Joint Department of Medical Imaging, Division of Neuroradiology, University Health Network, University of Toronto, 399 Bathurst St, 3MC-431, Toronto, ON, Canada M5T 2S8.
Radiology. 2013 Feb;266(2):592-8. doi: 10.1148/radiol.12112795. Epub 2012 Nov 30.
To evaluate the safety, tolerability, and technical feasibility of mapping cerebrovascular reactivity (CVR) in a clinical population by using a precise prospectively targeted CO(2) stimulus and blood oxygen level-dependent (BOLD) magnetic resonance (MR) imaging.
A chart review was performed of all CVR studies from institutional review board-approved projects at a tertiary care hospital between January 1, 2006, and December 1, 2010. Informed consent was obtained. Records were searched for the incidence of adverse events and failed examinations. CVR maps were evaluated for diagnostic quality by two blinded observers and were categorized as good, diagnostic but suboptimal, or nondiagnostic. Outcomes were presented as raw data and descriptive statistics (means ± standard deviations). Intraclass correlation coefficient was used to determine interobserver variability.
Four hundred thirty-four consecutive CVR examinations from 294 patients (51.8% female patients) were studied. Patient age ranged from 9 to 88 years (mean age, 45.9 years ± 20.6). Transient symptoms, such as shortness of breath, headache, and dizziness, were reported in 48 subjects (11.1% of studies) during hypercapnic phases only. There were no neurologic ischemic events, myocardial infarctions, or other major complications. The success rate in generating CVR maps was 83.9% (364 of 434). Of the 70 (16.1%) failed examinations, 25 (35.7%) were due to discomfort; eight (11.4%), to head motion; two (2.9%), to inability to cooperate; seven (10.0%), to technical difficulties with equipment; and 28 (40.0%), to unknown or unspecified conditions. Among the 364 remaining successful examinations, good quality CVR maps were obtained in 340 (93.4%); diagnostic but suboptimal, in 12 (3.3%); and nondiagnostic, in 12 (3.3%).
CVR mapping by using a prospectively targeted CO(2) stimulus and BOLD MR imaging is safe, well tolerated, and technically feasible in a clinical patient population.
通过使用精确的前瞻性靶向 CO2 刺激和血氧水平依赖（BOLD）磁共振成像来评估在临床人群中测量脑血管反应性（CVR）的安全性、耐受性和技术可行性。
对 2006 年 1 月 1 日至 2010 年 12 月 1 日在一家三级保健医院进行的经机构审查委员会批准的所有 CVR 研究进行图表审查。获得了知情同意。记录中搜索了不良事件和检查失败的发生率。两名盲法观察者评估 CVR 图的诊断质量，并将其分为良好、诊断但不理想或无诊断。结果以原始数据和描述性统计数据（平均值±标准差）表示。采用组内相关系数确定观察者间的变异性。
研究了 294 例患者的 434 次连续 CVR 检查（51.8%为女性患者）。患者年龄 9 至 88 岁（平均年龄，45.9 岁±20.6 岁）。仅在高碳酸血症期，48 例（11.1%的研究）患者报告出现短暂性症状，如呼吸急促、头痛和头晕。无神经缺血性事件、心肌梗死或其他重大并发症。生成 CVR 图的成功率为 83.9%（364/434）。在 70 次（16.1%）失败的检查中，25 次（35.7%）是由于不适；8 次（11.4%）是由于头部运动；2 次（2.9%）是由于无法合作；7 次（10.0%）是由于设备技术困难；28 次（40.0%）是由于未知或未指定的情况。在其余 364 次成功的检查中，获得了 340 次（93.4%）质量良好的 CVR 图；12 次（3.3%）为诊断但不理想；12 次（3.3%）为无诊断。
通过使用前瞻性靶向 CO2 刺激和 BOLD 磁共振成像进行 CVR 映射，在临床患者人群中是安全的、耐受良好的，并且在技术上是可行的。
