年首届全国fmri技术中西医结合应用研究培训课件-26 -of acupuncture

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

Acupunctureneedlesinthisstudy.(a)Standardstainlessneedle;(b)Goldneedle;(c)Austeniticstainlesssteelneedle.conventionalmetalneedlegoldacupunctureneedleAusteniticstainlesssteelneedleBOLDImaging磁共振兼容针刺针

BOLDImaging针刺针在磁共振成像中的温度变化

BOLDImaging针刺磁共振成像ThecoronalMRIofacupunctureatshankusingagoldneedleandaAusteniticstainlesssteelneedle,BOLDImaging针刺磁共振成像ThetransversalMRIofacupunctureatshankusingagoldneedleandaAusteniticstainlesssteelneedle.BOLDImaging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.

BOLDImaging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；BOLDImagingUltrasoundAcupunctureMachine1、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；BOLDImaging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BOLDImaging聚焦超声针灸仪超声针灸电路系统的设计和调试BOLDImaging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；MRIofAcupunctureAnatomicalLocalization:High-resolutionT1-weightedanatomicalvolumes:SpinEcho&SpoiledGrassseriesExtractionofcorticalsurfaceBOLD(blood-oxygenleveldependent)T2*-weightedfunctionalvolumesEcho-planerimagingseries,speedofacquisitionSignalintensitydependsonbloodoxygenationchangesASL(ArterialSpinLabeling)DTI/Connectom?MolecularMRI?Dataprocessing

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,Fixedandrandomeffects[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-testROI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fMRIviewofSUMASUMA和AFNI交互使用能够将脑沟和脑回展开InteractiveuseofSUMA

andAFNIPrincipleofASLGeneralizedprinciples:Taginflowingarterialbloodbymagneticinversion.Acquirethetagimage.Repeatexperimentwithouttag.Acquirethecontrolimage.Subtraction:

controlImage-tagimageAdvantagesandDrawbacksAdvantages:NocontrastinjectionneededQuantitativemeasurementofCBFPromisingclinicalapplicationsDrawbacks:LowSNRArtifactsOtherlimitationsIntroductiontoPASLPASLusesshort(5-20ms)radio-frequency(RF)pulsestoinvertathickslabofspinsinthetaggingplaneproximaltotheimagingregion.PASLpulsesEPISTAR(EchoPlanarImagingandSignalTargetingwithAlternatingRadiofrequency)anditsvariations:PICORE(ProximalInversionwithControlforOff-ResonanceEffects)TILT(TransferInsensitiveLabelingTechnique)FAIR(Flow-sensitiveAdiabaticInversionRecovery)anditsvariations:UNFAIR(UninvertedFAIR)BASE(unpreparedbasis(BA)andselective(SE)inversionpreparedimages)FAIRER(FAIRwithanextraRFpulse)PASLpulses:FAIRAFAIR(Flow-sensitiveAlternatingInversionRecovery)pulsesequenceIntroduction:CASLCASLuseslongandcontinuousRFpulses(1-2seconds)alongwithaconstantgradientfieldtoinduceaflow-drivenadiabaticinversioninanarrowplaneofspins,usuallyjustbelowtheimagingplane.CASLpulsesComparisons:CASLandPASLASLTypesAdvantagesDisadvantagesCASLHigherSNRthanPASL;

Shortertransitdelay;Lowertaggingefficiency;

ContinuousRFtransmithardwarerequired;

HigherSAR;

MagnetizationTransfereffects;PASLHighertaggingefficiency;

LowerSAR;

Improvedtransittimeeffects;LowerSNR;

Increasedtransitdelay;OthertypesofASLpCASL(pseudoCASL)pCASLwasintroducedtomatchtheinversionefficiencyofCASLwhilereducingtheRFpowerdeposition,withoutspecialhardware.HigherSNRthanPASLandhighertaggingefficiencythanCASL;SusceptibletoB0inhomogeneity;Limitedclinicalavailability;VS-ASL(VelocitySelectiveASL)VS-ASLsaturatesthebloodthatismovingatafastervelocitythanaspecificcutoffvalue.Abilitytomeasurelowbloodflow,suchasstroke;LowerSNR;difficulttodeterminetheoptimalcutoffvalue;BOLDImagingMA和EA的fMRI对比研究BOLDImagingMA和EA的fMRI对比研究PsychophysicalDeqisensationduringmanualandEA.NostatisticalsignificancewasfoundbetweenmodalitiesofMAandEAwithrespecttothesensationsofnumbness,fullness,andwarm(P>0.05).However,thesensingofsorenessanddullpainwasprominentlystrongerinEA(P<0.05)Hemodynamicresponseduringneedlemanipulation(a),post-acupuncturesessionI(b),andpost-acupuncturesessionIIofMA(c).Red-Yellow:activation;Blue-Cyan:deactivation.BOLDImagingBrainresponseofMABOLDImagingBrainResponseofEAHemodynamicresponseduringelectricalstimulation(a),post-acupuncturesessionI(b),andpost-acupuncturesessionII(c)ofEA.Red-Yellow:activation;Blue-Cyan:deactivation.Time-variedresponsesofrepresentativebrainregionsindifferentsessionsofMAatST-36.Themidbrain(i),leftcaudate(ii),andleftACC(iii)retainedtheiractivated/deactivatedstatusfromthestimulationsessiontothepost-acupuncturesessionII.TheBOLDsignalinthelefthippocampusgraduallyincreasedandfinallyreachedastatisticalsignificanceinpost-acupuncturesessionII(iv).BOLDImagingTime-variedresponsesofMABOLDImagingTime-variedresponsesofEATime-variedresponsesofrepresentativebrainregionsindifferentsessionsofEAatST-36.Theleftinsula(i),leftputamen(ii)maintainedactivatedfromstimulationsessiontopost-acupuncturesessionII.However,theleftcaudate(iii)andrightPCC(iv)graduallylostsignificanceasstimulationwasterminated.ThebrainactivityareaswerelocatedinthelimbicstructuresinEA,whiledeactivationdominatedinthesameareainMA.Mostregionswithlong-lastingactivationpresentedastrong-weak-strongfluctuationfrombothEAandMAacupuncturestimulationtotheearlyphaseofpost-acupuncturesession,whichmayindicateanactionmodeofthesustainedacupunctureeffect.BOLDImagingMA和EA的效应fMRI对比研究手针和超声刺激的fMRI对比研究ThelocationofacupointST36(left)andtheexperimentalparadigm(right)wasshown.ThefMRIscanningbeganwithan8-minutesrestingsession(R0).ThentheneedlewasinsertedintotheacupointST_36orultrasoundtransducerwasattachedtotheacupoint.“Deqi”sensationwithoutsharppainwasachievedinMA.Duringtask-statescanning,threecyclesofstimulation(S1,S2,S3)andresting(R1,R2,R3)wereperformed,whichtotallytook9minutes.Afterscanning,theneedleortheultrasonictransducerwasremovedfromtheacupoint.fMRIofMAatST-36fMRIofUAatST-36IntergroupdifferencesonbrainresponseIntergroupcomparisonshowedthatMAproducedstrongerbrainresponseinipsilateralhemisphere,includingcerebellum,caudate,andfrontalgyri.UAinducedstrongerresponseinpartofthefrontal,temporalandparietallobes,ventralDC,andPAG.Experiment1:Unilateralacousticstimulationwasalternatelyconductedtotheleftandrightearsfor30secondsseparatedbyintervalsof30-secondresting.Experiment2:Acupunctureneedlewasinsertedandmanipulationwasperiodicallyconductedfor30secondsandseparatedbyintervalsof30-secondresti