Transient Hypoxia Model Revealed Cerebrovascular Impairment in Anemia Using BOLD MRI and Near-Infrared Spectroscopy.
Transient Hypoxia Model Revealed Cerebrovascular Impairment in Anemia Using BOLD MRI and Near-Infrared Spectroscopy.
复制标题
短暂性缺氧模型显示，使用粗体MRI和近红外光谱法脑血管损伤。
DOI：
10.1002/jmri.27210
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发表时间：
2020-11
期刊：
影响因子：
--
通讯作者：
Wood JC
中科院分区：
文献类型：
--
作者：
Coloigner J;Vu C;Borzage M;Bush A;Choi S;Miao X;Chai Y;Galarza C;Lepore N;Tamrazi B;Coates TD;Wood JC
阻塞性睡眠呼吸暂停和夜间氧减饱和在镰状细胞病(SCD)和慢性贫血疾病中普遍存在，与中风和无症状性脑梗塞(SCI)的风险有关。间歇性脱饱和度对脑血管的反应尚未得到很好的研究，可能会识别出风险最高的患者。目的：探讨SCD伴和不伴脊髓损伤、慢性贫血患者及健康人对诱导脱饱和度的动态反应。有远见。SCD组26例(年龄21±8.2岁，女性46.2%)，其中无脊髓损伤组15例，脊髓损伤组9例，非镰刀性贫血组15例，年龄22±5.8岁，女性66.7%，对照组31例，年龄28±12.3岁，女性77.4%。3T，梯度回波平面成像。通过血氧水平依赖(BOLD)磁共振成像和近红外光谱(NIRS)采集，进行了五次100%氮气呼吸的短暂低氧挑战。低氧反应的特点是在BOLD和NIRS时间过程中的减饱和深度、达到峰值的时间、回到基线的半衰期和缺氧后的恢复。采用T2液体衰减反转恢复(FLAIR)技术记录脊髓损伤。在低氧参数和贫血预测因素之间进行了单变量和多变量回归。采用体方差双样本t-统计图分析贫血组和对照组低氧反应的区域差异。与对照组相比，SCD和慢性贫血患者表现出显著更高的减饱和深度(P<；0.01)和更短的回归基线时间反应(P<；0.01)。与非梗死组相比，有脊髓损伤的患者在危险白质区域和正常白质区域的达峰时间(P<；0.01)、恢复到基线的时间(P<；0.01)和减饱和深度(P<；0.01)都较短。在多变量分析中，减饱和深度和时间随年龄、性别、血流、白细胞和无细胞血红蛋白的不同而不同(R2=0.25；R2=0.18；R2=0.18；R2=0.37)。短暂低氧显示贫血受试者和健康受试者的整体和局部反应不同。脊髓损伤与去饱和度动力学的广泛异质性有关，与广泛的潜在微血管重构相一致。
Obstructive sleep apnea and nocturnal oxygen desaturations, which are prevalent in sickle cell disease (SCD) and chronic anemia disorders, have been linked to risks of stroke and silent cerebral infarcts (SCI). Cerebrovascular response to intermittent desaturations has not been well studied and may identify patients at greatest risk. To investigate the cerebral dynamic response to induced desaturation in SCD patients with and without SCI, chronic anemia, and healthy subjects. Prospective. Twenty-six SCD patients (age = 21 ± 8.2, female 46.2%), including 15 subjects without SCI and nine subjects with SCI, 15 nonsickle anemic patients (age = 22 ± 5.8, female 66.7%), and 31 controls (age = 28 ± 12.3, female 77.4%). 3T, gradient-echo echo-planar imaging. A transient hypoxia challenge of five breaths of 100% nitrogen gas was performed with blood oxygen level-dependent (BOLD) MRI and near-infrared spectroscopy (NIRS) acquisitions. Hypoxia responses were characterized by desaturation depth, time-to-peak, return-to-baseline half-life, and posthypoxia recovery in the BOLD and NIRS time courses. SCI were documented by T2fluid-attenuation inversion recovery (FLAIR). Univariate and multivariate regressions were performed between hypoxic parameters and anemia predictors. Voxelwise two-sample t-statistic maps were used to assess the regional difference in hypoxic responses between anemic and control groups. Compared to controls, SCD and chronically anemic patients demonstrated significantly higher desaturation depth (P < 0.01) and shorter return-to-baseline timing response (P < 0.01). Patients having SCI had shorter time-to-peak (P < 0.01), return-to-baseline (P < 0.01), and larger desaturation depth (P < 0.01) in both white matter regions at risk and normal-appearing white matter than patients without infarcts. On multivariate analysis, desaturation depth and timing varied with age, sex, blood flow, white blood cells, and cell-free hemoglobin (r2 = 0.25 for desaturation depth; r2 = 0.18 for time-to-peak; r2 = 0.37 for return-to-baseline). Transient hypoxia revealed global and regional response differences between anemic and healthy subjects. SCI was associated with extensive heterogeneity of desaturation dynamics, consistent with extensive underlying microvascular remodeling.
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影响因子：
5.7
作者：
MacDonald, M. Ethan;Berman, Avery J. L.;Pike, G. Bruce
通讯作者：
Pike, G. Bruce
影响因子：
6.5
作者：
Kosinski, Przemyslaw D.;Croal, Paula L.;Kassner, Andrea
通讯作者：
Kassner, Andrea
影响因子：
2.6
作者：
Glover, Gary H.
通讯作者：
Glover, Gary H.
影响因子：
1.9
作者：
Poublanc J;Han JS;Mandell DM;Conklin J;Stainsby JA;Fisher JA;Mikulis DJ;Crawley AP
通讯作者：
Crawley AP
DOI：
10.1038/jcbfm.2011.153
发表时间：
2012-02
期刊：
Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism
影响因子：
--
作者：
Jespersen SN;Østergaard L
通讯作者：
Østergaard L