Diffuse gliomas exhibit whole brain impaired cerebrovascular reactivity
Diffuse gliomas exhibit whole brain impaired cerebrovascular reactivity
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DOI：
10.1016/j.mri.2017.09.017
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发表时间：
2018-01-01
影响因子：
2.5
通讯作者：
Regli, Luca
中科院分区：
文献类型：
--
作者：
Fierstra, Jorn;van Niftrik, Christiaan;Regli, Luca
目的：脑弥漫性胶质瘤表现出病灶周围脑血管反应性（CVR）受损，但损伤的程度以及其在脑中的完整空间范围仍不清楚。与定量功能磁共振成像，我们研究了12名未经治疗的脑弥漫性胶质瘤和12名健康对照，以评估CVR损伤，并确定其分布在整个brain.Methods：在前瞻性病例对照研究中，定量CVR测量来自BOLD功能磁共振成像体积标准化的二氧化碳中的低氧变化。结果：与健康对照组相比，全脑CVR显著受损（0.11 +/-0.10对0.28 +/-0.8，p < 0.01）。所有弥漫性胶质瘤患者的病灶内CVR受损更严重（平均0.01 ± 0.06）。肿瘤体积的增大与病灶内CVR损害（p < 0.05，R-2 = 0.38）和全脑CVR损害（p < 0.05，R-2 = 0.55）显著相关。定量功能磁共振成像可以通过跟踪CVR的变化来研究抗肿瘤治疗的疗效，并可能具有补充作用，以更好地解释BOLD相关的神经血管解耦。
Purpose: Cerebral diffuse gliomas exhibit perilesional impaired cerebrovascular reactivity (CVR), yet the degree of impairment as well as its full spatial extent in the brain remains unknown. With quantitative fMRI, we studied twelve subjects with untreated brain diffuse glioma and twelve healthy controls to assess CVR impairment and determine its distribution throughout the brain.Methods: In a prospective case-control study, quantitative CVR measurements were derived from BOLD fMRI volumes during standardized iso-oxic changes in carbon dioxide. Whole brain CVR was assessed with additional detailed analyses using specific tumor and-tissue masks and compared to datasets of healthy controls.Results: Whole brain CVR was significantly impaired compared to healthy controls (0.11 +/- 0.10 versus 0.28 +/- 0.8, p < 0.01). All diffuse glioma patients exhibited even more severely impaired intralesional CVR (mean 0.01 +/- 0.06). Increasing tumor volume significantly correlated with severity of intralesional CVR impairment (p < 0.05, R-2 = 0.38), and whole brain CVR impairment (p < 0.05, R-2 = 0.55).Conclusion: Patients with brain diffuse glioma exhibit intralesional and whole brain impaired CVR with severity correlating to tumor volume. Quantitative fMRI may be entertained to study antitumor therapy efficacy by tracking CVR changes and may have a complementary role to better interpret BOLD associated neurovascular uncoupling.