Department of Neurosurgery, Ichinomiyanishi Hospital, Kaimei, Ichinomiya, 494-0001, Japan.
Eur Radiol. 2012 Nov;22(11):2382-91. doi: 10.1007/s00330-012-2511-5. Epub 2012 Jun 1.
To detect symptomatic hemispheres during the postoperative course of subarachnoid haemorrhage (SAH) using arterial spin labelling (ASL).
Eighteen patients with aneurysmal SAH were included; four exhibited symptomatic vasospasm postoperatively. All patients underwent ASL on days 9-10 (single time-point ASL). Nine patients underwent serial measurements of ASL (serial ASL) on days 1-2, 9-10 and 13-21, and seven patients also underwent imaging on days 4-7. CBF in the posterior part of the MCA territory was measured, and the ipsilateral/contralateral ratio of CBF was calculated. Differences between symptomatic hemispheres and others underwent ROC analysis.
Single time-point ASL revealed that CBF(day9-10) and CBF(i/c_day9-10) were significantly lower in symptomatic hemispheres than in asymptomatic hemispheres (P < 0.001). Serial ASL was significantly decreased on CBF(day4-7) compared with CBF(day1-2) and on CBF(day9-10) compared with CBF(day4-7), and significantly increased on CBF(day13-21) compared with CBF(day9-10). ROC analysis of single time-point ASL revealed that AUC for CBF(day9-10) was 0.95, significantly higher than CBF(i/c_day9-10) (P < 0.001). ROC analysis of serial ASL showed that AUC for CBF(day9-10) was 0.93 and significantly higher than CBF(day9-10/day1-2) and CBF(i/c_day9-10) (P < 0.001).
Single time-point ASL revealed significant CBF reduction in symptomatic hemispheres compared with asymptomatic hemispheres. Serial ASL showed time-dependent CBF changes after SAH.
• MR arterial spin labelling (ASL) can non-invasively assess cerebral blood flow (CBF) • ASL revealed significant CBF reduction in symptomatic hemispheres compared with asymptomatic hemispheres • Serial ASL measurements enable observation of time-dependent CBF changes after SAH • ASL is non- invasive and suitable for serial repeated examinations.
使用动脉自旋标记（ASL）检测蛛网膜下腔出血（SAH）术后的症状性半球。
纳入 18 例动脉瘤性 SAH 患者，其中 4 例术后出现症状性血管痉挛。所有患者均于第 9-10 天进行 ASL（单次 ASL）检查。9 例患者于第 1-2、9-10 和 13-21 天进行 ASL 连续测量，7 例患者于第 4-7 天进行影像学检查。测量 MCA 后部分脑血流量（CBF），计算 CBF 同侧/对侧比值。对症状性半球和其他半球之间的差异进行 ROC 分析。
单次 ASL 显示，症状性半球的 CBF（第 9-10 天）和 CBF（i/c_第 9-10 天）均明显低于无症状半球（P<0.001）。与第 1-2 天相比，第 4-7 天的 CBF（第 4-7 天）明显降低，与第 4-7 天相比，第 9-10 天的 CBF（第 9-10 天）明显降低，与第 9-10 天相比，第 13-21 天的 CBF（第 13-21 天）明显升高。单次 ASL 的 ROC 分析显示，CBF（第 9-10 天）的 AUC 为 0.95，明显高于 CBF（i/c_第 9-10 天）（P<0.001）。连续 ASL 的 ROC 分析显示，CBF（第 9-10 天）的 AUC 为 0.93，明显高于 CBF（第 9-10 天/第 1-2 天）和 CBF（i/c_第 9-10 天）（P<0.001）。
单次 ASL 显示症状性半球与无症状半球相比 CBF 明显降低。连续 ASL 显示 SAH 后 CBF 呈时间依赖性变化。
• MR 动脉自旋标记（ASL）可无创评估脑血流量（CBF）
• ASL 显示症状性半球与无症状半球相比 CBF 明显降低
• 连续 ASL 测量可观察 SAH 后 CBF 的时间依赖性变化
• ASL 无创，适合连续重复检查。
