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急性局灶性脑缺血中的灌注与扩散成像:时间分辨率与空间分辨率

Perfusion and diffusion imaging in acute focal cerebral ischemia: temporal vs. spatial resolution.

作者信息

Bardutzky Juergen, Shen Qiang, Bouley James, Sotak Christopher H, Duong Timothy Q, Fisher Marc

机构信息

Department of Neurology, University of Massachusetts Medical School, Boston, MA 02125, USA.

出版信息

Brain Res. 2005 May 10;1043(1-2):155-62. doi: 10.1016/j.brainres.2005.02.073.


DOI:10.1016/j.brainres.2005.02.073
PMID:15862529
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2949952/
Abstract

High-resolution diffusion- (DWI) and perfusion-weighted (PWI) imaging may provide substantial benefits in accurate delineation of normal, ischemic, and at-risk tissue. We compared the capability of low (400 x 400 microm(2)) and high (200 x 200 microm(2)) spatial resolution imaging in characterizing the spatiotemporal evolution of the ischemic lesion in a permanent middle artery occlusion (MCAO) model in rats. Serial measurements of cerebral blood flow (CBF) and the apparent diffusion coefficient (ADC) were performed. Lesion volumes were calculated by using viability thresholds or by visual inspection, and correlated with infarct volume defined by TTC staining at 24 h after MCAO. At the very early phase of ischemia, high-resolution resulted in a significantly larger ADC-derived lesion volume and a smaller PWI/DWI mismatch. At 3 h after MCAO, ADC and CBF lesions showed similar robust correlations with TTC-defined infarct volumes for both groups using previously established thresholds. When lesions were determined visually, low-resolution resulted in a substantial overestimation of TTC-defined infarct volume and a lower inter-observer reliability (r = 0.75), whereas high-resolution produced an excellent correlation with TTC-defined infarct volume and inter-observer reliability (r = 0.96). In conclusion, high-resolution MRI resulted in substantial temporal averaging of the ischemic lesion during the early phase, but was clearly superior in visual determination of final infarct size. Low-resolution reasonably evaluated the temporal and spatial evolution of ischemia when thresholds were used.

摘要

高分辨率扩散加权成像(DWI)和灌注加权成像(PWI)在准确描绘正常组织、缺血组织和危险组织方面可能具有显著优势。我们比较了低空间分辨率(400×400微米²)和高空间分辨率(200×200微米²)成像在大鼠永久性大脑中动脉闭塞(MCAO)模型中表征缺血性病变时空演变的能力。进行了脑血流量(CBF)和表观扩散系数(ADC)的系列测量。通过使用存活阈值或目视检查计算病变体积,并将其与MCAO后24小时TTC染色定义的梗死体积相关联。在缺血的极早期,高分辨率导致ADC衍生的病变体积显著增大,PWI/DWI不匹配减小。MCAO后3小时,两组使用先前确定的阈值时,ADC和CBF病变与TTC定义的梗死体积均显示出相似的强相关性。当通过目视确定病变时,低分辨率导致TTC定义的梗死体积被大幅高估,观察者间可靠性较低(r = 0.75),而高分辨率与TTC定义的梗死体积和观察者间可靠性具有极佳的相关性(r = 0.96)。总之,高分辨率MRI在早期导致缺血性病变有显著的时间平均化,但在最终梗死大小的目视判定方面明显更优。当使用阈值时,低分辨率能合理评估缺血的时空演变。

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本文引用的文献

[1]
Neuroprotective effects of an immunosuppressant agent on diffusion/perfusion mismatch in transient focal ischemia.

Magn Reson Med. 2004-6

[2]
Volumetric evaluation of the ischemic lesion size with serial MRI in a transient MCAO model of the rat: comparison of DWI and T1WI.

Brain Res Brain Res Protoc. 2004-2

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Characterizing the diffusion/perfusion mismatch in experimental focal cerebral ischemia.

Ann Neurol. 2004-2

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J Cereb Blood Flow Metab. 2003-12

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Stroke. 2003-11

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In vivo neuroprotective effects of ACEA 1021 confirmed by magnetic resonance imaging in ischemic stroke.

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Stroke. 2002-10

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J Cereb Blood Flow Metab. 2002-3

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Neurology. 2001-12-11

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J Cereb Blood Flow Metab. 2001-4

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