MRI Using Ferumoxytol Improves the Visualization of Central Nervous System Vascular Malformations
MRI Using Ferumoxytol Improves the Visualization of Central Nervous System Vascular Malformations
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DOI：
10.1161/strokeaha.110.607994
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发表时间：
2011-06-01
期刊：
影响因子：
8.3
通讯作者：
Neuwelt, Edward A.
中科院分区：
文献类型：
--
作者：
Dosa, Edit;Tuladhar, Suchita;Neuwelt, Edward A.
背景和目的-中枢神经系统血管畸形（VM）是由异常的血管和/或血管生成引起的。海绵状血管瘤和动静脉畸形也是活动性炎症的部位。本研究的目的是确定是否可以通过管理ferumoxytol氧化铁纳米粒子，作为一个血池剂在早期的时间点和炎症标记物时，采取了组织macrophage. Methods-19例（11名男性，8名女性;平均年龄，47.5岁）与中枢神经系统VM进行3-T MRI与钆特醇和ferumoxytol改善VM的MRI检测。在25分钟时分析ferumoxytol诱导的T1、T2和磁共振成像信号变化（范围：21至30分钟）和24小时（范围，22至27小时）。（毛细血管扩张症6例，海绵状血管瘤21例，发育性静脉畸形7例;动静脉畸形，n = 1）在术前和术后的图像。ferumoxytol后磁共振加权序列显示5个额外的VM（3个毛细血管扩张，2个海绵状血管瘤），并显示进一步的分支静脉在所有患者的发展静脉异常。24小时T1和T2 ferumoxytol相关信号异常在患者和VM类型内不一致。没有额外的区域T1或T2的增强与ferumoxytol与钆特醇相比，在任何lesions. Conclusions，我们的研究结果表明，血池剂ferumoxytol提供了重要的信息的数量和真实程度的VM的磁共振成像。使用ferumoxytol作为巨噬细胞显像剂在病变内和周围的炎症细胞的可视化值得进一步研究。（中风。2011;42：1581-1588.）
Background and Purpose-Central nervous system vascular malformations (VMs) result from abnormal vasculo-and/or angiogenesis. Cavernomas and arteriovenous malformations are also sites of active inflammation. The aim of this study was to determine whether MRI detection of VMs can be improved by administration of ferumoxytol iron oxide nanoparticle, which acts as a blood pool agent at early time points and an inflammatory marker when taken up by tissue macrophages.Methods-Nineteen patients (11 men, 8 women; mean age, 47.5 years) with central nervous system VMs underwent 3-T MRI both with gadoteridol and ferumoxytol. The ferumoxytol-induced signal changes on the T1-, T2-, and susceptibility-weighted images were analyzed at 25 minutes (range, 21 to 30 minutes) and 24 hours (range, 22 to 27 hours).Results-Thirty-five lesions (capillary telangiectasia, n = 6; cavernoma, n = 21; developmental venous anomaly, n = 7; arteriovenous malformation, n = 1) were seen on the pre- and postgadoteridol images. The postferumoxytol susceptibility-weighted sequences revealed 5 additional VMs (3 capillary telangiectasias, 2 cavernomas) and demonstrated further tributary veins in all patients with developmental venous anomalies. The 24-hour T1 and T2 ferumoxytol-related signal abnormalities were inconsistent among patients and within VM types. No additional area of T1 or T2 enhancement was noted with ferumoxytol compared with gadoteridol in any lesion.Conclusions-Our findings indicate that the blood pool agent ferumoxytol provides important information about the number and true extent of VMs on the susceptibility-weighted MRI. The use of ferumoxytol as a macrophage imaging agent in the visualization of inflammatory cells within and around the lesions warrants further investigation. (Stroke. 2011;42:1581-1588.)