Hemodynamic Alterations in Vertebrobasilar Large Artery Disease Assessed by Arterial Spin-Labeling MR Imaging
Hemodynamic Alterations in Vertebrobasilar Large Artery Disease Assessed by Arterial Spin-Labeling MR Imaging
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DOI：
10.3174/ajnr.a3090
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发表时间：
2012-11-01
影响因子：
3.5
通讯作者：
Bothwell, P. M.
中科院分区：
文献类型：
--
作者：
MacIntosh, B. J.;Marquardt, L.;Bothwell, P. M.
背景与目的：VB动脉狭窄与复发性缺血事件的高风险相关，了解VB动脉狭窄的血流动力学相关性对临床决策具有重要意义。在本研究中，评估了多次流入脉冲ASL磁共振成像在VB疾病患者中测量CBF和All的能力。材料与方法：41名参与者在3T MR成像扫描仪上进行ASL。21例患者有VB循环缺血性事件史（男14例，女7例，年龄66±11岁）。采用临床资料和CE-MRA对VB疾病严重程度进行分级。20名年龄相仿的成年人作为对照。进行组内和vb分析。通过排除不能产生可靠ASL估计的体素来调整roi中的平均CBF和ATT值。结果：与对照组相比，患者的CBF减少（P < 0.003），在排除了拟合不良的体素后，这是显著的。体素校正后，患者与对照组间的ATT差异不显著。患者CBF与All有很强的相关性。最后，ATT与VB疾病严重程度显著相关（P = 0.026）。结论：多次流入ASL可将VB患者与年龄匹配的对照组区分开来。VB疾病分级与All下游时间延长有关。在干预风险高的患者中，ASL可能具有诊断潜力。
BACKGROUND AND PURPOSE: VB artery stenosis is associated with a high risk of recurrent ischemic events, and knowledge about the hemodynamic relevance of VB stenosis is important for clinical decision making. In this study, multiple inflow pulsed ASL MR imaging was assessed for its ability to measure CBF and All in patients with VB disease.MATERIALS AND METHODS: ASL was performed on a 3T MR imaging scanner in 41 participants. Twenty-one patients had a history of ischemic events in the VB circulation (14 men, 7 women, age 66 +/- 11 years). Clinical data and CE-MRA were used to classify VB disease severity. Twenty age-matched adults were controls. Group and within-VB analyses were performed. Mean CBF and ATT values in the ROIs were adjusted by excluding voxels that did not produce a reliable ASL estimate.RESULTS: CBF was reduced (P < .003) in patients compared with controls, which was significant after excluding voxels with a poor fit. Differences in ATT between patients and controls were not significant after voxel correction. There was a strong correlation between CBF and All among patients. Finally, ATT was significantly correlated with VB disease severity (P = .026).CONCLUSIONS: Multiple inflow ASL distinguished patients with VB disease from age matched-controls. VB disease rating was associated with prolonged All downstream. ASL may have diagnostic potential among patients in whom risk of intervention is high.