应用 T 弛豫时间（T ρ）和表观扩散系数来评估脑卒中风演变。
Use of T relaxation time in rotating frame (T ρ) and apparent diffusion coefficient to estimate cerebral stroke evolution.
机构信息
Department of Medical Imaging Center, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
出版信息
J Magn Reson Imaging. 2018 Nov;48(5):1247-1254. doi: 10.1002/jmri.25971. Epub 2018 Feb 15.
BACKGROUND
The major factor for the appropriate treatment strategies for ischemia patients is its onset timing.
PURPOSE/HYPOTHESIS: To study to evaluate the diagnostic accuracy of T relaxation time in a rotating frame (T ρ) and apparent diffusion coefficient (ADC) from MRI to estimate ischemia stages.
STUDY TYPE
Prospective.
POPULATION/SUBJECTS/PHANTOM/SPECIMEN/ANIMAL MODEL: In all, 73 patients (49 males, aged 29-78 years and 24 females, aged 22-94 years) with ischemia were prospectively imaged with T ρ and diffusion MRI during the postischemic period.
FIELD STRENGTH/SEQUENCE: 3T/T ρ and diffusion-weighted imaging (DWI).
ASSESSMENT
Ischemic parenchyma included tissue with elevated signal areas on DWI and correlative hypointense areas on ADC maps.
STATISTICAL TESTS
The sensitivity of variables to ischemia time was quantified by analyzing the respective correlations of these values with onset time.
RESULTS
ΔT ρ (ipsilateral-contralateral differences in T ρ) (R = 0.956) and T ρ (ipsilateral ischemia T ρ values) (R = 0.941) were elevated in all ischemic lesions; these values increased linearly as a function of time, unlike ΔADC (ipsilateral-contralateral differences in ADC) (R = -0.410) and ADC (ipsilateral ischemia ADC values) (R = 0.550). ΔT ρ and T ρ were significantly different between all stages (P < 0.01), except the acute and hyperacute stages (P = 0.589 for ΔT ρ, P = 0.290 for T ρ , respectively), but ΔADC and ADC only between the late subacute and early subacute stages (P < 0.01) and the late subacute and chronic stages (P < 0.01).
DATA CONCLUSION
These data suggest that T ρ can provide estimates for the ischemic time in patients. T ρ has the potential to outperform diffusion for single-timepoint examination because the T ρ change during strokes is positive and linear. If patients with suspected stroke are scanned by MRI within the appropriate timeframe, T ρ may provide tools for evaluating stroke onset, potentially aiding in treatment strategies.
LEVEL OF EVIDENCE
4 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2018;47:1247-1254.
背景
缺血患者的适当治疗策略的主要因素是其发病时间。
目的/假设：研究评估 MRI 中的 T 弛豫时间（T ρ）和表观扩散系数（ADC）在估计缺血阶段方面的诊断准确性。
研究类型
前瞻性。
人群/受试者/模型：共对 73 例（49 名男性，年龄 29-78 岁；24 名女性，年龄 22-94 岁）缺血患者进行前瞻性成像，在缺血后期间进行 T ρ和弥散 MRI。
磁场强度/序列：3T/T ρ和弥散加权成像（DWI）。
评估
缺血组织包括 DWI 上信号升高的区域和 ADC 图上相关的低信号区域。
统计检验
通过分析这些值与发病时间的相关性，定量变量对缺血时间的敏感性。
结果
所有缺血性病变中 T ρ（同侧-对侧 T ρ差异）（R = 0.956）和 T ρ（同侧缺血 T ρ值）（R = 0.941）升高；这些值随时间呈线性增加，而 ΔADC（同侧-对侧 ADC 差异）（R = -0.410）和 ADC（同侧缺血 ADC 值）（R = 0.550）则不然。ΔT ρ和 T ρ在所有阶段均有显著差异（P < 0.01），但急性和超急性阶段除外（ΔT ρ为 P = 0.589，T ρ为 P = 0.290），但 ΔADC 和 ADC 仅在晚期亚急性期和早期亚急性期之间以及晚期亚急性期和慢性期之间有显著差异（P < 0.01）。
数据结论
这些数据表明，T ρ可以为患者的缺血时间提供估计值。T ρ 有可能比弥散更适合单次检查，因为中风期间 T ρ 的变化是阳性和线性的。如果怀疑中风的患者在适当的时间窗内接受 MRI 扫描，T ρ 可能为评估中风发作提供工具，从而有可能辅助治疗策略。
证据水平
4 技术功效：3 级 J. Magn. Reson. Imaging 2018;47:1247-1254.
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