Department of Physiology and Experimental Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.
J Magn Reson Imaging. 2010 Nov;32(5):1068-75. doi: 10.1002/jmri.22230.
To demonstrate the feasibility and repeatability of cerebrovascular reactivity (CVR) imaging using a controlled CO(2) challenge in mechanically ventilated juvenile pigs.
Precise end-tidal partial pressure CO(2) (PETCO(2)) control was achieved via a computer-controlled model-driven prospective end-tidal targeting (MPET) system integrated with mechanical ventilation using a custom-built secondary breathing circuit. Test-retest blood-oxygen level dependent (BOLD) CVR images were collected in nine juvenile pigs by quantifying the BOLD response to iso-oxic square-wave PETCO(2) changes. For comparison, test-retest baseline arterial spin labeling (ASL) cerebral blood flow (CBF) images were collected. Repeatability was quantified using the intra-class correlation coefficient (ICC) and coefficient of variation (CV).
The repeatability of the PETCO(2) (CV < 2%) step changes resulted in BOLD CVR ICC > 0.94 and CV < 6% for cortical brain regions, which was similar to ASL CBF repeatability (ICC > 0.96 and CV < 4%).
This study demonstrates the feasibility and precision of CVR imaging with an MPET CO(2) challenge in mechanically ventilated subjects using an animal model. Translation of this method into clinical imaging protocols may enable CVR imaging in young children with cerebrovascular disease who require general anesthesia.
展示在机械通气的幼年猪中使用受控 CO2 挑战进行脑血管反应性 (CVR) 成像的可行性和可重复性。
通过与机械通气集成的计算机控制模型驱动的前瞻性呼气末靶向 (MPET) 系统,实现了精确的呼气末二氧化碳分压 (PETCO2) 控制,该系统使用定制的二级呼吸回路。通过量化对同氧方波 PETCO2 变化的血氧水平依赖性 (BOLD) CVR 反应,在 9 只幼年猪中采集了测试-再测试 BOLD CVR 图像。为了进行比较,采集了测试-再测试基线动脉自旋标记 (ASL) 脑血流 (CBF) 图像。使用组内相关系数 (ICC) 和变异系数 (CV) 来量化重复性。
PETCO2(CV<2%)阶跃变化的重复性导致 BOLD CVR ICC>0.94,皮质脑区的 CV<6%,这与 ASL CBF 重复性相似(ICC>0.96,CV<4%)。
本研究在机械通气的动物模型中展示了使用 MPET CO2 挑战进行 CVR 成像的可行性和精确性。将这种方法转化为临床成像方案,可能使需要全身麻醉的脑血管疾病的幼儿能够进行 CVR 成像。