Arterial spin labeling imaging for the detection of cerebral blood flow asymmetry in patients with corticobasal syndrome.
Arterial spin labeling imaging for the detection of cerebral blood flow asymmetry in patients with corticobasal syndrome.
复制标题
动脉自旋标记成像用于检测皮质基底综合征患者脑血流不对称性。
DOI：
10.1007/s00234-022-02942-9
复制
发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Hamano T.
中科院分区：
文献类型：
--
作者：
Yamaguchi T;Ikawa M;Enomoto S;Shirafuji N;Yamamura O;Tsujikawa T;Okazawa H;Kimura H;Nakamoto Y;Hamano T.
目的：皮质基底综合征（CBS）和帕金森病（PD）均表现为不对称锥体外系症状，常导致诊断困境。CBS患者常表现为脑血流不对称并伴有不对称皮质萎缩。本研究旨在评估动脉自旋标记（ASL）磁共振成像（MRI）检测CBS患者CBF不对称性的临床应用价值。方法我们回顾性研究了13例CBS患者和22例年龄匹配的PD患者的区域性CBF和皮质体积的不对称性，使用ASL和t1加权MRI测量。区域CBF和皮质体积值分别来自大脑两侧的9个区域。CBF和体积不对称分别以每个区域的差异%计算。结果与PD患者相比，CBS患者的scbf不对称性在9个区域中的7个区域表现出更大的差异，如- 8.7% vs. - 1.4%,p< 0.001)和顶叶皮质（- 9.7% vs. - 1.3%,p< 0.001）。相比之下，在显示CBF不对称的7个区域中，有3个区域的体积不对称存在显著差异，这表明CBF不对称在检测CBS不对称方面比体积不对称更敏感。结论ASL成像显示CBS患者在更大范围的脑区存在明显的脑血流不对称，这表明无创MRI合并ASL成像是诊断CBS的一种很有前景的工具，其优点包括同时评估不对称灌注不足和局灶性萎缩。
PurposeCorticobasal syndrome (CBS) and Parkinson’s disease (PD) both present with asymmetrical extrapyramidal symptoms, often leading to a diagnostic dilemma. Patients with CBS frequently show cerebral blood flow (CBF) asymmetry alongside asymmetrical cortical atrophy. This study aimed to evaluate the clinical utility of arterial spin labeling (ASL) magnetic resonance imaging (MRI) to detect CBF asymmetry in patients with CBS.MethodsWe retrospectively investigated asymmetries of regional CBF and cortical volume, measured using ASL and T1-weighted MRI, in 13 patients with CBS and 22 age-matched patients with PD. Regional CBF and cortical volume values were derived from nine brain regions on each side. CBF and volume asymmetries were calculated as %difference in each region, respectively.ResultsCBF asymmetry showed significantly greater differences in seven of nine regions, such as the perirolandic area (− 8.7% vs. − 1.4%,p< 0.001) and parietal cortex (− 9.7% vs. − 1.3%,p< 0.001) in patients with CBS compared with patients with PD. In contrast, significant differences in volume asymmetry were observed in three regions included within the seven regions showing CBF asymmetry, which indicated that CBF asymmetry has greater sensitivity than volume asymmetry to detect asymmetricity in CBS.ConclusionASL imaging showed significant CBF asymmetry in a wider range of brain regions in patients with CBS, which suggests that noninvasive MRI with ASL imaging is a promising tool for the diagnosis of CBS, with advantages that include the simultaneous evaluation of asymmetrical hypoperfusion in addition to focal atrophy.