Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Korea.
Eur Radiol. 2018 Nov;28(11):4890-4899. doi: 10.1007/s00330-018-5468-1. Epub 2018 May 22.
To explore the feasibility of using correlation-based time-delay (CTD) maps produced from time-resolved MR angiography (TRMRA) to diagnose perfusion abnormalities in patients suspected to have steno-occlusive lesions in the craniocervical arteries.
Twenty-seven patients who were suspected to have steno-occlusive lesions in the craniocervical arteries underwent both TRMRA and brain single-photon emission computed tomography (SPECT). TRMRA was performed on the supra-aortic area after intravenous injection of a 0.03 mmol/kg gadolinium-based contrast agent. Time-to-peak (TTP) maps and CTD maps of the brain were automatically generated from TRMRA data, and their quality was assessed. Detection of perfusion abnormalities was compared between CTD maps and the time-series maximal intensity projection (MIP) images from TRMRA and TTP maps. Correlation coefficients between quantitative changes in SPECT and parametric maps for the abnormal perfusion areas were calculated.
The CTD maps were of significantly superior quality than TTP maps (p < 0.01). For perfusion abnormality detection, CTD maps (kappa 0.84, 95% confidence interval [CI] 0.67-1.00) showed better agreement with SPECT than TTP maps (0.66, 0.46-0.85). For perfusion deficit detection, CTD maps showed higher accuracy (85.2%, 95% CI 66.3-95.8) than MIP images (66.7%, 46-83.5), with marginal significance (p = 0.07). In abnormal perfusion areas, correlation coefficients between SPECT and CTD (r = 0.74, 95% CI 0.34-0.91) were higher than those between SPECT and TTP (r = 0.66, 0.20-0.88).
CTD maps generated from TRMRA were of high quality and offered good diagnostic performance for detecting perfusion abnormalities associated with steno-occlusive arterial lesions in the craniocervical area.
• Generation of perfusion parametric maps from time-resolved MR angiography is clinically useful. • Correlation-based delay maps can be used to detect perfusion abnormalities associated with steno-occlusive craniocervical arteries. • Estimation of correlation-based delay is robust for low signal-to-noise 4D MR data.
探讨基于相关的时滞（CTD）图在诊断颅颈动脉狭窄性闭塞病变患者灌注异常中的应用价值。
对 27 例疑有颅颈动脉狭窄性闭塞病变的患者进行了磁共振血管造影（TRMRA）和脑单光子发射计算机断层扫描（SPECT）检查。TRMRA 采用静脉注射 0.03mmol/kg 钆对比剂后对主动脉以上区域进行。从 TRMRA 数据中自动生成 TTP 图和 CTD 图，并对其质量进行评估。比较 CTD 图与 TRMRA 的时间序列最大强度投影（MIP）图像和 TTP 图在检测灌注异常方面的差异。计算 SPECT 定量变化与异常灌注区参数图之间的相关系数。
CTD 图的质量明显优于 TTP 图（p<0.01）。在检测灌注异常方面，CTD 图（kappa 0.84，95%置信区间 [CI] 0.67-1.00）与 SPECT 的一致性优于 TTP 图（0.66，0.46-0.85）。在检测灌注缺损方面，CTD 图的准确率（85.2%，95%CI 66.3-95.8）高于 MIP 图像（66.7%，46-83.5），但差异无统计学意义（p=0.07）。在异常灌注区，SPECT 与 CTD 的相关系数（r=0.74，95%CI 0.34-0.91）高于 SPECT 与 TTP 的相关系数（r=0.66，0.20-0.88）。
TRMRA 生成的 CTD 图质量高，对诊断颅颈区狭窄性闭塞性动脉病变相关的灌注异常具有良好的诊断性能。
从时间分辨磁共振血管造影生成灌注参数图在临床上很有用。
基于相关的时滞图可用于检测与颅颈狭窄性闭塞性动脉病变相关的灌注异常。
对低信噪比的 4D MR 数据进行基于相关的时滞估计是稳健的。
