Prolonged Mean Transit Time Detected by Dynamic Susceptibility Contrast Magnetic Resonance Imaging Predicts Cerebrovascular Reserve Impairment in Patients with Moyamoya Disease
Prolonged Mean Transit Time Detected by Dynamic Susceptibility Contrast Magnetic Resonance Imaging Predicts Cerebrovascular Reserve Impairment in Patients with Moyamoya Disease
复制标题
DOI：
10.1159/000445696
复制
发表时间：
2016-01-01
影响因子：
2.9
通讯作者：
Kuratsu, Jun-ichi
中科院分区：
文献类型：
--
作者：
Kawano, Takayuki;Ohmori, Yuki;Kuratsu, Jun-ichi
背景：评估脑血管储备（CVR）对烟雾病（MMD）患者具有重要意义。I-123-碘苯丙胺单光子发射CT（SPECT）与乙酰唑胺（ACZ）激发广泛进行，但使用ACZ成为问题，由于其标签外使用和不良反应。在这里，我们报告了动态磁敏感对比MRI（DSC-MRI）的MMD患者的CVR评价的有效性。方法：33例MMD患者（平均年龄38.3岁）均接受SPECT和DSC-MRI检查，间隔< 10天。感兴趣区（ROI）为大脑前动脉（ACA）区、大脑中动脉（MCA）区、基底节区和小脑半球，用于脑血流量（CBF）、脑血容量（CBV）和平均通过时间（MTT）图像。计算每个参数的ROI与同侧小脑的比值并进行评价。使用ACZ给药前后通过SPECT获得的图像计算CVR。比较并评价每个ROI的DSC-MRI参数和CVR的比值。结果：ACA和MCA区的MTT值与CVR值呈显著正相关（p < 0.0001）。CBF、CBV与CVR无相关性。MTT比值的阈值为1.966，预测CVR降低的敏感性为68.4%，特异性为91.5%。
Background: Evaluating cerebrovascular reserve (CVR) is important for patients with moyamoya disease (MMD). I-123-iodoamphetamine single-photon emission CT (SPECT) with acetazolamide (ACZ) challenge is widely carried out, but using ACZ becomes problematic owing to its off-label use and its adverse effects. Here, we report the efficacy of dynamic susceptibility contrast MRI (DSC-MRI) for the evaluation of CVR in MMD patients. Methods: All 33 MMD patients underwent both SPECT and DSC-MRI at an interval of < 10 days from each other (mean age 38.3 years). The region of interest (ROI) was the anterior cerebral artery (ACA) territory, middle cerebral artery (MCA) territory, basal ganglia and cerebellum hemisphere for cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) images. The ratios of the ROIs to the ipsilateral cerebellum were calculated for each parameter and evaluated. The CVR was calculated using images acquired by SPECT before and after ACZ administration. The ratios of DSC-MRI parameters and CVR were compared and evaluated for each ROI. Results: The MTT of the ACA and MCA territories significantly correlated with CVR (p < 0.0001). However, CBF and CBV had no correlation with CVR. The MTT ratio had a threshold of 1.966, with a sensitivity of 68.4% and a specificity of 91.5% for predicting decreased CVR (