Advanced magnetic resonance imaging of cerebral cavernous malformations: part I. High-field imaging of excised human lesions.
Advanced magnetic resonance imaging of cerebral cavernous malformations: part I. High-field imaging of excised human lesions.
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DOI：
10.1227/01.neu.0000325490.80694.a2
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发表时间：
2008-10
期刊：
影响因子：
4.8
通讯作者：
Awad IA
中科院分区：
文献类型：
--
作者：
Shenkar R;Venkatasubramanian PN;Zhao JC;Batjer HH;Wyrwicz AM;Awad IA
我们假设，通过使用高场磁共振(MR)和共聚焦显微镜，将在大脑海绵状畸形(CCM)中揭示结构细节，这在以前还没有描述过。通过高场磁共振成像检查，寻找从人类患者身上切除的CCM的结构细节，并与相同标本的共聚焦显微镜相关联。概述了CCM结构的新特征，包括方法学的局限性、未来研究的场所和可能的临床意义。4例患者切除的CCM病灶固定在2%多聚甲醛中，用自旋回波和梯度回波方法进行9.4或14.1Tesla的高分辨率磁共振成像。在共聚焦显微镜下使用内皮荧光探针对CCM病变的厚层切片进行血管构筑的组织学验证。切除的人CCM病变的图像采用质子密度加权、T1加权、T2加权自旋回波和T2*加权梯度回波MR。这些图像显示大片“平淡”区域，有薄壁空洞，“蜂窝”区域有显著的毛细血管增生，较大的空洞周围有较小的空洞。不同大小的增殖性毛细血管和空洞也与病变中明显较大的血管壁相关。通过共聚焦显微镜在CCM的厚切片中也证实了类似的特征。不同感兴趣区的MR弛豫时间表明，在具有明显血管新生增殖活性的区域中，存在不同状态的血液分解产物。高场磁共振成像技术显示了CCM血管结构的新特征，在接近组织学分辨率的情况下可见，包括具有明显不同生物学活性的区域。这些初步观察将推动未来的研究，将病变的生物学和临床活动与较高场强下的磁共振成像特征相关联。
We hypothesized that structural details would be revealed in cerebral cavernous malformations (CCMs) through the use of high field magnetic resonance (MR) and confocal microscopy, which have not been described previously. The structural details of CCMs excised from human patients were sought by examination with high field MR imaging, and correlated with confocal microscopy of the same specimens. Novel features of CCM structure are outlined, including methodological limitations, venues for future research and possible clinical implications. CCM lesions excised from four patients were fixed in 2% paraformaldehyde and subjected to high resolution MR imaging at 9.4 or 14.1 Tesla by spin-echo and gradient recalled echo methods. Histological validation of angioarchitecture was conducted on thick sections of CCM lesions using fluorescent probes to endothelium under confocal microscopy. Images of excised human CCM lesions were acquired with proton density-weighted, T1-weighted, T2-weighted spin echo and T2*-weighted gradient-recalled echo MR. These images revealed large “bland” regions with thin walled caverns, and “honeycombed” regions with notable capillary proliferation and smaller caverns surrounding larger caverns. Proliferating capillaries and caverns of various sizes were also associated with the wall of apparent larger blood vessels in the lesions. Similar features were confirmed within thick sections of CCMs by confocal microscopy. MR relaxation times in different regions of interest suggested the presence of different states of blood breakdown products in areas with apparent angiogenic proliferative activity. The high field MR imaging techniques demonstrate novel features of CCM angioarchitecture, visible at near histological resolution, including regions with apparently different biologic activity. These preliminary observations will motivate future research, correlating lesion biologic and clinical activity with features of MR imaging at higher field strength.