Vidmar Jernej, Kralj Eduard, Bajd Franci, Serša Igor
Institute of Physiology, Medical Faculty, University of Ljubljana, Slovenia.
Jožef Stefan Institute, Ljubljana, Slovenia.
J Magn Reson Imaging. 2015 Aug;42(2):354-61. doi: 10.1002/jmri.24816. Epub 2014 Dec 3.
The structure of thrombi plays an important role in delaying reperfusion and re-occlusion after intravenous thrombolysis and could influence the performance of mechanical thrombectomy devices. This study aims to distinguish various thrombi groups based on their T2 and apparent diffusion coefficient (ADC) properties.
26 venous thrombi (VT), 28 acute (aPTE) and 18 chronic pulmonary thromboemboli (cPTE) and 18 sedimented clots (SC) were scanned by a three-dimensional T1 -weighted spin-echo sequence and by T2 and ADC mapping. Immunohistochemical analysis was used as a reference. Differences in the ADC, T2 and paired ADC-T2 distributions between the various thrombi group pairs were analyzed by standard statistics as well as by overlap integrals.
Paired ADC-T2 distribution enabled the most efficient discrimination of structural changes between pairs of thrombi. For thrombi pairs VT-cPTE, VT-SC, aPTE-cPTE, aPTE-SC, cPTE-SC differences were statistically significant (pADC , pT 2 , pADC-T 2 < 0.05) and the values of the overlap integrals were low (OIADC ≤ 0.505, OIT2 ≤ 0.823, OIADC-T2 ≤ 0.379). Least efficient was the structural discrimination for the VT-aPTE pair (pT 2 = 0.877, OIT2 = 0.940).
Multiparametric MRI is an efficient method for discriminating different thrombi groups at various stages of organization.
血栓结构在静脉溶栓后延迟再灌注和再闭塞过程中起着重要作用，并且可能影响机械取栓装置的性能。本研究旨在基于血栓的T2和表观扩散系数（ADC）特性区分不同的血栓组。
对26个静脉血栓（VT）、28个急性肺血栓栓塞（aPTE）、18个慢性肺血栓栓塞（cPTE）和18个沉积血块（SC）进行三维T1加权自旋回波序列扫描以及T2和ADC成像。免疫组织化学分析用作参考。通过标准统计学方法以及重叠积分分析不同血栓组对之间ADC、T2和配对ADC-T2分布的差异。
配对ADC-T2分布能够最有效地辨别血栓组对之间的结构变化。对于VT-cPTE、VT-SC、aPTE-cPTE、aPTE-SC、cPTE-SC血栓组对，差异具有统计学意义（pADC、pT2、pADC-T2<0.05），且重叠积分值较低（OIADC≤0.505，OIT2≤0.823，OIADC-T2≤0.379）。VT-aPTE组对的结构辨别效率最低（pT2=0.877，OIT2=0.940）。
多参数MRI是辨别不同组织阶段不同血栓组的有效方法。
