Lee Han-Jui, Hong Jia-Sheng, Lin Chung-Jung, Kao Yi-Hsuan, Chang Feng-Chi, Luo Chao-Bao, Chu Wei-Fa
Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
PLoS One. 2017 Sep 26;12(9):e0185330. doi: 10.1371/journal.pone.0185330. eCollection 2017.
Current time-density curve analysis of digital subtraction angiography (DSA) provides intravascular flow information but requires manual vasculature selection. We developed an angiographic marker that represents cerebral perfusion by using automatic independent component analysis.
We retrospectively analyzed the data of 44 patients with unilateral carotid stenosis higher than 70% according to North American Symptomatic Carotid Endarterectomy Trial criteria. For all patients, magnetic resonance perfusion (MRP) was performed one day before DSA. Fixed contrast injection protocols and DSA acquisition parameters were used before stenting. The cerebral circulation time (CCT) was defined as the difference in the time to peak between the parietal vein and cavernous internal carotid artery in a lateral angiogram. Both anterior-posterior and lateral DSA views were processed using independent component analysis, and the capillary angiogram was extracted automatically. The full width at half maximum of the time-density curve in the capillary phase in the anterior-posterior and lateral DSA views was defined as the angiographic mean transient time (aMTT; i.e., aMTTAP and aMTTLat). The correlations between the degree of stenosis, CCT, aMTTAP and aMTTLat, and MRP parameters were evaluated.
The degree of stenosis showed no correlation with CCT, aMTTAP, aMTTLat, or any MRP parameter. CCT showed a strong correlation with aMTTAP (r = 0.67) and aMTTLat (r = 0.72). Among the MRP parameters, CCT showed only a moderate correlation with MTT (r = 0.67) and Tmax (r = 0.40). aMTTAP showed a moderate correlation with Tmax (r = 0.42) and a strong correlation with MTT (r = 0.77). aMTTLat also showed similar correlations with Tmax (r = 0.59) and MTT (r = 0.73).
Apart from vascular anatomy, aMTT estimates brain parenchyma hemodynamics from DSA and is concordant with MRP. This process is completely automatic and provides immediate measurement of quantitative peritherapeutic brain parenchyma changes during stenting.
目前数字减影血管造影（DSA）的时间密度曲线分析可提供血管内血流信息，但需要手动选择血管。我们通过使用自动独立成分分析开发了一种代表脑灌注的血管造影标记物。
我们根据北美症状性颈动脉内膜切除术试验标准，回顾性分析了44例单侧颈动脉狭窄高于70%患者的数据。对所有患者在DSA前一天进行磁共振灌注（MRP）检查。在支架置入前使用固定的造影剂注射方案和DSA采集参数。脑循环时间（CCT）定义为侧位血管造影中顶叶静脉与海绵窦段颈内动脉之间的峰值时间差。前后位和侧位DSA图像均使用独立成分分析进行处理，并自动提取毛细血管造影图像。前后位和侧位DSA图像中毛细血管期时间密度曲线的半高全宽定义为血管造影平均通过时间（aMTT；即aMTTAP和aMTTLat）。评估狭窄程度、CCT、aMTTAP和aMTTLat与MRP参数之间的相关性。
狭窄程度与CCT、aMTTAP、aMTTLat或任何MRP参数均无相关性。CCT与aMTTAP（r = 0.67）和aMTTLat（r = 0.72）呈强相关性。在MRP参数中，CCT仅与MTT（r = 0.67）和Tmax（r = 0.40）呈中度相关性。aMTTAP与Tmax（r = 0.42）呈中度相关性，与MTT（r = 0.77）呈强相关性。aMTTLat与Tmax（r = 0.59）和MTT（r = 0.73）也呈相似的相关性。
除血管解剖结构外，aMTT可从DSA估计脑实质血流动力学，且与MRP结果一致。该过程完全自动化，并可在支架置入期间即时测量治疗期间脑实质的定量变化。
