Section on Experimental Radiology, University Hospital of Tübingen, Tübingen, Germany.
Department of High-field Magnetic Resonance, Max Planck Institute for Biological Cybernetics, Tübingen, Germany.
Z Med Phys. 2019 May;29(2):173-183. doi: 10.1016/j.zemedi.2018.08.004. Epub 2018 Sep 25.
To investigate the capabilities of a modern pseudo-continuous arterial spin labeling (PCASL) technique for non-invasive assessment of the temporal and spatial distribution of the liver perfusion in healthy volunteers on a clinical MR system at 3T.
A 2D-PCASL multi-slice echo planar imaging sequence was adapted to the specific conditions in liver: a) labeling by PCASL was optimized to the flow characteristics in the portal vein, b) background suppression was applied for reduction of motion related artifacts, c) post labeling delays (PLDs) were varied over a large range (0.7-3.5s) in order to get better insight in the temporal and spatial distribution of tagged blood in the liver, and d) a special timed-breathing protocol was used allowing for recording of 16 to 18 label-control image pairs and a reference M0 image for each of 4 to 6 slices within approx. 5min for one PLD.
Measurements with multiple PLDs showed dominating perfusion signal in macroscopic blood vessels for PLDs up to 1.5 s, whereas pure liver parenchyma revealed maximum perfusion signal for a PLD of approx. 2 s, and detectable signal up to PLDs of 3.5 s. Data fitting to a perfusion model for liver provided a mean global perfusion of 153±15ml/100g/min and a mean transit time of 1938±332ms in liver parenchyma. Measurements with a single PLD of 2 s demonstrated that portal-venous and arterial perfusion components can be measured separately by two measurements with two different positions of the labeling plane (one for labeling of the global hepatopetal blood flow and one for selective labeling of the portal blood flow only). Relative contribution of blood from the hepatic artery to the global liver perfusion, the hepatic perfusion index (HPI), amounted to approx. 23%.
Modern and adapted protocols for assessment of liver perfusion by PCASL have the potential to provide perfusion and blood transit time maps in reasonable acquisition time.
研究一种现代的伪连续动脉自旋标记(PCASL)技术,在 3T 临床磁共振系统上对健康志愿者的肝脏灌注的时间和空间分布进行非侵入性评估。
将 2D-PCASL 多层平面回波成像序列适用于肝脏的具体情况:a)通过 PCASL 对门静脉中的血流特征进行优化,b)应用背景抑制以减少运动相关伪影,c)在较大范围内改变后标记延迟(PLD)(0.7-3.5s),以便更好地了解肝脏中标记血液的时间和空间分布,d)使用特殊的定时呼吸协议,允许在每个 PLD 下为每个 4-6 个切片记录 16 到 18 个标记-对照图像对和一个参考 M0 图像,对于一个 PLD,大约需要 5 分钟。
使用多个 PLD 的测量结果表明,在 1.5s 以内的 PLD 时,宏观血管中存在主要的灌注信号,而纯肝实质在约 2s 的 PLD 时显示出最大的灌注信号,并且在 3.5s 的 PLD 时仍可检测到信号。对肝脏灌注模型进行数据拟合提供了肝脏的平均整体灌注为 153±15ml/100g/min,肝实质的平均通过时间为 1938±332ms。使用 2s 的单个 PLD 的测量结果表明,门静脉和动脉灌注成分可以通过两个标记平面位置的两个不同测量来分别测量(一个用于标记整体肝向血流,一个用于仅选择性标记门静脉血流)。肝动脉对整体肝脏灌注的贡献相对较大,即肝灌注指数(HPI)约为 23%。
通过 PCASL 评估肝脏灌注的现代和适应性方案有可能在合理的采集时间内提供灌注和血液通过时间图。