Intracranial 4D flow magnetic resonance imaging reveals altered haemodynamics in sickle cell disease
Intracranial 4D flow magnetic resonance imaging reveals altered haemodynamics in sickle cell disease
复制标题
颅内 4D 血流磁共振成像揭示镰状细胞病的血流动力学改变
DOI：
10.1111/bjh.15043
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发表时间：
2018
影响因子：
6.5
通讯作者：
A. Nederveen
中科院分区：
文献类型：
--
作者：
L. Václavů;Zelonna A V Baldew;S. Gevers;H. Mutsaerts;K. Fijnvandraat;M. Cnossen;C. Majoie;J. Wood;E. Vanbavel;B. Biemond;P. van Ooij;A. Nederveen
目前，镰状细胞病（SCD）儿童的卒中风险是通过常规经颅多普勒超声（TCD）测量Willis环（CoW）的血流速度来评估的。然而，目前还没有生物标志物在成人患者中具有已证实的预后价值。四维（4D）血流磁共振成像（MRI）可改善基于颅内血流动力学的风险分析。我们对69名SCD患者[中位年龄15岁（四分位距，IQR：12-50）]和14名健康对照[中位年龄21岁（IQR：18-43）]进行了神经血管4D流动MRI和血液采样。我们测量了速度，流量，管腔面积和内皮剪切应力（ESS）在牛。与健康对照组相比，SCD患者的红细胞压积和粘度较低，流速、流量和管腔面积较高，ESS较低。我们观察到SCD患者的血流动力学4D血流参数：速度（斯皮尔曼的ρ = −0·36至−0·61）、流量（ρ = −0·26至−0·52）和ESS（ρ = −0·14至−0·54）均出现显著的年龄相关性下降。仅对成人进行的进一步分析显示，SCD患者的速度值与健康对照组相似，但SCD组的其他4D血流参数（血流和管腔面积）较高，ESS较低。我们的数据表明，4D flow MRI可以比当前基于TCD的速度更准确地识别卒中风险增加的成年患者。
Stroke risk in children with sickle cell disease (SCD) is currently assessed with routine transcranial Doppler ultrasound (TCD) measurements of blood velocity in the Circle of Willis (CoW). However, there is currently no biomarker with proven prognostic value in adult patients. Four‐dimensional (4D) flow magnetic resonance imaging (MRI) may improve risk profiling based on intracranial haemodynamics. We conducted neurovascular 4D flow MRI and blood sampling in 69 SCD patients [median age 15 years (interquartile range, IQR: 12–50)] and 14 healthy controls [median age 21 years (IQR: 18–43)]. We measured velocity, flow, lumen area and endothelial shear stress (ESS) in the CoW. SCD patients had lower haematocrit and viscosity, and higher velocity, flow and lumen area, with lower ESS compared to healthy controls. We observed significant age‐related decline in haemodynamic 4D flow parameters; velocity (Spearman's ρ = −0·36 to −0·61), flow (ρ = −0·26 to −0·52) and ESS (ρ = −0·14 to −0·54) in SCD patients. Further analysis in only adults showed that velocity values were similar in SCD patients compared to healthy controls, but that the additional 4D flow parameters, flow and lumen area, were higher, and ESS lower, in the SCD group. Our data suggest that 4D flow MRI may identify adult patients with an increased stroke risk more accurately than current TCD‐based velocity.
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影响因子：
20.3
作者：
Hulbert, Monica L.;McKinstry, Robert C.;DeBaun, Michael R.
通讯作者：
DeBaun, Michael R.
DOI：
10.1056/nejm199405193302008
发表时间：
1994-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
G. Gibbons;V. Dzau
通讯作者：
G. Gibbons;V. Dzau
影响因子：
158.5
作者：
Adams, RJ;McKie, VC;Wiznitzer, M
通讯作者：
Wiznitzer, M
影响因子：
158.5
作者：
ADAMS, R;MCKIE, V;HESS, D
通讯作者：
HESS, D