Cardiac magnetic resonance T1 and extracellular volume mapping with motion correction and co-registration based on fast elastic image registration

Objective

Our aim was to investigate the technical feasibility of a novel motion compensation method for cardiac magntic resonance (MR) T1 and extracellular volume fraction (ECV) mapping.

Materials and methods

Native and post-contrast T1 maps were obtained using modified look-locker inversion recovery (MOLLI) pulse sequences with acquisition scheme defined in seconds. A nonrigid, nonparametric, fast elastic registration method was applied to generate motion-corrected T1 maps and subsequently ECV maps. Qualitative rating was performed based on T1 fitting-error maps and overlay images. Local deformation vector fields were produced for quantitative assessment. Intra- and inter-observer reproducibility were compared with and without motion compensation.

Results

Eighty-two T1 and 39 ECV maps were obtained in 21 patients with diverse myocardial diseases. Approximately 60% demonstrated clear quality improvement after motion correction for T1 mapping, particularly for the poor-rating cases (23% before vs 2% after). Approximately 67% showed further improvement with co-registration in ECV mapping. Although T1 and ECV values were not clinically significantly different before and after motion compensation, there was improved intra- and inter-observer reproducibility after motion compensation.

Conclusions

Automated motion correction and co-registration improved the qualitative assessment and reproducibility of cardiac MR T1 and ECV measurements, allowing for more reliable ECV mapping.

     

Reproducible segmentation of white matter hyperintensities using a new statistical definition

Objectives

We present a method based on a proposed statistical definition of white matter hyperintensities (WMH), which can work with any combination of conventional magnetic resonance (MR) sequences without depending on manually delineated samples.

Materials and methods

T1-weighted, T2-weighted, FLAIR, and PD sequences acquired at 1.5 Tesla from 119 subjects from the Kings Health Partners-Dementia Case Register (healthy controls, mild cognitive impairment, Alzheimer’s disease) were used. The segmentation was performed using a proposed definition for WMH based on the one-tailed Kolmogorov–Smirnov test.

Results

The presented method was verified, given all possible combinations of input sequences, against manual segmentations and a high similarity (Dice 0.85–0.91) was observed. Comparing segmentations with different input sequences to one another also yielded a high similarity (Dice 0.83–0.94) that exceeded intra-rater similarity (Dice 0.75–0.91). We compared the results with those of other available methods and showed that the segmentation based on the proposed definition has better accuracy and reproducibility in the test dataset used.

Conclusion

Overall, the presented definition is shown to produce accurate results with higher reproducibility than manual delineation. This approach can be an alternative to other manual or automatic methods not only because of its accuracy, but also due to its good reproducibility.

     

Cranial fixation plates in cerebral magnetic resonance imaging: a 3 and 7 Tesla in vivo image quality study

Objective

This study assesses and quantifies impairment of postoperative magnetic resonance imaging (MRI) at 7 Tesla (T) after implantation of titanium cranial fixation plates (CFPs) for neurosurgical bone flap fixation.

Materials and methods

The study group comprised five patients who were intra-individually examined with 3 and 7 T MRI preoperatively and postoperatively (within 72 h/3 months) after implantation of CFPs. Acquired sequences included T₁-weighted magnetization-prepared rapid-acquisition gradient-echo (MPRAGE), T₂-weighted turbo-spin-echo (TSE) imaging, and susceptibility-weighted imaging (SWI). Two experienced neurosurgeons and a neuroradiologist rated image quality and the presence of artifacts in consensus reading.

Results

Minor artifacts occurred around the CFPs in MPRAGE and T₂ TSE at both field strengths, with no significant differences between 3 and 7 T. In SWI, artifacts were accentuated in the early postoperative scans at both field strengths due to intracranial air and hemorrhagic remnants. After resorption, the brain tissue directly adjacent to skull bone could still be assessed. Image quality after 3 months was equal to the preoperative examinations at 3 and 7 T.

Conclusion

Image quality after CFP implantation was not significantly impaired in 7 T MRI, and artifacts were comparable to those in 3 T MRI.

     

Semi-automated myocardial segmentation of bright blood multi-gradient echo images improves reproducibility of myocardial contours and T2* determination

Objectives

Early detection of iron loading is affected by the reproducibility of myocardial contour assessment. A novel semi-automatic myocardial segmentation method is presented on contrast-optimized composite images and compared to the results of manual drawing.

Materials and methods

Fifty-one short-axis slices at basal, mid-ventricular and apical locations from 17 patients were acquired by bright blood multi-gradient echo MRI. Four observers produced semi-automatic and manual myocardial contours on contrast-optimized composite images. The semi-automatic segmentation method relies on vector field convolution active contours to generate the endocardial contour. After creating radial pixel clusters on the myocardial wall, a combination of pixel-wise coefficient of variance (CoV) assessment and k-means clustering establishes the epicardial contour for each segment.

Results

Compared to manual drawing, semi-automatic myocardial segmentation lowers the variability of T2* quantification within and between observers (CoV of 12.05 vs. 13.86% and 14.43 vs. 16.01%) by improving contour reproducibility (P < 0.001). In the presence of iron loading, semi-automatic segmentation also lowers the T2* variability within and between observers (CoV of 13.14 vs. 15.19% and 15.91 vs. 17.28%).

Conclusion

Application of semi-automatic myocardial segmentation on contrast-optimized composite images improves the reproducibility of T2* quantification.

     

Contrast-optimized composite image derived from multigradient echo cardiac magnetic resonance imaging improves reproducibility of myocardial contours and T2* measurement

Objectives

Reproducibility of myocardial contour determination in cardiac magnetic resonance imaging is important, especially when determining T2* values per myocardial segment as a prognostic factor of heart failure or thalassemia. A method creating a composite image with contrasts optimized for drawing myocardial contours is introduced and compared with the standard method on a single image.

Materials and methods

A total of 36 short-axis slices from bright-blood multigradient echo (MGE) T2* scans of 21 patients were acquired at eight echo times. Four observers drew free-hand myocardial contours on one manually selected T2* image (method 1) and on one image composed by blending three images acquired at TEs providing optimum contrast-to-noise ratio between the myocardium and its surrounding regions (method 2).

Results

Myocardial contouring by method 2 met higher interobserver reproducibility than method 1 (P < 0.001) with smaller Coefficient of variance (CoV) of T2* values in the presence of myocardial iron accumulation (9.79 vs. 15.91 %) and in both global myocardial and mid-ventricular septum regions (12.29 vs. 16.88 and 5.76 vs. 8.16 %, respectively).

Conclusion

The use of contrast-optimized composite images in MGE data analysis improves reproducibility of myocardial contour determination, leading to increased consistency in the calculated T2* values enhancing the diagnostic impact of this measure of iron overload.

     

Improving fMRI in signal drop-out regions at 7 T by using tailored radio-frequency pulses: application to the ventral occipito-temporal cortex

Objective

Signal drop-off occurs in echo-planar imaging in inferior brain areas due to field gradients from susceptibility differences between air and tissue. Tailored-RF pulses based on a hyperbolic secant (HS) have been shown to partially recover signal at 3 T, but have not been tested at higher fields.

Materials and methods

The aim of this study was to compare the performance of an optimized tailored-RF gradient-echo echo-planar imaging (TRF GRE-EPI) sequence with standard GRE-EPI at 7 T, in a passive viewing of faces or objects fMRI paradigm in healthy subjects.

Results

Increased temporal-SNR (tSNR) was observed in the middle and inferior temporal lobes and orbitofrontal cortex of all subjects scanned, but elsewhere tSNR decreased relative to the standard acquisition. In the TRF GRE-EPI, increased functional signal was observed in the fusiform, lateral occipital cortex, and occipital pole, regions known to be part of the visual pathway involved in face-object perception.

Conclusion

This work highlights the potential of TRF approaches at 7 T. Paired with a reversed-gradient distortion correction to compensate for in-plane susceptibility gradients, it provides an improved acquisition strategy for future neurocognitive studies at ultra-high field imaging in areas suffering from static magnetic field inhomogeneities.

     

Application of the limited-memory quasi-Newton algorithm for multi-dimensional,large flip-angle RF pulses at 7T

Objective

Ultrahigh field MRI provides great opportunities for medical diagnostics and research. However, ultrahigh field MRI also brings challenges, such as larger magnetic susceptibility induced field changes. Parallel-transmit radio-frequency pulses can ameliorate these complications while performing advanced tasks in routine applications. To address one class of such pulses, we propose an optimal-control algorithm as a tool for designing advanced multi-dimensional, large flip-angle, radio-frequency pulses. We contrast initial conditions, constraints, and field correction abilities against increasing pulse trajectory acceleration factors.

Materials and methods

On an 8-channel 7T system, we demonstrate the quasi-Newton algorithm with pulse designs for reduced field-of-view imaging with an oil phantom and in vivo with scans of the human brain stem. We used echo-planar imaging with 2D spatial-selective pulses. Pulses are computed sufficiently rapid for routine applications.

Results

Our dataset was quantitatively analyzed with the conventional mean-square-error metric and the structural-similarity index from image processing. Analysis of both full and reduced field-of-view scans benefit from utilizing both complementary measures.

Conclusion

We obtained excellent outer-volume suppression with our proposed method, thus enabling reduced field-of-view imaging using pulse trajectory acceleration factors up to 4.

     

7 Tesla quantitative hip MRI: a comparison between TESS and CPMG for T2 mapping

Objectives

We aimed to evaluate the feasibility of triple-echo steady state (TESS) T2 mapping as an alternative to conventional multi-echo-spin-echo (CPMG) T2 mapping for the quantitative assessment of hip joint cartilage at 7 T.

Materials and methods

A total of eight healthy volunteers and three patients were included. Reproducibility of both techniques was evaluated in five volunteers in five scans each. T2 relaxation times were measured by manually drawing regions of interest in multiple regions of the hip joint. Data from both methods were compared using Pearson correlation coefficient, intra-class correlation coefficient, and coefficient of repeatability. The overall image quality and presence of artifacts was assessed.

Results

Cartilage transplant and surrounding fluid were well depicted by both methods. Compared to CPMG, TESS provided systematically reduced T2 values (43.3 ± 7.3 vs. 19.2 ± 5.5 ms for acetabular cartilage, and 41.4 ± 5.6 vs. 21.7 ± 5.2 ms for femoral cartilage), in line with previously reported values. No correlation between both methods was found. TESS yielded a slightly better reproducibility than CPMG, while CPMG showed pronounced sensitivity to B1 inhomogeneities.

Conclusion

TESS seems to be an attractive alternative to CPMG for improvements in quantitative hip joint imaging at 7 T, allowing shortening of the total acquisition time paired with insensitivity to B1, while rendering comparable image quality with good repeatability.

     

Reproducibility of locus coeruleus and substantia nigra imaging with neuromelanin sensitive MRI

Objectives

The purpose of this study was to assess the reproducibility of substantia nigra pars compacta (SNpc) and locus coeruleus (LC) delineation and measurement with neuromelanin-sensitive MRI.

Materials and methods

Eleven subjects underwent two neuromelanin-sensitive MRI scans. SNpc and LC volumes were extracted for each scan. Reproducibility of volume and magnetization transfer contrast measurements in SNpc and LC was assessed using intraclass correlation coefficients (ICC) and dice similarity coefficients (DSC).

Results

SNpc and LC volume measurements showed excellent reproducibility (SNpc-ICC: 0.94, p < 0.001; LC-ICC: 0.96, p < 0.001). SNpc and LC were accurately delineated between scans (SNpc-DSC: 0.80 ± 0.03; LC-DSC: 0.63 ± 0.07).

Conclusion

Neuromelanin-sensitive MRI can consistently delineate SNpc and LC.

     

Robust imaging of hippocampal inner structure at 7T: in vivo acquisition protocol and methodological choices

Objective

Motion-robust multi-slab imaging of hippocampal inner structure in vivo at 7T.

Materials and methods

Motion is a crucial issue for ultra-high resolution imaging, such as can be achieved with 7T MRI. An acquisition protocol was designed for imaging hippocampal inner structure at 7T. It relies on a compromise between anatomical details visibility and robustness to motion. In order to reduce acquisition time and motion artifacts, the full slab covering the hippocampus was split into separate slabs with lower acquisition time. A robust registration approach was implemented to combine the acquired slabs within a final 3D-consistent high-resolution slab covering the whole hippocampus. Evaluation was performed on 50 subjects overall, made of three groups of subjects acquired using three acquisition settings; it focused on three issues: visibility of hippocampal inner structure, robustness to motion artifacts and registration procedure performance.

Results

Overall, T2-weighted acquisitions with interleaved slabs proved robust. Multi-slab registration yielded high quality datasets in 96 % of the subjects, thus compatible with further analyses of hippocampal inner structure.

Conclusion

Multi-slab acquisition and registration setting is efficient for reducing acquisition time and consequently motion artifacts for ultra-high resolution imaging of the inner structure of the hippocampus.

     

In vivo functional connectome of human brainstem nuclei of the ascending arousal,autonomic, and motor systems by high spatial resolution 7-Tesla fMRI

Objective

Our aim was to map the in vivo human functional connectivity of several brainstem nuclei with the rest of the brain by using seed-based correlation of ultra-high magnetic field functional magnetic resonance imaging (fMRI) data.

Materials and methods

We used the recently developed template of 11 brainstem nuclei derived from multi-contrast structural MRI at 7 Tesla as seed regions to determine their connectivity to the rest of the brain. To achieve this, we used the increased contrast-to-noise ratio of 7-Tesla fMRI compared with 3 Tesla and time-efficient simultaneous multi-slice imaging to cover the brain with high spatial resolution (1.1-mm isotropic nominal resolution) while maintaining a short repetition time (2.5 s).

Results

The delineated Pearson’s correlation-based functional connectivity diagrams (connectomes) of 11 brainstem nuclei of the ascending arousal, motor, and autonomic systems from 12 controls are presented and discussed in the context of existing histology and animal work.

Conclusion

Considering that the investigated brainstem nuclei play a crucial role in several vital functions, the delineated preliminary connectomes might prove useful for future in vivo research and clinical studies of human brainstem function and pathology, including disorders of consciousness, sleep disorders, autonomic disorders, Parkinson’s disease, and other motor disorders.

     

ESMRMB 2016, 33rd Annual Scientific Meeting,Vienna, AT,September 29–October 1: Abstracts,Thursday

Objective

To evaluate the feasibility of in vivo measurement of the fatty acid (FA) composition of breast adipose tissue by MRS on a clinical platform.

Material and methods

MRS experiments were performed at 3 T, using a STEAM sequence, on 25 patients diagnosed with breast cancer. MR spectra, acquired on healthy breast tissue, were analysed with the LCModel.

Results

The measured values of the saturated fatty acid (SFA), mono-unsaturated fatty acid (MUFA) and poly-unsaturated fatty acid (PUFA) fractions were 23.8 ± 7.1 %, 55.4 ± 6.8 % and 20.8 ± 4.4 %, respectively.The values of SFA, MUFA and PUFA observed in the current study are in the same range as those found in two previous studies performed at 7 T.

Conclusion

The results of the current study show that it is possible to quantify the fatty acid composition of breast tissue in vivo in a clinical setting (3 T).

     

Measurements of RF power reflected and radiated by multichannel transmit MR coils at 7T

Objective

The power balance of multichannel transmit coils is a central consideration in assessing performance and safety issues. At ultrahigh fields, in addition to absorption and reflection, radiofrequency (RF) radiation into the far field becomes a concern.

Materials and methods

We engineered a system for in situ measurement of complex-valued scattering parameter (S-parameter) matrices of multichannel transmit coils that allows for the calculation of the reflected and accepted power for arbitrary steering conditions. The radiated power from an RF coil inside a large single-mode waveguide couples to that mode. Finite-difference time-domain simulations were used for the calculations, and E-field probes were used to measure the electric field distribution, and hence the radiated power, in the waveguide. To test this concept, an eight-channel shielded-loop array for 7T imaging was studied inside a 280-cm-long cylindrical waveguide with a 60-cm diameter.

Results

For a 7T parallel-transmit coil, the S-parameters were measured and the reflected power calculated as a function of steering conditions. Maximum radiated power was observed for the circularly polarized mode.

Conclusion

A system was developed for in situ S-parameter measurements combined with a method for determining radiated power, allowing a complete assessment of the power balance of multichannel transmit coils at 7T.

     

Improving the clinical potential of ultra-high field fMRI using a model-free analysis method based on response consistency

Objective

To develop an analysis method that is sensitive to non-model-conform responses often encountered in ultra-high field presurgical planning fMRI. Using the consistency of time courses over a number of experiment repetitions, it should exclude low quality runs and generate activation maps that reflect the reliability of responses.

Materials and methods

7 T fMRI data were acquired from six healthy volunteers: three performing purely motor tasks and three a visuomotor task. These were analysed with the proposed approach (UNBIASED) and the GLM.

Results

UNBIASED results were generally less affected by false positive results than the GLM. Runs that were identified as being of low quality were confirmed to contain little or no activation. In two cases, regions were identified as activated in UNBIASED but not GLM results. Signal changes in these areas were time-locked to the task, but were delayed or transient.

Conclusion

UNBIASED is shown to be a reliable means of identifying consistent task-related signal changes regardless of response timing. In presurgical planning, UNBIASED could be used to rapidly generate reliable maps of the consistency with which eloquent brain regions are activated without recourse to task timing and despite modified hemodynamics.

     

Vessel radius mapping in an extended model of transverse relaxation

Objectives

Spin dephasing of the local magnetization in blood vessel networks can be described in the static dephasing regime (where diffusion effects may be ignored) by the established model of Yablonskiy and Haacke. However, for small capillary radii, diffusion phenomena for spin-bearing particles are not negligible.

Material and methods

In this work, we include diffusion effects for a set of randomly distributed capillaries and provide analytical expressions for the transverse relaxation times T2* and T2 in the strong collision approximation and the Gaussian approximation that relate MR signal properties with microstructural parameters such as the mean local capillary radius.

Results

Theoretical results are numerically validated with random walk simulations and are used to calculate capillary radius distribution maps for glioblastoma mouse brains at 9.4 T. For representative tumor regions, the capillary maps reveal a relative increase of mean radius for tumor tissue towards healthy brain tissue of \(128 \pm 23 \%\) (p < 0.001).

Conclusion

The presented method may be used to quantify angiogenesis or the effects of antiangiogenic therapy in tumors whose growth is associated with significant microvascular changes.

     

Subjective perception of safety in healthy individuals working with 7 T MRI scanners: a retrospective multicenter survey

Objective

To retrospectively assess perception of safety of healthy individuals working with human 7 Tesla (T) magnetic resonance imaging (MRI) scanners.

Materials and methods

A total of 66 healthy individuals with a mean age of 31 ± 7 years participated in this retrospective multicentre survey study. Nonparametric correlation analysis was conducted to evaluate the relation between self-reported perception of safety and prevalence of sensory effects while working with 7 T MRI scanners for an average 47 months.

Results

The results indicated that 98.5 % of the study participants had a neutral or positive feeling about safety aspects at 7 T MRI scanners. 45.5 % reported that they feel very safe and none of the participants stated that they feel moderately or very unsafe while working with 7 T MRI scanners. Perception of safety was not affected by the number of hours per week spent in the vicinity of the 7 T MRI scanner or the duration of experience with 7 T MRI. More than 50 % of individuals experienced vertigo and metallic taste while working with 7 T MRI scanners. However, participants’ perceptions of safety were not affected by the prevalence of MR-related symptoms.

Conclusions

The overall data indicated an average perception of a moderately safe work environment. To our knowledge, this study delineates the first attempt to assess the subjective safety perception among 7 T MRI workers and suggests further investigations are indicated.

     

Scan–rescan reproducibility of segmental aortic wall shear stress as assessed by phase-specific segmentation with 4D flow MRI in healthy volunteers

Objective

The aim was to investigate scan–rescan reproducibility and observer variability of segmental aortic 3D systolic wall shear stress (WSS) by phase-specific segmentation with 4D flow MRI in healthy volunteers.

Materials and methods

Ten healthy volunteers (age 26.5?±?2.6 years) underwent aortic 4D flow MRI twice. Maximum 3D systolic WSS (WSSmax) and mean 3D systolic WSS (WSSmean) for five thoracic aortic segments over five systolic cardiac phases by phase-specific segmentations were calculated. Scan–rescan analysis and observer reproducibility analysis were performed.

Results

Scan–rescan data showed overall good reproducibility for WSSmean (coefficient of variation, COV 10–15%) with moderate-to-strong intraclass correlation coefficient (ICC 0.63–0.89). The variability in WSSmax was high (COV 16–31%) with moderate-to-good ICC (0.55–0.79) for different aortic segments. Intra- and interobserver reproducibility was good-to-excellent for regional aortic WSSmax (ICC?≥?0.78; COV?≤?17%) and strong-to-excellent for WSSmean (ICC?≥?0.86; COV?≤?11%). In general, ascending aortic segments showed more WSSmax/WSSmean variability compared to aortic arch or descending aortic segments for scan–rescan, intraobserver and interobserver comparison.

Conclusions

Scan–rescan reproducibility was good for WSSmean and moderate for WSSmax for all thoracic aortic segments over multiple systolic phases in healthy volunteers. Intra/interobserver reproducibility for segmental WSS assessment was good-to-excellent. Variability of WSSmax is higher and should be taken into account in case of individual follow-up or in comparative rest–stress studies to avoid misinterpretation.

     

Segmentation and texture analysis of structural biomarkers using neighborhood-clustering-based level set in MRI of the schizophrenic brain

Objective

Schizophrenia (SZ) is a psychiatric disorder that especially affects individuals during their adolescence. There is a need to study the subanatomical regions of SZ brain on magnetic resonance images (MRI) based on morphometry. In this work, an attempt was made to analyze alterations in structure and texture patterns in images of the SZ brain using the level-set method and Laws texture features.

Materials and methods

T1-weighted MRI of the brain from Center of Biomedical Research Excellence (COBRE) database were considered for analysis. Segmentation was carried out using the level-set method. Geometrical and Laws texture features were extracted from the segmented brain stem, corpus callosum, cerebellum, and ventricle regions to analyze pattern changes in SZ.

Results

The level-set method segmented multiple brain regions, with higher similarity and correlation values compared with an optimized method. The geometric features obtained from regions of the corpus callosum and ventricle showed significant variation (p < 0.00001) between normal and SZ brain. Laws texture feature identified a heterogeneous appearance in the brain stem, corpus callosum and ventricular regions, and features from the brain stem were correlated with Positive and Negative Syndrome Scale (PANSS) score (p < 0.005).

Conclusion

A framework of geometric and Laws texture features obtained from brain subregions can be used as a supplement for diagnosis of psychiatric disorders.

     

Theory of MRI contrast in the annulus fibrosus of the intervertebral disc

Objective

Here we develop a three-dimensional analytic model for MR image contrast of collagen lamellae in the annulus fibrosus of the intervertebral disc of the spine, based on the dependence of the MRI signal on collagen fiber orientation.

Materials and methods

High-resolution MRI scans were performed at 1.5 and 7 T on intact whole disc specimens from ovine, bovine, and human spines. An analytic model that approximates the three-dimensional curvature of the disc lamellae was developed to explain inter-lamellar contrast and intensity variations in the annulus. The model is based on the known anisotropic dipolar relaxation of water in tissues with ordered collagen.

Results

Simulated MRI data were generated that reproduced many features of the actual MRI data. The calculated inter-lamellar image contrast demonstrated a strong dependence on the collagen fiber angle and on the circumferential location within the annulus.

Conclusion

This analytic model may be useful for interpreting MR images of the disc and for predicting experimental conditions that will optimize MR image contrast in the annulus fibrosus.

     

Mapping fine-scale anatomy of gray matter,white matter,and trigeminal-root region applying spherical deconvolution to high-resolution 7-T diffusion MRI

Objectives

We assessed the use of high-resolution ultra-high-field diffusion magnetic resonance imaging (dMRI) to determine neuronal fiber orientation density functions (fODFs) throughout the human brain, including gray matter (GM), white matter (WM), and small intertwined structures in the cerebellopontine region.

Materials and methods

We acquired 7-T whole-brain dMRI data of 23 volunteers with 1.4-mm isotropic resolution; fODFs were estimated using constrained spherical deconvolution.

Results

High-resolution fODFs enabled a detailed view of the intravoxel distributions of fiber populations in the whole brain. In the brainstem region, the fODF of the extra- and intrapontine parts of the trigeminus could be resolved. Intrapontine trigeminal fiber populations were crossed in a network-like fashion by fiber populations of the surrounding cerebellopontine tracts. In cortical GM, additional evidence was found that in parts of primary somatosensory cortex, fODFs seem to be oriented less perpendicular to the cortical surface than in GM of motor, premotor, and secondary somatosensory cortices.

Conclusion

With 7-T MRI being introduced into clinical routine, high-resolution dMRI and derived measures such as fODFs can serve to characterize fine-scale anatomic structures as a prerequisite to detecting pathologies in GM and small or intertwined WM tracts.