Intra-arterial high signals on arterial spin labeling perfusion images predict the occluded internal carotid artery segment
Intra-arterial high signals on arterial spin labeling perfusion images predict the occluded internal carotid artery segment
复制标题
动脉自旋标记灌注图像上的动脉内高信号可预测闭塞的颈内动脉段
DOI：
10.1007/s00234-017-1828-9
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Nagahiro S
中科院分区：
文献类型：
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作者：
Sogabe S;Satomi J;Tada Y;Kanematsu Y;Kuwayama K;Yagi K;Yoshioka S;Mizobuchi Y;Mure H;Yamaguchi I;Abe T;Yamamoto N;Kitazato KT;Kaji R;Harada M;Nagahiro S
目的动脉自旋标记 (ASL) 涉及利用动脉水的反向磁化进行灌注成像。如果动脉到达时间长于标记后延迟，则标记的自旋在 ASL 图像上可见为明亮的高动脉内信号 (IAS)；在急性缺血性中风患者的闭塞血管内发现了此类信号。颈内动脉（ICA）闭塞段的识别对于血管内治疗至关重要。我们测试了我们的假设，即 ASL 图像上的高 IAS 可以预测闭塞节段。方法我们的研究包括 13 名急性 ICA 闭塞患者，他们在发病后 48 小时内接受了血管造影和 ASL 研究。我们回顾性地识别了 ASL 图像和血管造影上的高 IAS，并记录了 ASL 图像上的闭塞段和高 IAS 阳性切片的数量。 ICA 节段分为颈部 (C1)、岩部 (C2)、海绵体 (C3) 和床突上 (C4)。 结果 在 7 名颅内 ICA 闭塞患者中，5 名在 C1-C2 表现出高 IAS，表明高 IAS 可以识别闭塞节段近端的停滞血流。在六名颅外 ICA 闭塞患者中，五名在 C3-C4 处出现高 IAS，表明信号可以识别通过眼动脉的侧支血流。没有人在 C1-C2 处具有高 IAS。颅内 ICA 闭塞患者的高 IAS 阳性切片的平均数量显着高于颅外 ICA 闭塞患者。结论 ASL 图像上的高 IAS 可以识别急性 ICA 闭塞患者眼动脉的缓慢停滞和侧支血流，并有助于预测闭塞部位。
PurposeArterial spin labeling (ASL) involves perfusion imaging using the inverted magnetization of arterial water. If the arterial arrival times are longer than the post-labeling delay, labeled spins are visible on ASL images as bright, high intra-arterial signals (IASs); such signals were found within occluded vessels of patients with acute ischemic stroke. The identification of the occluded segment in the internal carotid artery (ICA) is crucial for endovascular treatment. We tested our hypothesis that high IASs on ASL images can predict the occluded segment.MethodsOur study included 13 patients with acute ICA occlusion who had undergone angiographic and ASL studies within 48 h of onset. We retrospectively identified the high IAS on ASL images and angiograms and recorded the occluded segment and the number of high IAS-positive slices on ASL images. The ICA segments were classified as cervical (C1), petrous (C2), cavernous (C3), and supraclinoid (C4).ResultsOf seven patients with intracranial ICA occlusion, five demonstrated high IASs at C1–C2, suggesting that high IASs could identify stagnant flow proximal to the occluded segment. Among six patients with extracranial ICA occlusion, five presented with high IASs at C3–C4, suggesting that signals could identify the collateral flow via the ophthalmic artery. None had high IASs at C1–C2. The mean number of high IAS-positive slices was significantly higher in patients with intra- than extracranial ICA occlusion.ConclusionHigh IASs on ASL images can identify slow stagnant and collateral flow through the ophthalmic artery in patients with acute ICA occlusion and help to predict the occlusion site.