Continuous Arterial Spin Labeling Perfusion Magnetic Resonance Imaging Findings in Postpartum Vasculopathy
Continuous Arterial Spin Labeling Perfusion Magnetic Resonance Imaging Findings in Postpartum Vasculopathy
复制标题
连续动脉旋转标记灌注磁共振成像在产后血管病变中的发现
作者：
J. Chalela;S. Kasner;M. McGarvey;D. Alsop;J. Detre
产后血管病变（PPV）是一种罕见的异质性非动脉粥样硬化性血管病变，发生在产褥期。它是自发发生的，但也可能由血管收缩物质引发。血管造影表现不同，包括颅内动脉狭窄和血管痉挛。血管造影结果和缺血性梗死的发生提示PPV的脑血流量（CBF）受损。本研究的目的是确定PPV患者的CBF。作者对3例患者进行了病例研究，这些患者在2年的时间里接受了PPV的临床和实验室检查。对所有患者进行临床检查、计算机断层成像、结构磁共振成像（MRI）、脑血管造影和持续动脉自旋标记灌注（CASL‐PI） MRI。测定平均全脑血流，目测血流灌注图。脑血流值和灌注图与临床症状和神经影像学表现相关。研究了三名女性（22岁、34岁和36岁）。中位出现时间为产后4天。1例表现为颅内出血和弥漫性动脉狭窄，另外2例表现为卒中样病变、脑病和主要在后循环的节段性狭窄。所有3例患者均在症状出现后1周内进行CASL - PI。全球平均CBF值分别为51.8、39.3和41.8 cc/100 g/min。虽然整体脑血流轻度减少，但仍高于缺血水平。CASL - PI灌注图的目视检查未显示局灶性低灌注或高灌注区域。在这组PPV患者中，CBF接近正常。虽然血管造影经常显示弥漫性动脉狭窄，但本研究中遇到的CBF值不支持全面性或局灶性血少血症的状态。PPV患者血管舒缩性张力可能间歇性改变。
Postpartum vasculopathy (PPV) is a rare heterogeneous nonatherosclerotic vasculopathy that occurs in the puerperium. It occurs spontaneously but may be triggered by vasoconstrictor substances. The angiographic findings vary and include narrowing of the intracranial arteries and vasospasm. The angiographic findings and the occurrence of ischemic infarcts suggest that cerebral blood flow (CBF) is impaired in PPV. The purpose of this study is to determine CBF in patients with PPV. The authors conducted a case study of 3 patients with clinical and laboratory criteria for PPV examined during a 2‐year period. Clinical examination, computed tomography imaging, structural magnetic resonance imaging (MRI), cerebral angiography, and continuous arterial spin labeling perfusion (CASL‐PI) MRI were performed in all patients. Mean global CBF was determined, and perfusion maps were visually inspected. The CBF values and perfusion maps were correlated with the clinical symptoms and the neuroimaging findings. Three women were studied (22, 34, and 36 years old). The median time of presentation was 4 days postpartum. One presented with intracranial hemorrhage and diffuse arterial narrowing, the other 2 with stroke‐like lesions, encephalopathy, and segmental narrowing mainly in the posterior circulation. CASL‐PI was performed within 1 week of symptom onset in all 3 patients. Global mean CBF values were 51.8, 39.3, and 41.8 cc/100 g/min. Although global CBF was mildly diminished, it was above ischemic levels. Visual inspection of the CASL‐PI perfusion maps did not reveal areas of focal hypoperfusion or hyperperfusion. In this series of patients with PPV, CBF was close to normal. Although angiography often reveals diffuse arterial narrowing, the CBF values encountered in this study do not support a state of generalized or focal oligoemia. Vasomotor tone may change intermittently in patients with PPV.
影响因子：
19.7
作者：
Alsop, DC;Detre, JA
通讯作者：
Detre, JA