MR Imaging of Individual Perfusion Reorganization Using Superselective Pseudocontinuous Arterial Spin-Labeling in Patients with Complex Extracranial Steno-Occlusive Disease
MR Imaging of Individual Perfusion Reorganization Using Superselective Pseudocontinuous Arterial Spin-Labeling in Patients with Complex Extracranial Steno-Occlusive Disease
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DOI：
10.3174/ajnr.a5090
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发表时间：
2017-04-01
影响因子：
3.5
通讯作者：
Zimmer, C.
中科院分区：
文献类型：
--
作者：
Richter, V.;Helle, M.;Zimmer, C.
背景和目的：颅外动脉多发性狭窄或闭塞的患者需要个体化的诊断方法。我们评估了一种新的MR成像技术在该患者组中用于区域灌注成像的可行性和临床实用性。材料和方法：在50例患者的前瞻性初步研究中，将具有环形标记点的超选择性伪连续动脉自旋标记添加到常规成像中，（10名女性，70.05 ± 10.55岁），患有颅外狭窄闭塞性疾病。33例有梗死病变。16/50例（32%）患者进行了DSC-MR成像，12/50例（24%）患者进行了脑DSA。通过超声和TOF-MRA确定血管解剖和血管狭窄和闭塞的分布。根据NASET标准对狭窄进行分类。分别在FLAIR和DSC-MR成像上定义CT病变和灌注缺损。在超选择性伪连续动脉自旋标记图上定义个体灌注模式，并与血管解剖结构和梗死灶定位相关。结果：超选择性伪连续动脉自旋标记成像序列可由训练有素的技术人员轻松应用，患者对12.7分钟的额外扫描时间耐受良好。在所有病例中，检测到的血管闭塞/狭窄和灌注模式在脑DSA和超选择性假连续动脉自旋标记图之间一致。DSC-CBF图与超选择性假连续动脉自旋标记图的灌注缺损显著相关（Pearson r = 0.9593，P
BACKGROUND AND PURPOSE: Patients with multiple stenoses or occlusions of the extracranial arteries require an individualized diagnostic approach. We evaluated the feasibility and clinical utility of a novel MR imaging technique for regional perfusion imaging in this patient group.MATERIALS AND METHODS: Superselective pseudocontinuous arterial spin-labeling with a circular labeling spot enabling selective vessel labeling was added to routine imaging in a prospective pilot study in 50 patients (10 women, 70.05 +/- 10.55 years of age) with extracranial steno-occlusive disease. Thirty-three had infarct lesions. DSC-MR imaging was performed in 16/50 (32%), and cerebral DSA, in 12/50 patients (24%). Vascular anatomy and the distribution of vessel stenoses and occlusions were defined on sonography and TOF-MRA. Stenoses were classified according to the NASCET criteria. Infarct lesions and perfusion deficits were defined on FLAIR and DSC-MR imaging, respectively. Individual perfusion patterns were defined on the superselective pseudocontinuous arterial spin-labeling maps and were correlated with vascular anatomy and infarct lesion localization.RESULTS: The superselective pseudocontinuous arterial spin -labeling imaging sequence could be readily applied by trained technicians, and the additional scan time of 12.7 minutes was well-tolerated by patients. The detected vessel occlusions/stenoses and perfusion patterns corresponded between cerebral DSA and superselective pseudocontinuous arterial spin -labeling maps in all cases. Perfusion deficits on DSC-CBF maps significantly correlated with those on superselective pseudocontinuous arterial spin-labeling maps (Pearson r = 0.9593, P