Pseudocontinuous arterial spin labeling quantifies relative cerebral blood flow in acute stroke.
Pseudocontinuous arterial spin labeling quantifies relative cerebral blood flow in acute stroke.
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DOI：
10.1161/strokeaha.111.635979
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发表时间：
2012-03
期刊：
影响因子：
8.3
通讯作者：
Latour LL
中科院分区：
文献类型：
--
作者：
Hernandez DA;Bokkers RP;Mirasol RV;Luby M;Henning EC;Merino JG;Warach S;Latour LL
本研究的目的是测试动脉自旋标记(ASL)能否检测核心、错配和反向错配区域的相对脑血流量(RCBF)是否存在显著差异，以及ASL在这些区域测量的rCBF值是否与DSC MRI测量的值不同。对急性卒中患者行弥散成像(DWI)和灌注成像(ASL和DSC)。专家阅读器在DWI和DSC峰值时间(TTP)图上对缺血性病变进行分段。定义了三个区域：核心区域(DWi+、Ttp+)、不匹配区域(Dwi−、Ttp+)和反向不匹配区域(Dwi+、Ttp−)。对于ASL和DSC，使用商业软件创建rCBF图，并根据在病变侧测量的平均信号强度与对侧大脑半球相应区域的平均信号强度来计算比率。从核心、失配和反向失配获得的值用于配对比较。这项研究包括28名患者。平均年龄为65.6(16.9)岁，基线NIHSS中位数为10(IQR4-17)。从最后一次已知正常到MRI的中位时间为5.7小时(IQR 2.9-22.6)。平均rCBF比值在错配0.53(0.23)比核心0.39(0.33)和反向错配0.68(0.49)比核心0.38(0.35)显著更高。DSC和ASL测量的rCBF差异无统计学意义。ASL允许测量核心区和错配区的rCBF。错配中的数值明显高于核心中的数值，这表明存在潜在的可挽救组织。
The aim of this study was to test whether arterial spin labeling (ASL) can detect significant differences in relative cerebral blood flow (rCBF) in the core, mismatch, and reverse-mismatch regions, and whether rCBF values measured by ASL in those areas differ from values obtained using DSC MRI. Acute stroke patients were imaged with diffusion (DWI) and perfusion (ASL and DSC) MRI. An expert reader segmented the ischemic lesion on DWI and the DSC time-to-peak (TTP) maps. Three regions were defined: core (DWI+, TTP+), mismatch (DWI−, TTP+) and reverse-mismatch (DWI+, TTP−). For both ASL and DSC, rCBF maps were created with commercially available software, and the ratio was calculated as the mean signal intensity measured on the side of the lesion to that of the homologous region in the contralateral hemisphere. Values obtained from core, mismatch, and reverse-mismatch were used for paired comparison. Twenty-eight patients were included in the study. The mean age was 65.6 (16.9) years with a median baseline NIHSS of 10 (IQR 4-17). Median time from last known normal to MRI was 5.7 hours (IQR 2.9-22.6). Mean rCBF ratios were significantly higher in the mismatch 0.53 (0.23) versus the core 0.39 (0.33) and reverse-mismatch 0.68 (0.49) versus the core 0.38 (0.35). Differences in rCBF measured with DSC and ASL was not significant. ASL allows for the measurement of rCBF in the core and mismatch regions. Values in the mismatch were significantly higher than in the core, suggesting there is potential salvageable tissue.