Characterizing Diaschisis-Related Thalamic Perfusion and Diffusion After Middle Cerebral Artery Infarction
Characterizing Diaschisis-Related Thalamic Perfusion and Diffusion After Middle Cerebral Artery Infarction
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大脑中动脉梗死后与神经联系联系不能相关的丘脑灌注和扩散特征
DOI：
10.1161/strokeaha.120.032464
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发表时间：
2021-05
期刊：
影响因子：
8.3
通讯作者：
Ju Shenghong
中科院分区：
文献类型：
--
作者：
Xia Cong;Zhou Jiaying;Lu Chunqiang;Wang Yuancheng;Tang Tianyu;Cai Yu;Ju Shenghong
补充数字内容可在文本中找到。背景和目的：同侧丘脑神经联系不能（ITD）最初描述了幕上病变同侧丘脑的功能性抑制，但越来越多的证据表明也发生了形态学变化。因此，我们的目的是表征丘脑灌注和扩散相关的ITD随着时间的推移和它们之间的相互关系后，大脑中动脉梗死。研究方法：回顾性纳入85例接受弥散峰度成像和动脉自旋标记的大脑中动脉梗死患者。ITD诊断为≥2次脑血流图显示的同侧丘脑低灌注。丘脑不对称指数计算为（同侧值-对侧值）/对侧值× 100%。最后分析了丘脑灌注和弥散的相互关系。结果：85例患者中56例存在ITD（65.9%，ITD+）。在ITD+患者中，观察到比ITD−患者更大的异常灌注体积、更高的灌注-梗死不匹配和更低的局灶性过度灌注率。累及放射冠的梗死在ITD+患者中更常见。亚急性组和慢性组ITD+患者的同侧丘脑内的平均峰度与对侧丘脑相比略有但显著增加，而亚急性组ITD+和ITD−患者的各向异性分数显著增加，而慢性组ITD+和ITD−患者的各向异性分数均降低。慢性组ITD+患者的平均扩散系数显著增加。此外，亚急性组ITD+患者的AICBF与AIMK和AIFA呈显著负相关，慢性组AIMD与AIMK和AIFA呈显著负相关，即使调整了异常灌注量和症状发作天数。ITD+患者在入院和出院时的国立卫生研究院卒中量表和改良兰金量表评分显著较高，并且在出院时也显示出与临床结局独立相关的趋势。结论：动脉自旋标记和弥散峰度成像的结合可以显示大脑中动脉梗死后早期、时间特异性的丘脑灌注和弥散变化。ITD相关的低灌注与潜在的微结构改变显著相关。
Supplemental Digital Content is available in the text. Background and Purpose: Ipsilateral thalamic diaschisis (ITD) initially describes functional depression of the thalamus ipsilateral to a supratentorial lesion, but accumulating evidence has shown morphological changes also occur. Therefore, we aimed to characterize thalamic perfusion and diffusion related to ITD over time and their inter-relationships after middle cerebral artery infarction. Methods: Eighty-five patients with middle cerebral artery infarction who underwent diffusion kurtosis imaging and arterial spin labeling were retrospectively included. ITD was diagnosed as ipsilateral thalamic hypoperfusion present on ≥2 cerebral blood flow maps. The thalamic asymmetrical index was calculated as (ipsilateral value−contralateral value)/contralateral value×100%. Finally, the inter-relationships of thalamic perfusion and diffusion were analyzed. Results: ITD was present in 56/85 patients (65.9%, ITD+). In ITD+ patients, larger abnormal perfusion volume, higher perfusion-infarct mismatch and lower rates of focal hyperperfusion were observed than ITD− patients. Infarction affecting the corona radiata were more frequent among ITD+ patients. Mean kurtosis were slightly but significantly increased within the ipsilateral thalamus compared with the contralateral one in ITD+ patients of subacute and chronic groups, while fractional anisotropy was significantly increased in subacute group but decreased in chronic group for both ITD+ and ITD− patients. Mean diffusivity was significantly increased in ITD+ patients of chronic group. Furthermore, the AICBF was negatively and significantly correlated with AIMK and AIFA in ITD+ patients in subacute group, and AIMD, even after adjustment for abnormal perfusion volume and days from symptoms onset, in chronic group. ITD+ patients had significantly higher National Institutes of Health Stroke Scale and modified Rankin Scale scores at admission and discharge and also showed a trend to independent association with clinical outcome at discharge. Conclusions: The combination of arterial spin labeling and diffusion kurtosis imaging can reveal early, time-specific thalamic perfusion and diffusion changes after middle cerebral artery infarction. ITD-related hypoperfusion was significantly correlated with underlying microstructural alterations.
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DOI：
10.1016/b978-0-12-811749-1.00017-1
发表时间：
2019
期刊：
Sustainable Construction Technologies
影响因子：
--
作者：
C. S. Goh
通讯作者：
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影响因子：
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作者：
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影响因子：
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影响因子：
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作者：
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影响因子：
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作者：
Hervé, D;Molko, N;Chabriat, H
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