Quantitative Assessment of External Carotid Artery Territory Supply with Modified Vessel-Encoded Arterial Spin-Labeling
Quantitative Assessment of External Carotid Artery Territory Supply with Modified Vessel-Encoded Arterial Spin-Labeling
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DOI：
10.3174/ajnr.a2978
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发表时间：
2012-08-01
影响因子：
3.5
通讯作者：
Fang, J.
中科院分区：
文献类型：
--
作者：
Dang, Y.;Wu, B.;Fang, J.
背景与目的：在颈动脉狭窄或闭塞的患者中，脑供血可通过侧支通路改善局部血流，防止缺血事件的发生。通过ASL对血管灌注区域的描述，可以评估ICA侧支的作用。然而，到目前为止，还没有一种方法可以在MR成像中评估ECA的侧支灌注区域。在这项研究中，我们提出了一种新的基于VE-ASL的标记方案来定量评估ECA的灌注区域。材料和方法：开发了一种新的标记方法，采用Hadamard编码方案来标记大动脉，特别是ECA。对12例脑血管解剖正常的健康人进行了脑灌注区检查。对8例颈动脉狭窄或闭塞患者进行术前、术后侧支血供变化评估。结果：提出的方法能够评估ECA的灌注区域。健康受试者的血管区域与正常脑血管解剖结构吻合良好。对于颈动脉狭窄或闭塞的患者，我们的无创结果提供了与DSA相当的侧支血流信息。此外，他们从非洲经委会的附带流量可以在术前和术后进行定量估计。结论：改进后的方法已通过侧络灌注区域与脑血管解剖的一致性得到验证，并且对侧络的定量评估有助于评估治疗干预措施。
BACKGROUND AND PURPOSE: In patients with carotid stenosis or occlusion, cerebral blood could be supplied through collateral pathways to improve regional blood flow and protect against ischemic events. The contribution of collaterals from the ICA can be assessed by depiction of vascular perfusion territories with ASL. However, so far there is no method available to evaluate the collateral perfusion territory from the ECA in MR imaging. In this study, we present a new labeling scheme based on VE-ASL to quantitatively assess the perfusion territory of the ECA.MATERIALS AND METHODS: A new labeling approach with a Hadamard encoding scheme was developed to label major arteries, especially the ECA. Twelve healthy subjects with normal cerebrovascular anatomy were examined to demonstrate their perfusion territories. Eight patients with carotid artery stenosis or occlusion were assessed before and after surgery to show changes of their collateral blood supply.RESULTS: The proposed method enables assessment of the perfusion territories of the ECA. Good agreement was found between the vascular territories and normal cerebrovascular anatomy in healthy subjects. For the patients with carotid stenosis or occlusion, our noninvasive results provided information on collateral flow comparable with that from DSA. Their collateral flows from the ECA, moreover, could be quantitatively estimated pre- and postoperatively.CONCLUSIONS: The modified approach has been validated by the consistency of collateral perfusion territories with cerebrovascular anatomy, and quantitative assessment of collaterals proved useful for assisting in evaluating therapeutic interventions.