Evolution of Cerebral Ischemia Assessed by Amide Proton Transfer-Weighted MRI.
Evolution of Cerebral Ischemia Assessed by Amide Proton Transfer-Weighted MRI.
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酰胺质子转移加权 MRI 评估脑缺血的演变
DOI：
10.3389/fneur.2017.00067
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发表时间：
2017
影响因子：
3.4
通讯作者：
Chen M
中科院分区：
文献类型：
--
作者：
Song G;Li C;Luo X;Zhao X;Zhang S;Zhang Y;Jiang S;Wang X;Chen Y;Chen H;Gong T;Zhou J;Chen M
酰胺质子转移加权（APTW）磁共振成像（MRI）最近已成为评估缺血性卒中酸中毒的潜在重要工具。本研究的目的是评估缺血患者病变中与pH相关的动态变化。39例缺血性卒中患者（症状发作至成像时间范围为2 h-7 d）采用3.0 T MRI系统进行检查。将患者分为4组：超急性期（发病时间≤ 6 h）、急性期（6 h <发病时间≤ 48 h）、亚急性早期（48 h <发病时间≤ 96 h）和亚急性晚期（96 h <发病时间≤ 168 h）。定量测量每例患者多个缺血区域的APTW信号强度。与对侧正常白色物质相比，缺血组织中的APTW信号在四个阶段均显著降低（P < 0.05）。APTW信号强度（APTWave和APTWmin）随发作时间增加而增加（R2 = 0.11，P = 0.040; R2 = 0.13，P = 0.022）。APTWmax-min随发病时间延长而持续下降（R2 = 0.44，P < 0.001）。我们的研究结果表明，持续的组织酸化可能发生在缺血后，随着中风发作时间的增加，酸环境将减轻。APTW信号强度可以反映缺血组织在不同阶段和时间点的pH加权特性。
Amide proton transfer-weighted (APTW) magnetic resonance imaging (MRI) has recently become a potentially important tool for evaluating acidosis in ischemic stroke. The purpose of this study was to evaluate the dynamic pH-related changes in the lesions in patients with ischemia. Thirty-nine patients with ischemic stroke (symptom onset to imaging time ranging 2 h–7 days) were examined with a 3.0-T MRI system. Patients were divided into four groups: at the hyperacute stage (onset time ≤ 6 h), at the acute stage (6 h < onset time ≤ 48 h), at the early subacute stage (48 h < onset time ≤ 96 h), and at the late subacute stage (96 h < onset time ≤ 168 h). The APTW signal intensities were quantitatively measured in multiple ischemic regions for each patient. Compared with the contralateral normal white matter, APTW signals were significantly lower in ischemic tissue for all four stages (P < 0.05). The APTW signal intensities (APTWave and APTWmin) increased consistently with onset time (R2 = 0.11, P = 0.040; R2 = 0.13, P = 0.022, respectively). APTWmax–min showed a continued reduction with onset time (R2 = 0.44, P < 0.001). Our results suggest that persistent tissue acidification could occur after ischemia, and as the time from stroke onset increases, the acidotic environment would alleviate. APTW signal intensities could reflect pH-weighted properties in ischemic tissue at different stages and time points.