Arterial spin labeling perfusion MRI: Inter-vendor reproducibility and clinical applicability
Arterial spin labeling perfusion MRI: Inter-vendor reproducibility and clinical applicability
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发表时间：
2015
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通讯作者：
H. Mutsaerts
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作者：
H. Mutsaerts
动脉自旋标记 (ASL) 是一种灌注磁共振成像 (MRI) 技术，可无创测量脑血流量 (CBF)。本论文的第一部分涉及 ASL 的供应商间再现性。本论文的研究表明，在总灰质（GM）水平上，长期生理灌注波动主导着 ASL 序列和扫描仪之间的技术差异。然而，只有当不同供应商 MRI 系统上的序列尽可能相同时，来自较小感兴趣区域的 CBF 数据才具有可比性。主要影响包括不同的读出模块、有效标记后延迟的差异导致传输时间灵敏度的差异、点扩散函数的范围和背景抑制的效率。此外，序列参数的微小差异可能比 MRI 硬件的差异产生更大的影响。本文的第二部分研究了 ASL 的几个潜在的临床应用。我们表明，可以在老年人中测量白质 (WM) 灌注信号，但还应小心侵蚀感兴趣的 WM 区域，以避免被 GM CBF 污染。我们证明了对大量患有高血压的老年人群进行适度血管挤压的统计学益处。在同一人群中，WM 病变体积与 WM 病变 CBF 相关，但与正常出现的 WM 或 GM CBF 无关。在患有镰状细胞病的儿童中，我们展示了 CBF 和血液学参数之间的相关性，这些参数都参与了 WML 的发病机制，并且是治疗该疾病的关键目标。
Arterial spin labeling (ASL) is a perfusion magnetic resonance imaging (MRI) technique that non-invasively measures cerebral blood flow (CBF). The first part of this thesis concerns the inter-vendor reproducibility of ASL. Studies in this thesis show that on a total gray matter (GM) level, long-term physiological perfusion fluctuation dominates technical differences between ASL sequences and scanners. However, CBF data from smaller regions of interest were only comparable when sequences were made as identical as possible on different vendor MRI systems. Major effects include different readout modules, differences in effective post-labeling delay leading to differences in transit time sensitivity, the extent of the point spread function and the efficiency of background suppression. Furthermore, slight differences in sequence parameters can have a larger effect than differences in MRI hardware. The second part of this thesis investigates several potential clinical applications of ASL. We show that white matter (WM) perfusion signal can be measured in the elderly, but also that the WM region of interest should be carefully eroded to avoid contamination with GM CBF. We demonstrate the statistical benefits of modest vascular crushing in a large population of elderly with hypertension. In the same population, WM lesion volume was correlated with WM lesion CBF but not with normal appearing WM or GM CBF. In children with sickle cell disease, we show correlations between CBF and hematological parameters that are both involved in the pathogenesis of WML and are key targets in the treatment of this disease.