Arterial Transit Time-Based Multidelay Combination Strategy Improves Arterial Spin Labeling Cerebral Blood Flow Measurement Accuracy in Severe Steno-Occlusive Diseases
Arterial Transit Time-Based Multidelay Combination Strategy Improves Arterial Spin Labeling Cerebral Blood Flow Measurement Accuracy in Severe Steno-Occlusive Diseases
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DOI：
10.1002/jmri.27823
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发表时间：
2021-07-15
影响因子：
4.4
通讯作者：
Saito, Nobuhito
中科院分区：
文献类型：
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作者：
Amemiya, Shiori;Watanabe, Yusuke;Saito, Nobuhito
背景尽管灌注成像在狭窄闭塞性疾病的治疗中起着关键作用，但动脉自旋标记（ASL）的临床应用受到技术问题的限制。目的探讨动脉通过时间（ATT）延长对脑血流量（CBF）测量准确性的影响，并确定狭窄闭塞性疾病的最佳CBF测量方案。研究类型前瞻性。烟雾病（10例）和动脉粥样硬化性疾病（8例）。场强/序列A 3.0T/3DT（1）-加权和ASL。评估采集了Hadamard编码的多延迟ASL扫描（有/无血管抑制（VS））和单延迟ASL扫描（长标记持续时间（LD）和长标记后延迟（PLD），称为长标记长延迟（LLLD））。CBF测量准确度及其ATT依赖性，测量为相对CBF测量差异之间的相关性（ASL-单光子发射计算机断层扫描[SPECT]）和ATT，在1）Combo（结合基于ATT的多延迟和LLLD数据），2）标准（LD/PLD = 1333/2333毫秒）和3）LLLD（LD/PLD = 4000/4000毫秒）方案，使用与参考标准SPECT CBF的全脑体素相关性。还评估了VS对CBF测量准确性的影响。统计检验Pearson相关系数，重复测量方差分析，t检验。P< 0.05被认为是显著的。结果ASL和SPECT CBF测量值之间的Pearson相关系数如下：组合= 0.55 +/- 0.09;标准= 0.52 +/- 0.12; LLLD = 0.41 +/- 0.10。CBF测量在LLLD中最不准确，在Combo中最准确。VS显著改善了标准方案和Combo烟雾病患者的总体CBF测量准确性。ATT依赖性分析显示，与Combo相比，标准和LLLD方案分别显示出显著较低和负相关以及显著较高和正相关（标准= -0.12 +/-0.04，Combo = -0.04 +/-0.03，LLLD = 0.17 +/-0.03）。数据结论：以LD/PLD = 1333/2333 msec为基础，采用多延迟扫描补偿延迟区的低估，基于ATT的Combo策略与单延迟方案相比，可提高严重狭窄闭塞性疾病的CBF测量准确性。证据等级1技术有效性阶段2
Background Although perfusion imaging plays a key role in the management of steno-occlusive diseases, the clinical usefulness of arterial spin labeling (ASL) is limited by technical issues. Purpose To examine the effect of arterial transit time (ATT) prolongation on cerebral blood flow (CBF) measurement accuracy and identify the best CBF measurement protocol for steno-occlusive diseases. Study Type Prospective. Population Moyamoya (n = 10) and atherosclerotic diseases (n = 8). Field Strength/Sequence A 3.0T/3DT(1)-weighted and ASL. Assessment Hadamard-encoded multidelay ASL scans with/without vessel suppression (VS) and single-delay ASL scans with long-label duration (LD) and long postlabeling delay (PLD), referred to as long-label long-delay (LLLD), were acquired. CBF measurement accuracy and its ATT dependency, measured as the correlation between the relative CBF measurement difference (ASL-single-photon emission computed tomography [SPECT]) and ATT, were compared among 1) Combo (incorporating multidelay and LLLD data based on ATT), 2) standard (LD/PLD = 1333/2333 msec), and 3) LLLD (LD/PLD = 4000/4000 msec) protocols, using whole-brain voxel-wise correlation with reference standard SPECT CBF. The effect of VS on CBF measurement accuracy was also assessed. Statistical Tests Pearson's correlation coefficient, repeated-measures analysis of variance, t-test. P< 0.05 was considered significant. Results Pearson's correlation coefficients between ASL and SPECT CBF measurements were as follows: Combo = 0.55 +/- 0.09; standard = 0.52 +/- 0.12; LLLD = 0.41 +/- 0.10. CBF measurement was least accurate in LLLD and most accurate in Combo. VS significantly improved overall CBF measurement accuracy in the standard protocol and in moyamoya patients for the Combo. ATT dependency analysis revealed that, compared with Combo, the standard and LLLD protocols showed significantly lower and negative and significantly higher and positive correlations, respectively (standard = -0.12 +/- 0.04, Combo = -0.04 +/- 0.03, LLLD = 0.17 +/- 0.03). Data Conclusion By using ATT-corrected CBF derived from LD/PLD = 1333/2333 msec as a base and by compensating underestimation in delayed regions using multidelay scans, the ATT-based Combo strategy improves CBF measurement accuracy compared with single-delay protocols in severe steno-occlusive diseases. Evidence Level 1 Technical Efficacy Stage 2