Zhang Shui-Xia, Yao Yi-Hao, Zhang Shun, Zhu Wen-Jie, Tang Xiang-Yu, Qin Yuan-Yuan, Zhao Ling-Yun, Liu Cheng-Xia, Zhu Wen-Zhen
Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
J Huazhong Univ Sci Technolog Med Sci. 2015 Dec;35(6):923-927. doi: 10.1007/s11596-015-1529-8. Epub 2015 Dec 16.
The purpose of this study was to quantitatively analyze the relationship between three dimensional arterial spin labeling (3D-ASL) and dynamic susceptibility contrast-enhanced perfusion weighted imaging (DSC-PWI) in ischemic stroke patients. Thirty patients with ischemic stroke were included in this study. All subjects underwent routine magnetic resonance imaging scanning, diffusion weighted imaging (DWI), magnetic resonance angiography (MRA), 3D-ASL and DSC-PWI on a 3.0T MR scanner. Regions of interest (ROIs) were drawn on the cerebral blood flow (CBF) maps (derived from ASL) and multi-parametric DSC perfusion maps, and then, the absolute and relative values of ASL-CBF, DSC-derived CBF, and DSC-derived mean transit time (MTT) were calculated. The relationships between ASL and DSC parameters were analyzed using Pearson's correlation analysis. Receiver operative characteristic (ROC) curves were performed to define the thresholds of relative value of ASL-CBF (rASL) that could best predict DSC-CBF reduction and MTT prolongation. Relative ASL better correlated with CBF and MTT in the anterior circulation with the Pearson correlation coefficients (R) values being 0.611 (P<0.001) and-0.610 (P<0.001) respectively. ROC curves demonstrated that when rASL ≤0.585, the sensitivity, specificity and accuracy for predicting ROIs with rCBF<0.9 were 92.3%, 63.6% and 76.6% respectively. When rASL ≤0.952, the sensitivity, specificity and accuracy for predicting ROIs rMTT>1.0 were 75.7%, 89.2% and 87.8% respectively. ASL-CBF map has better linear correlations with DSC-derived parameters (DSC-CBF and MTT) in anterior circulation in ischemic stroke patients. Additionally, when rASL is lower than 0.585, it could predict DSC-CBF decrease with moderate accuracy. If rASL values range from 0.585 to 0.952, we just speculate the prolonged MTT.
本研究的目的是定量分析缺血性脑卒中患者三维动脉自旋标记（3D-ASL）与动态磁敏感对比增强灌注加权成像（DSC-PWI）之间的关系。本研究纳入了30例缺血性脑卒中患者。所有受试者均在3.0T磁共振成像扫描仪上接受常规磁共振成像扫描、弥散加权成像（DWI）、磁共振血管造影（MRA）、3D-ASL和DSC-PWI检查。在脑血流量（CBF）图（源自ASL）和多参数DSC灌注图上绘制感兴趣区（ROI），然后计算ASL-CBF、DSC衍生的CBF和DSC衍生的平均通过时间（MTT）的绝对值和相对值。使用Pearson相关分析来分析ASL和DSC参数之间的关系。绘制受试者操作特征（ROC）曲线以确定能最佳预测DSC-CBF降低和MTT延长的ASL-CBF相对值（rASL）阈值。相对ASL在前循环中与CBF和MTT的相关性更好，Pearson相关系数（R）值分别为0.611（P<0.001）和-0.610（P<0.001）。ROC曲线表明，当rASL≤0.585时，预测rCBF<0.9的ROI的灵敏度、特异度和准确度分别为92.3%、63.6%和76.6%。当rASL≤0.952时，预测ROI的rMTT>1.0的灵敏度、特异度和准确度分别为75.7%、89.2%和87.8%。在缺血性脑卒中患者的前循环中，ASL-CBF图与DSC衍生参数（DSC-CBF和MTT）具有更好的线性相关性。此外，当rASL低于0.585时，它可以以中等准确度预测DSC-CBF降低。如果rASL值在0.585至0.952之间，我们只能推测MTT延长。
