MR perfusion imaging in moyamoya syndrome - Potential implications for clinical evaluation of occlusive cerebrovascular disease
MR perfusion imaging in moyamoya syndrome - Potential implications for clinical evaluation of occlusive cerebrovascular disease
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DOI：
10.1161/hs1201.099893
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发表时间：
2001-12-01
期刊：
影响因子：
8.3
通讯作者：
Connelly, A
中科院分区：
文献类型：
--
作者：
Calamante, F;Ganesan, V;Connelly, A
背景与目的：烟雾综合征（MMS）患者的缺血性症状通常是由血流动力学介导的灌注衰竭引起的。因此，鉴别这些患者的异常组织灌注具有重要的临床意义。虽然动态敏感性对比（DSC） MRI可以用来研究组织灌注。彩信存在潜在的技术问题。本研究探讨灌注MRI在此类患者临床评价中的范围和局限性。方法：对13例双侧MMS患者进行结构分析。扩散和灌注MRI。对DSC MRI数据进行视觉分析和定量区域分析，探讨灌注状态与临床症状的关系。结果：所有患者均有广泛的双侧DSC MRI异常。药物到达时间的分布极不均匀。异常区域包括所有病例的主要动脉边界区，尽管这些区域在结构和扩散MRI上通常表现正常。在定量区域分析中，只有临床上最不稳定的患者峰宽（定义为到达峰的时间减去药物到达时间）为bbb50秒。介绍了MMS灌注定量的几个技术限制。以及这些限制在其他形式的闭塞性大血管疾病患者中的意义。结论：本研究描述的DSC MRI的技术局限性对于MMS灌注MRI的准确解释是重要的。尽管存在这些局限性，这些初步研究结果表明，使用定量区域分析的汇总参数可能为MMS患者提供临床有用的信息。
Background and Purpose-Ischemic symptoms in patients with moyamoya syndrome (MMS) are usually due to hemodynamical ly mediated perfusion failure. and identification of abnormal tissue perfusion in these patients is therefore clinically important. Although dynamic susceptibility contrast (DSC) MRI can be used to study tissue perfusion. there are potential technical problems in MMS. This study investigates the scope and limitations of perfusion MRI in the clinical evaluation of such patients.Methods-Thirteen patients with bilateral MMS were studied with the use of structural. diffusion, and perfusion MRI. The DSC MRI data were analyzed both visually and by a quantitative regional analysis, and the relationship between perfusion Status and clinical symptoms was investigated.Results-Extensive bilateral DSC MRI abnormalities were observed in all the patients. There was a very heterogeneous distribution of bolus arrival time. The areas of abnormality included the major arterial border zones in all cases, although these usually appeared normal on structural and diffusion MRI. Only the most clinically unstable patients had peak width (defined as time to peak minus bolus arrival time) > 5 seconds on the quantitative regional analysis. Several technical limitations of perfusion quantification in MMS are described. as well Lis the implications of these limitations in patients with other forms of occlusive large-vessel disease.Conclusions-The technical limitations of DSC MRI described in this study are important for the accurate interpretation of perfusion MRI in MMS. Despite these limitations, these preliminary findings suggest that the use of quantitative regional analysis of summary parameters may provide clinically useful information in patients with MMS.