FUNCTIONAL MRI OF REGIONAL CEREBRAL BLOOD CHANGES DURING BREATH HOLDING

屏气期间脑部血液变化的功能性 MRI

• 批准号: 6123019
• 负责人: ANDREAS KASTRUP
• 金额: $ 3.49万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1999
• 资助国家: 美国
• 起止时间: 1999-01-01 至 2000-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6123019
• 关键词: bioimaging /biomedical imaging; biomedical resource; magnetic resonance imaging; radiology

Introduction: Diffusion- and perfusion-weighted MRI (DWI and PWI) provides unique diagnostic information not available from neurological or CT assessments. To implement these new methodologies in the clinical setting, a 20-minute DWI/PWI protocol has been used to evaluate these new MR methodologies for the diagnostic advantages and predictive value they bring to the management of clinical stroke and to longitudinally monitor the progression of ischemia to infarction. Methods: Patients presenting with new neurologic symptoms within 6 hours of onset were studied over the past 8 months. These patients were imaged at presentation following neurological and CT exams and again at 3-6 hours, 9-12 hours, 36-48 hours and finally at 30 days. Cases were excluded if the time of onset was not clearly established. Because the time of ischemic onset within the first few hours is often difficult to determine accurately, eight patients were included in this study. An in-patient GE Signa Horizon (gradient strengths 22 mT/m) was used for all studies. Results: The ASE-EPI sequence was chosen over corresponding SE-EPI and the GRE-EPI options as the best balance between susceptibility sensitivity (FR2*) and background image artifacts at a single-dose injection. All patients showed regional DW hyperintensity in anatomic locations appropriate to the clinical symptoms. ADC values were lower than normal at acute timepoints and elevated above normal beyond 10 days, in agreement with earlier studies. Depiction of the acute ischemic lesions from normal brain or pre-exiting chronic lesions was significantly improved using the IR-ADC maps over the conventional ADC maps. The DW and IR-ADC maps were superior over the conventional and FLAIR T2-wt images in depiction of hyperacute lesions and the differentiation of acute from chronic lesions. Averaged ("trace") ADC maps were superior in lesion conspicuity to the anisotropic ADC maps for all lesions. The PWI exam was superior to the DWI and T2 exams in the depiction of hyperacute events. Conclusions: DWI/PWI protocols provide rapid identification of the extent, location, and circulation of the relevant lesion(s) and the underlying hemodynamic behaviors responsible for the clinical symptoms.

引言：弥散和灌注加权MRI（DWI和PWI） 提供了神经系统无法提供的独特诊断信息 或CT评估。 为了在 在临床环境中，20分钟DWI/PWI方案已用于 评估这些新的MR方法的诊断优势， 它们为临床卒中管理带来的预测价值， 以纵向监测局部缺血到梗塞的进展。 方法：在6周内出现新的神经系统症状的患者 在过去的8个月里，研究了发病时间。 这些患者 在神经系统和CT检查后进行成像， 再次在3-6小时、9-12小时、3 - 6 -48小时以及最后在30天进行。 如果发病时间不明确，则排除病例。 因为缺血发作的最初几个小时内， 难以准确确定，8名患者被纳入 本研究 住院患者GE Signa Horizon（梯度强度22 mT/m）用于所有研究。 结果：ASE-EPI序列为 在相应的SE-EPI和GRE-EPI选项中选择为最佳 磁化率灵敏度（FR 2 *）和背景图像之间的平衡 单剂量注射时的伪影。 所有患者均显示区域性DW 在适合于临床的解剖位置的高信号 症状 在急性时间点，ADC值低于正常值， 高于正常水平超过10天，与早期一致 问题研究 正常脑组织急性缺血性病变的描述 预先存在的慢性病变显着改善使用 IR-ADC图优于常规ADC图。 DW和IR-ADC图 上级常规和FLAIR T2-wt图像， 超急性病变的描述和急性与 慢性病变 病变的平均（“迹线”）ADC图为上级 所有病变的各向异性ADC图的显著性。 PWI考试 在显示超急性期病灶方面上级DWI和T2检查 事件 结论：DWI/PWI方案提供快速识别 相关病变的范围、位置和循环，以及 导致临床症状的潜在血流动力学行为 症状