Reliability and Sensitivity to Longitudinal CBF Changes in Steno-Occlusive Diseases: ASL Versus 123I-IMP-SPECT
Reliability and Sensitivity to Longitudinal CBF Changes in Steno-Occlusive Diseases: ASL Versus 123I-IMP-SPECT
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DOI：
10.1002/jmri.27996
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发表时间：
2021-11-15
影响因子：
4.4
通讯作者：
Saito, Nobuhito
中科院分区：
文献类型：
--
作者：
Amemiya, Shiori;Watanabe, Yusuke;Saito, Nobuhito
背景使用动脉自旋标记(ASL)磁共振成像的无创性脑血流(CBF)监测在治疗大脑大动脉狭窄闭塞疾病中是有用的。然而，与参考标准灌注成像相比，对其测量特性的了解是有限的。目的应用ASL纵向评价狭窄闭塞症患者的血流灌注，并与单光子发射计算机断层扫描(SPECT)进行比较。研究类型：前瞻性。人口烟雾病(10例，女性8例)和动脉粥样硬化性疾病(2例，男性2例)。场强/序列3.0T；梯度回波三维T-1加权和自旋回波ASL。评估多延迟ASL和[I-123]-碘苯丙胺SPECT CBF测量在前循环血运重建前和9天内进行。对全脑体素CBF改变的可靠性和敏感性(Delta CBF)及其标记后延迟(PLD)依赖(以毫秒为单位)进行了检测，分别为1000、2333和3666。统计检验使用受试者内标准差(Sw)和组内相关系数(ICCs)来检验Delta CBF的可靠性和敏感性。为了进行统计学比较，手术对侧大脑半球内的纵向Delta CBF的标准差以及它与同侧感兴趣区内的平均Delta CBF之间的比率分别进行配对t检验。P<；0.05被认为具有统计学意义。结果ASL复测时间间隔为31+/-18天。SPECT的重测信度(0.16+/-0.02)显著低于ASL(0.13+/-0.04)。ASL对术后变化的敏感性(2.71+/-2.79)显著高于SPECT(0.27+/-0.62)。重测信度2333(0.13+/-0.04)显著高于3666(0.19+/-0.05)，对Delta CBF的敏感性分别为1000(2.53+/-2.50)和2333(0.79+/-1.88)显著高于3666(0.79+/-1.88)。ICC图对ASL诊断的可靠性也高于SPECT。数据结论对于术后Delta CBF，重测信度高的ASL敏感性好于SPECT。ASL重测信度和对Delta CBF的敏感性较高，PLD为2333。证据级别1技术功效阶段2
Background Noninvasive cerebral blood flow (CBF) monitoring using arterial spin labeling (ASL) magnetic resonance imaging is useful for managing large cerebral artery steno-occlusive diseases. However, knowledge about its measurement characteristics in comparison with reference standard perfusion imaging is limited. Purpose To evaluate perfusion in a longitudinal manner in patients with steno-occlusive disease using ASL and compare with single-photon emission computed tomography (SPECT). Study Type Prospective. Population Moyamoya (n = 10, eight females) and atherosclerotic diseases (n = 2, two males). Field Strength/Sequence 3.0 T; gradient-echo three-dimensional T-1-weighted and spin-echo ASL. Assessment Multi-delay ASL and [I-123]-iodoamphetamine SPECT CBF measurements were performed both before and within 9 days of anterior-circulation revascularization. Reliability and sensitivity to whole-brain voxel-wise CBF changes (Delta CBF) and their postlabeling delay (PLD) dependency with varied PLDs (in milliseconds) of 1000, 2333, and 3666 were examined. Statistical Tests Reliability and sensitivity to Delta CBF were examined using within-subject standard deviation (Sw) and intraclass correlation coefficients (ICCs). For statistical comparisons, standard deviation of longitudinal Delta CBF within the hemisphere contralateral to surgery, and the ratio between it and average Delta CBF within the ipsilateral regions of interest were subjected to paired t tests, respectively. P < 0.05 was considered statistically significant. Results ASL test-retest time interval was 31 +/- 18 days. Test-retest reliability was significantly lower for SPECT (0.16 +/- 0.02) than ASL (0.13 +/- 0.04). Sensitivity to postoperative changes was significantly higher for ASL (2.71 +/- 2.79) than SPECT (0.27 +/- 0.62). Test-retest reliability was significantly higher for a PLD of 2333 (0.13 +/- 0.04) than 3666 (0.19 +/- 0.05), and sensitivity to Delta CBF was significantly higher for PLDs of 1000 (2.53 +/- 2.50) and 2333 than 3666 (0.79 +/- 1.88). ICC maps also showed higher reliability for ASL than SPECT. Data Conclusion Higher test-retest reliability led to better ASL sensitivity than SPECT for postoperative Delta CBF. ASL test-retest reliability and sensitivity to Delta CBF were higher with a PLD of 2333. Level of Evidence 1 Technical Efficacy Stage 2