Ultra-high-field arterial spin labelling MRI for non-contrast assessment of cortical lesion perfusion in multiple sclerosis.
Ultra-high-field arterial spin labelling MRI for non-contrast assessment of cortical lesion perfusion in multiple sclerosis.
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DOI：
10.1007/s00330-018-5707-5
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发表时间：
2019-04
影响因子：
5.9
通讯作者：
Francis ST
中科院分区：
文献类型：
--
作者：
Dury RJ;Falah Y;Gowland PA;Evangelou N;Bright MG;Francis ST
评估使用优化的超高场高空间分辨率低失真动脉自旋标记（ASL）MRI采集测量多发性硬化（MS）皮质病变（CL）中局灶性血流动力学病理的可行性。12名MS患者（8名女性，平均年龄50岁;范围35-64岁）提供知情同意书，并在7特斯拉Philips Achieva扫描仪上进行扫描。在多个标记后延迟时间处使用具有平衡稳态自由旋进读出方案的单层流动敏感交替反转恢复ASL方案收集灌注数据。使用高分辨率相敏反转恢复（PSIR）扫描识别CL。使用配对t检验评估CL内灌注与直接周围正常表现的灰质（NAGM局部）和总皮质正常表现的灰质（NAGM皮质）相比的显著差异。在PSIR扫描中识别出40个CL，与ASL采集覆盖范围重叠。在排除由于尺寸小或血管内污染的病变后，27处病变有资格进行分析。CL的平均灌注为40 ± 25 ml/100 g/min，NAGM局部为53 ± 12 ml/100 g/min，NAGM皮质为53 ± 8 ml/100 g/min。相对于NAGM局部和NAGM皮质灌注，CL灌注分别显著减少23 ± 9%（平均值± SE，p = 0.013）和26 ± 9%（p = 0.006）。这是第一项在7特斯拉下量化MS中CL灌注的ASL MRI研究，证明了优化的ASL采集对先前使用动态磁敏感对比MRI观察到的局灶性血液动力学病理敏感。ASL不需要外源性造影剂，使其成为监测MS纵向灌注变化的更合适的工具，为研究病变发展提供了新的窗口。·可以使用超高场优化的高空间分辨率动脉自旋标记MRI采集来量化多发性硬化症皮质病变内的灌注。·使用动脉自旋标记评估的大多数皮质病变与正常表现的灰质相比是低灌注的，与动态磁敏感对比MRI文献一致。·动脉自旋标记MRI不涉及造影剂的注射，是一种安全且适用于重复扫描个体患者的技术。
To assess the feasibility of using an optimised ultra-high-field high-spatial-resolution low-distortion arterial spin labelling (ASL) MRI acquisition to measure focal haemodynamic pathology in cortical lesions (CLs) in multiple sclerosis (MS). Twelve MS patients (eight female, mean age 50 years; range 35–64 years) gave informed consent and were scanned on a 7 Tesla Philips Achieva scanner. Perfusion data were collected at multiple post-labelling delay times using a single-slice flow-sensitive alternating inversion recovery ASL protocol with a balanced steady-state free precession readout scheme. CLs were identified using a high-resolution Phase-Sensitive Inversion Recovery (PSIR) scan. Significant differences in perfusion within CLs compared to immediately surrounding normal appearing grey matter (NAGMlocal) and total cortical normal appearing grey matter (NAGMcortical) were assessed using paired t-tests. Forty CLs were identified in PSIR scans that overlapped with the ASL acquisition coverage. After excluding lesions due to small size or intravascular contamination, 27 lesions were eligible for analysis. Mean perfusion was 40 ± 25 ml/100 g/min in CLs, 53 ± 12 ml/100 g/min in NAGMlocal, and 53 ± 8 ml/100 g/min in NAGMcortical. CL perfusion was significantly reduced by 23 ± 9% (mean ± SE, p = 0.013) and 26 ± 9% (p = 0.006) relative to NAGMlocal and NAGMcortical perfusion, respectively. This is the first ASL MRI study quantifying CL perfusion in MS at 7 Tesla, demonstrating that an optimised ASL acquisition is sensitive to focal haemodynamic pathology previously observed using dynamic susceptibility contrast MRI. ASL requires no exogenous contrast agent, making it a more appropriate tool to monitor longitudinal perfusion changes in MS, providing a new window to study lesion development. • Perfusion can be quantified within cortical lesions in multiple sclerosis using an optimised high spatial resolution arterial spin Labelling MRI acquisition at ultra-high-field. • The majority of cortical lesions assessed using arterial spin labelling are hypo-perfused compared to normal appearing grey matter, in agreement with dynamic susceptibility contrast MRI literature. • Arterial spin labelling MRI, which does not involve the injection of a contrast agent, is a safe and appropriate technique for repeat scanning of an individual patient.
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影响因子：
5.7
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通讯作者：
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