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<meta name="citation_author" content="J.-Y. Li" />
<meta name="citation_author_institution" content="dDepartment of Neurology (J.-Y.L.), E-Da Hospital, Kaohsiung, Taiwan" />
<meta name="citation_author_institution" content="eSchool of Medicine (J.-Y.L.), I-Shou University, Kaohsiung, Taiwan" />
<meta name="citation_author_institution" content="fDepartment of Nursing (J.-Y.L.), Yuh-Ing Junior College of Health Care and Management, Kaohsiung, Taiwan" />
<meta name="citation_author_orcid" content="https://orcid.org/0000-0003-4118-3301" />
<meta name="citation_author" content="P.-H. Lai" />
<meta name="citation_author_institution" content="gDepartment of Radiology (P.-H.L.), Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan" />
<meta name="citation_author_institution" content="hFaculty of Medicine (P.-H.L.), College of Medicine, National Yang-Ming University, Taipei, Taiwan." />
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<meta name="twitter:title" content="Longitudinal White Matter Changes following Carbon Monoxide Poisoning: A 9-Month Follow-Up Voxelwise Diffusional Kurtosis Imaging Study" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Patients with carbon monoxide (CO) intoxication exhibit progressive WM changes that are not well-understood. The purpose of this study was to detect longitudinal WM changes using voxelwise diffusional kurtosis imaging in patients with CO intoxication from the acute-to-chronic stage after CO intoxication.

MATERIALS AND METHODS: Twenty-four patients with CO intoxication and 21 age- and sex-matched healthy controls were enrolled in this study. Diffusional kurtosis imaging was performed on all subjects and was conducted repeatedly in patients at 1 week and 1, 3, and 9 months after CO intoxication. Voxelwise diffusional kurtosis imaging analysis was performed to detect global WM changes in the patients with and without WM lesions. Receiver operating characteristic analysis was performed to compare the performance of diffusional indices in differentiating patients with delayed neuropsychiatric sequelae from patients without them.

RESULTS: In voxelwise analysis, progressive WM changes were detected in patients with WM lesions. In the acute phase, WM injuries were found mainly in the dopaminergic pathways at 1 week, whereas in the chronic stage, WM injuries extended toward subcortical areas from 1 to 9 months. However, no significant WM change was noted in patients without WM lesions during the 9 months after CO intoxication. Moreover, receiver operating characteristic analysis demonstrated that axial kurtosis and mean kurtosis values had better performance than other diffusional indices in differentiating patients with delayed neuropsychiatric sequelae from patients without them at 1 week after CO intoxication.

CONCLUSIONS: Voxelwise diffusional kurtosis imaging analysis was helpful to longitudinally investigate WM changes and predict the prognosis of patients after CO intoxication.

AD
:   axial diffusivity
AK
:   axial kurtosis
CO
:   carbon monoxide
CP
:   cerebral peduncle
DKI
:   diffusional kurtosis imaging
DNS
:   delayed neuropsychiatric sequelae
FA
:   fractional anisotropy
FWM
:   frontal white matter
GP
:   globus pallidus
IC
:   internal capsule
MD
:   mean diffusivity
MK
:   mean kurtosis
RD
:   radial diffusivity
RK
:   radial kurtosis
WML
:   white matter lesion" />
<meta name="og-title" property="og:title" content="Longitudinal White Matter Changes following Carbon Monoxide Poisoning: A 9-Month Follow-Up Voxelwise Diffusional Kurtosis Imaging Study" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/40/3/478" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Patients with carbon monoxide (CO) intoxication exhibit progressive WM changes that are not well-understood. The purpose of this study was to detect longitudinal WM changes using voxelwise diffusional kurtosis imaging in patients with CO intoxication from the acute-to-chronic stage after CO intoxication.

MATERIALS AND METHODS: Twenty-four patients with CO intoxication and 21 age- and sex-matched healthy controls were enrolled in this study. Diffusional kurtosis imaging was performed on all subjects and was conducted repeatedly in patients at 1 week and 1, 3, and 9 months after CO intoxication. Voxelwise diffusional kurtosis imaging analysis was performed to detect global WM changes in the patients with and without WM lesions. Receiver operating characteristic analysis was performed to compare the performance of diffusional indices in differentiating patients with delayed neuropsychiatric sequelae from patients without them.

RESULTS: In voxelwise analysis, progressive WM changes were detected in patients with WM lesions. In the acute phase, WM injuries were found mainly in the dopaminergic pathways at 1 week, whereas in the chronic stage, WM injuries extended toward subcortical areas from 1 to 9 months. However, no significant WM change was noted in patients without WM lesions during the 9 months after CO intoxication. Moreover, receiver operating characteristic analysis demonstrated that axial kurtosis and mean kurtosis values had better performance than other diffusional indices in differentiating patients with delayed neuropsychiatric sequelae from patients without them at 1 week after CO intoxication.

CONCLUSIONS: Voxelwise diffusional kurtosis imaging analysis was helpful to longitudinally investigate WM changes and predict the prognosis of patients after CO intoxication.

AD
:   axial diffusivity
AK
:   axial kurtosis
CO
:   carbon monoxide
CP
:   cerebral peduncle
DKI
:   diffusional kurtosis imaging
DNS
:   delayed neuropsychiatric sequelae
FA
:   fractional anisotropy
FWM
:   frontal white matter
GP
:   globus pallidus
IC
:   internal capsule
MD
:   mean diffusivity
MK
:   mean kurtosis
RD
:   radial diffusivity
RK
:   radial kurtosis
WML
:   white matter lesion" />
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      <h1 class="highwire-cite-title" id="page-title">Longitudinal White Matter Changes following Carbon Monoxide Poisoning: A 9-Month Follow-Up Voxelwise Diffusional Kurtosis Imaging Study</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">M.-C. Chou</span>, <span class="highwire-citation-author" data-delta="1">J.-Y. Li</span> and <span class="highwire-citation-author" data-delta="2">P.-H. Lai</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">March 2019,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">478-482; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A5979 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-66675--6549296028" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">M.-C. Chou </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Medical Imaging and Radiological Sciences (M.-C.C.)</div><div class='author-affiliation'><span class='nlm-sup'>b</span>Healthcare Administration and Medical Informatics (M.-C.C.), Kaohsiung Medical University, Kaohsiung, Taiwan</div><div class='author-affiliation'><span class='nlm-sup'>c</span>Medical Research (M.-C.C.), Kaohsiung Medical University Hospital, Kaohsiung, Taiwan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.-C.%2BChou%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Chou%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.-C.%2BChou%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-8488-2693" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M.-C. Chou</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J.-Y. Li </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Neurology (J.-Y.L.), E-Da Hospital, Kaohsiung, Taiwan</div><div class='author-affiliation'><span class='nlm-sup'>e</span>School of Medicine (J.-Y.L.), I-Shou University, Kaohsiung, Taiwan</div><div class='author-affiliation'><span class='nlm-sup'>f</span>Department of Nursing (J.-Y.L.), Yuh-Ing Junior College of Health Care and Management, Kaohsiung, Taiwan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.-Y.%2BLi%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Li%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.-Y.%2BLi%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-4118-3301" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.-Y. Li</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">P.-H. Lai </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>g</span>Department of Radiology (P.-H.L.), Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan</div><div class='author-affiliation'><span class='nlm-sup'>h</span>Faculty of Medicine (P.-H.L.), College of Medicine, National Yang-Ming University, Taipei, Taiwan.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.-H.%2BLai%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lai%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.-H.%2BLai%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6348-7907" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.-H. Lai</a></li></ul></div></div></div>  </div>

  
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      <div class="highwire-cite-title">Longitudinal White Matter Changes following Carbon Monoxide Poisoning: A 9-Month Follow-Up Voxelwise Diffusional Kurtosis Imaging Study</div>  
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