Planning-free cerebral blood flow territory mapping in patients with intracranial arterial stenosis
Planning-free cerebral blood flow territory mapping in patients with intracranial arterial stenosis
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DOI：
10.1177/0271678x16657573
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发表时间：
2017-06-01
影响因子：
6.3
通讯作者：
Donahue, Manus J.
中科院分区：
文献类型：
--
作者：
Arteaga, Daniel F.;Strother, Megan K.;Donahue, Manus J.
血管编码的伪连续动脉自旋标记MRI是一种非侵入性的脑血流定量和脑血流区域可视化方法。然而，获取这些信息的障碍包括临床中心对方法学的访问有限，以及临床获取的血管编码伪连续动脉自旋标记数据如何与金标准方法相关的工作有限。这项工作的目的是开发和验证一个半自动化的管道，用于在线定量脑血流图和脑血流领域的无计划血管编码伪连续动脉自旋标记MRI与金标准数字减影血管造影。健康对照组（n=10）和颅内动脉粥样硬化性疾病患者（n=34）进行了3.0T MRI成像，包括血管（MR血管造影）和血流动力学（脑血流加权动脉自旋标记）MRI。患者还接受了导管和/或CT血管造影术。对照组的跨域充盈变化按Willis血管环直径分组。在患者中，计算Cohen的k-统计量以量化血管编码的伪连续动脉自旋标记和血管造影之间的灌注模式的一致性。跨区域充盈模式与Willis环解剖结构一致。脑血流区域和数字减影血管造影灌注一致性的观察者内Cohen k统计量分别为0.730（95% CI=0.593-0.867;阅片人1）和0.708（95% CI=0.561-0.855;阅片人2）。这些结果支持了半自动管道用于评价颅内动脉粥样硬化疾病患者主要神经血管脑血流区域的可行性。
A noninvasive method for quantifying cerebral blood flow and simultaneously visualizing cerebral blood flow territories is vessel-encoded pseudocontinuous arterial spin labeling MRI. However, obstacles to acquiring such information include limited access to the methodology in clinical centers and limited work on how clinically acquired vessel-encoded pseudocontinuous arterial spin labeling data correlate with gold-standard methods. The purpose of this work is to develop and validate a semiautomated pipeline for the online quantification of cerebral blood flow maps and cerebral blood flow territories from planning-free vessel-encoded pseudocontinuous arterial spin labeling MRI with gold-standard digital subtraction angiography. Healthy controls (n=10) and intracranial atherosclerotic disease patients (n=34) underwent 3.0T MRI imaging including vascular (MR angiography) and hemodynamic (cerebral blood flow-weighted arterial spin labeling) MRI. Patients additionally underwent catheter and/or CT angiography. Variations in cross-territorial filling were grouped according to diameters of circle of Willis vessels in controls. In patients, Cohen's k-statistics were computed to quantify agreement in perfusion patterns between vessel-encoded pseudocontinuous arterial spin labeling and angiography. Cross-territorial filling patterns were consistent with circle of Willis anatomy. The intraobserver Cohen's k-statistics for cerebral blood flow territory and digital subtraction angiography perfusion agreement were 0.730 (95% CI=0.593-0.867; reader one) and 0.708 (95% CI=0.561-0.855; reader two). These results support the feasibility of a semiautomated pipeline for evaluating major neurovascular cerebral blood flow territories in patients with intracranial atherosclerotic disease.