Calf muscle perfusion at peak exercise in peripheral arterial disease: Measurement by first-pass contrast-enhanced magnetic resonance imaging
Calf muscle perfusion at peak exercise in peripheral arterial disease: Measurement by first-pass contrast-enhanced magnetic resonance imaging
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DOI：
10.1002/jmri.20899
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发表时间：
2007-05-01
影响因子：
4.4
通讯作者：
Kramer, Christopher M.
中科院分区：
文献类型：
--
作者：
Isbell, David C.;Epstein, Frederick H.;Kramer, Christopher M.
目的：材料与方法：应用磁共振增强测力计对11例轻中度症状性外周动脉疾病（PAD）患者（年龄61 ± 11岁）（踝臂指数[ABI] = 0.75 ± 0.08）和22例正常人（对照组）的骨骼肌灌注进行研究。PAD和正常（最大值）（NImax; N = 11）运动至精疲力尽。NIlow（N = 11）进行与PAD相同的工作量。在运动高峰期，以3-4 cm（3）/s的速度输注0.1 mm/kg的二亚乙基三胺五乙酸钆（Gd-DTPA），然后以相同的速度进行生理盐水冲洗。双对比梯度回波（GRE）序列能够同时采集肌肉灌注和动脉输入功能（AIF）。结果：PAD、NIlow和NImax的中位工作负荷分别为120 Joules、210 Joules和698 Joules（P < 0.001 vs. NIlow和PAD）。PAD中的中位PI为0.29（第25和第75位百分比[%] = 0.20，0.40），NI低中的中位PI为0.48（第25和第75位百分比[ %]= 0.36）。0.62; P < 0.02 vs. PAD），NIlow为0.69（第25、75位百分比= 0.5。0.77; P < 0.001 vs. PAD）。PI区分患者与NImax的ROC曲线下面积为0.95（95%置信区间[CI] = 0.77-0.99）。结论：双对比、首过MR下肢灌注峰值运动测量可区分PAD与正常人。这种方法可能有助于PAD新疗法的研究。
Purpose: To develop a contrast-enhanced magnetic resonance (MR) technique to measure skeletal muscle perfusion in peripheral arterial disease (PAD).Materials and Methods: A total of 11 patients (age = 61 +/- 11 years) with mild to moderate symptomatic PAD (ankle-brachial index [ABI] = 0.75 +/- 0.08) and 22 normals were studied using MR-campatible ergometer. PAD and normal(max) (NImax; N = 11) exercised to exhaustion. NIlow (N = 11) exercised to the same workload achieved by PAD. At peak exercise, 0.1 mm/kg of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) was infused at 3-4 cm(3)/second followed by a saline flush at the same rate. A dual-contrast gradient echo (GRE) sequence enabled simultaneous acquisition of muscle perfusion and arterial input function (AIF). The perfusion index (PI) was defined as the slope of the time-intensity curve (TIC) in muscle divided by the arterial TIC slope.Results: Median workload was 120 Joules in PAD, 210 Joules in NIlow, and 698 Joules in NImax (P < 0.001 vs. NIlow and PAD). Median PI was 0.29 in PAD (25th and 75th percentiles [%] = 0.20, 0.40), 0.48 in NIlow (25th, 75th % = 0.36. 0.62; P < 0.02 vs. PAD), and 0.69 in NIlow (25th, 75th % = 0.5. 0.77; P < 0.001 vs. PAD). Area under the ROC-curve for PI differentiating patients from NImax was 0.95 (95% confidence interval [CI] = 0.77-0.99).Conclusion: Peak-exercise measurement of lower limb perfusion with dual-contrast, first-pass MR distinguishes PAD from normals. This method may be useful in the study of novel therapies for PAD.