Role of flow magnetic resonance imaging in the monitoring of facial allotransplantations: preliminary results on graft vasculopathy
Role of flow magnetic resonance imaging in the monitoring of facial allotransplantations: preliminary results on graft vasculopathy
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DOI：
10.1016/j.ijom.2019.05.003
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发表时间：
2020-02-01
影响因子：
2.4
通讯作者：
Dakpe, S.
中科院分区：
文献类型：
--
作者：
Bettoni, J.;Baledent, O.;Dakpe, S.
慢性血管排斥反应的特点是平滑肌细胞的肌内膜增生，逐渐阻塞动脉移植物管腔可能成为血管化复合同种异体移植（VCA）中长期移植物丢失的主要原因，如在实体器官移植中观察到的。因此，需要新的诊断工具。本研究的目的是评价流动磁共振成像（MRI）在2005年至2012年期间移植的3例患者中定性和定量监测VCA的有用性。2015年至2017年期间，在标准化临床和组织学监测的同时进行了7次流式MRI采集。移植物动脉蒂的平均流速和管腔内直径逐渐减小。在随访期间，2例患者发生慢性血管排斥反应，需要部分切除移植物。对于这些患者，血流MRI采集的特点是血管信号显著减少，在解剖损伤之前血管内血流减少。本研究的结果证实了可重复的、非侵入性的、非操作者依赖的形态测量和血流动力学放射学分析的可行性，为临床医生提供了关于VCA随时间推移的血管状态的新信息，并提供了血管流出特异性成像技术的前景。
Chronic vascular rejection characterized by the myointimal proliferation of smooth muscle cells that progressively obstruct the arterial graft lumen may become the main cause of long-term graft loss in vascularized composite allotransplantation (VCA), as observed in solid organ transplantation. As such, new diagnostic tools are required. The objective of this study was to evaluate the usefulness of flow magnetic resonance imaging (MRI) in the qualitative and quantitative monitoring of VCA in three patients transplanted between 2005 and 2012. Seven flow MRI acquisitions were performed concurrently with standardized clinical and histological monitoring between 2015 and 2017. A progressive reduction in the average flow rate and intraluminal diameter of the arterial pedicle of the grafts was demonstrated. During follow-up, two patients developed chronic vascular rejection requiring partial resection of the graft. For these patients, flow MRI acquisitions were characterized by a significant reduction in vascular signal, with a reduction in intravascular flow prior to anatomical injury. The results of this study confirm the feasibility of reproducible, non-invasive, and non-operator-dependent morphometric and haemodynamic radiological analysis, providing clinicians with new information on the vascular status of VCA over time and offering the prospect of an imaging technique specific to vascular outflow.