Noninvasive MR imaging of cerebral perfusion in patients with a carotid artery stenosis
Noninvasive MR imaging of cerebral perfusion in patients with a carotid artery stenosis
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DOI：
10.1212/wnl.0b013e3181b7840c
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发表时间：
2009-09-15
期刊：
影响因子：
9.9
通讯作者：
Hendrikse, J.
中科院分区：
文献类型：
--
作者：
Bokkers, R. P. H.;van der Worp, H. B.;Hendrikse, J.
背景：动脉自旋标记（ASL）灌注MRI具有多个延迟时间的图像采集，可用于测量动脉血到达大脑的延迟。我们评估了症状性颈内动脉（ICA）狭窄对ASL时间参数的影响，并评估了威利斯环侧支血流的影响。方法：对44例近期症状性ICA狭窄患者（男性30例，69±9岁）和34名性别匹配和年龄匹配的健康志愿者进行调查。采用磁共振血管造影和二维相衬成像评估威利斯周围侧支血流。结果：在ICA狭窄的同侧半球，脑前额区、后额区、顶枕区和枕区的脑血流量（CBF）低于对照组（p < 0.01）。与对照组相比，同侧前额、后额和额顶叶区域的传递时间延长（p < 0.01）。与对照组相比，同侧额顶区后缘时间延长（p < 0.01）。在27例无对侧狭窄的患者中，同侧后额区、额顶叶区和顶枕区后缘较对侧长（p < 0.01）。通过威利斯圈的侧支流不影响CBF和过境或后缘时间。结论：动脉自旋标记MRI是一种无创成像脑血流和动脉血流到达脑延迟的工具，可能为脑血管疾病患者的脑灌注质量提供有价值的信息。神经病学(R) 2009；73: 869 - 875
Background: Arterial spin labeling (ASL) perfusion MRI with image acquisition at multiple delay times can be used to measure delays in the arrival of arterial blood to the brain. We assessed the effect of a symptomatic internal carotid artery (ICA) stenosis on ASL timing parameters, and evaluated the effect of collateral flow through the circle of Willis.Methods: Forty-four functionally independent patients (30 men, 69 +/- 9 years) with a recently symptomatic ICA stenosis >= 50% and 34 sex-matched and age-matched healthy volunteers were investigated. Magnetic resonance angiography and 2-dimensional phase-contrast imaging were used to assess collateral flow in the circle of Willis.Results: In the hemisphere ipsilateral to the ICA stenosis, cerebral blood flow (CBF) was lower (p < 0.01) in the anterior frontal, posterior frontal, parieto-occipital, and occipital regions than in control subjects. The transit times were prolonged (p < 0.01) in the ipsilateral anterior frontal, posterior frontal, and frontoparietal regions when compared with the control subjects. The trailing edge time was prolonged (p < 0.01) in the ipsilateral frontoparietal region when compared to the control subjects. In the 27 patients without a contralateral stenosis, the trailing edge was longer (p < 0.01) in the ipsilateral posterior frontal, frontoparietal, and parieto-occipital regions than in the contralateral regions. Collateral flow via the circle of Willis did not affect CBF and transit or trailing edge times.Conclusion: Arterial spin labeling MRI is a noninvasive tool for imaging cerebral blood flow and delays in the arrival of arterial blood to the brain, and can potentially provide valuable information on the quality of perfusion to the brain in patients with cerebrovascular disease. Neurology (R) 2009;73: 869-875