Perfusion and Permeability MRI Predicts Future Cavernous Angioma Hemorrhage and Growth.
Perfusion and Permeability MRI Predicts Future Cavernous Angioma Hemorrhage and Growth.
复制标题
DOI：
10.1002/jmri.27935
复制
发表时间：
2022-05
期刊：
影响因子：
--
通讯作者：
Awad IA
中科院分区：
文献类型：
--
作者：
Sone JY;Hobson N;Srinath A;Romanos SG;Li Y;Carrión-Penagos J;Shkoukani A;Stadnik A;Piedad K;Lightle R;Moore T;DeBiasse D;Bi D;Shenkar R;Carroll T;Ji Y;Girard R;Awad IA
脑海绵状血管瘤（CA）是一种毛细血管病变，影响超过一百万的美国人与一小部分的情况下，表现出病变出血或生长的主要临床后遗症。灌注和渗透性是CA病理生理学的基本特征，但其作为预后生物标志物的作用尚不清楚。研究从动态对比增强定量灌注（DCEQP）MRI中获得的灌注或渗透性病变描述符是否可以预测成像后一年内的后续病变出血/生长。单中心病例对照研究。205例连续入组患者（63.4%女性）。对比增强动态2D SPGR序列的3-T/T1标测。通过DCEQP评估了205例患者的745处CA病变，评估了与第二年出血/生长（存在或不存在）的预后相关性，这些病变与根据渗透性和灌注图计算的病变描述符有关。一个30例病例的亚组在DCEQP扫描时也进行了外周血采集，并测定了可溶性CD 14、IL-1β、VEGF和可溶性ROBO 4蛋白的血浆水平，这些蛋白的加权组合先前已报告与未来CA出血相关。单变量分析的Mann-Whitney U检验。最小化贝叶斯信息标准（BIC）的逻辑回归模型，测试参数加权组合的灵敏度和特异性（受试者操作特征曲线）。病灶出血或生长的最佳预后生物标志物包括脑干病灶位置、平均病灶渗透性和低值灌注簇平均值（BIC=201.5，灵敏度= 77%，特异性= 72%，p<0.05）。添加先前发表的预后血浆蛋白生物标志物改善了成像模型的性能（灵敏度= 100%，特异性= 88%，p<0.05）。基于MRI的描述符的组合反映了较高的病变渗透性和较低的灌注簇可能潜在地预测CA中的未来出血/生长。当与脑干病变位置和CA出血的血浆蛋白生物标志物结合时，预后成像生物标志物的灵敏度和特异性可以增强。
Cerebral cavernous angioma (CA) is a capillary vasculopathy affecting more than a million Americans with a small fraction of cases demonstrating lesional bleed or growth with major clinical sequelae. Perfusion and permeability are fundamental features of CA pathophysiology, but their role as prognostic biomarkers is unclear. To investigate whether perfusion or permeability lesional descriptors derived from dynamic contrast-enhanced quantitative perfusion (DCEQP) MRI can predict subsequent lesional bleed/growth in the year following imaging. Single-site case-controlled study. 205 consecutively enrolled patients (63.4% female). 3-Tesla/T1-mapping with contrast-enhanced dynamic 2D SPGR sequences. Prognostic associations with bleed/growth (present or absent) in the following year were assessed in 745 CA lesions evaluated by DCEQP in the 205 patients in relation to lesional descriptors calculated from permeability and perfusion maps. A subgroup of 30 cases also underwent peripheral blood collection at the time of DCEQP scans and assays of plasma levels of soluble CD14, IL-1β, VEGF, and soluble ROBO4 proteins, whose weighted combination had been previously reported in association with future CA bleeding. Mann-Whitney U-test for univariate analyses. Logistic regression models minimizing the Bayesian information criterion (BIC), testing sensitivity and specificity (receiver operating characteristic curves) of weighted combinations of parameters The best prognostic biomarker for lesional bleed or growth included brainstem lesion location, mean lesional permeability, and low-value perfusion cluster mean (BIC=201.5, sensitivity=77%, specificity=72%, p<0.05). Adding a previously published prognostic plasma protein biomarker improved the performance of the imaging model (sensitivity=100%, specificity=88%, p<0.05). A combination of MRI-based descriptors reflecting higher lesional permeability and lower perfusion cluster may potentially predict future bleed/growth in CAs. The sensitivity and specificity of the prognostic imaging biomarker can be enhanced when combined with brainstem lesion location and a plasma protein biomarker of CA hemorrhage.
登录
查看更多内容
影响因子：
6.3
作者：
Mikati, Abdul G.;Khanna, Omaditya;Awad, Issam A.
通讯作者：
Awad, Issam A.
影响因子：
20.1
作者：
Girard R;Zeineddine HA;Koskimäki J;Fam MD;Cao Y;Shi C;Moore T;Lightle R;Stadnik A;Chaudagar K;Polster S;Shenkar R;Duggan R;Leclerc D;Whitehead KJ;Li DY;Awad IA
通讯作者：
Awad IA
影响因子：
3.5
作者：
McDonald, David A.;Shi, Changbin;Marchuk, Douglas A.
通讯作者：
Marchuk, Douglas A.
影响因子：
48
作者：
Salman, Rustam Al-Shahi;Hall, Julie M.;Horne, Margaret A.;Moultrie, Fiona;Josephson, Colin B.;Bhattacharya, Joj;Counsell, Carl E.;Murray, Gordon D.;Papanastassiou, Vakis;Ritchie, Vaughn;Roberts, Richard C.;Sellar, Robin J.;Warlow, Charles P.
通讯作者：
Warlow, Charles P.
影响因子：
20.3
作者：
Lopez-Ramirez, Miguel Alejandro;Pham, Angela;Ginsberg, Mark H.
通讯作者：
Ginsberg, Mark H.