1 Department of Radiology, Renji Hospital, China.
2 Department of Radiology, Renji Hospital South Campus, China.
Cell Transplant. 2019 Aug;28(8):1062-1070. doi: 10.1177/0963689719856290. Epub 2019 Jun 14.
Intravoxel incoherent motion has received extensive attention in brain studies for its potential as a non-invasive magnetic resonance perfusion method. However, studies on intravoxel incoherent motion imaging and crossed cerebellar diaschisis detection are relatively scarce. The aim of our study was to evaluate the feasibility of using intravoxel incoherent motion imaging in crossed cerebellar diaschisis diagnosis in subacute ischemic stroke patients by comparing results from intravoxel incoherent motion imaging, single-photon emission computed tomography, and arterial spin-labeling perfusion methods. In total, 39 patients with subacute ischemic stroke who underwent intravoxel incoherent motion, arterial spin-labeling, and single-photon emission computed tomography scanning were enrolled. Intravoxel incoherent motion-derived perfusion-related parameters including fast diffusion coefficient, vascular volume fraction, arterial spin-labeling-derived cerebral blood flow as well as single-photon emission computed tomography-derived cerebral blood flow of bilateral cerebellum were measured. A crossed cerebellar diaschisis-positive result was considered present with an asymmetry index ≥10% of single-photon emission computed tomography. In the crossed cerebellar diaschisis-positive group, fast diffusion coefficient, arterial spin-labeling-derived cerebral blood flow, and computed tomography-derived cerebral blood flow of the contralateral cerebellum decreased compared with those of the ipsilesional cerebellum; whereas vascular volume fraction significantly increased. The National Institutes of Health Stroke Scale score and infarct volume in the crossed cerebellar diaschisis-positive group were significantly higher than those in the crossed cerebellar diaschisis-negative group. A positive correlation was detected between the fast diffusion coefficient-based asymmetry index and the single-photon emission computed tomography-based asymmetry index, fast diffusion coefficient-based asymmetry, and arterial spin-labeling based asymmetry index; whereas the vascular volume fractionbased asymmetry index value had a negative correlation with the single-photon emission computed tomography-based asymmetry index and arterial spin-labeling based asymmetry index. Furthermore, the area under the receiver operating characteristic curve value of the arterial spin-labeling-based asymmetry index was 0.923. The fast diffusion coefficient derived from the intravoxel incoherent motion could be valuable for the assessment of crossed cerebellar diaschisis in supratentorial stroke patients.
磁共振体素内不相干运动扩散加权成像技术在脑科学研究中受到广泛关注，有望成为一种非侵入性磁共振灌注方法。然而，关于磁共振体素内不相干运动扩散加权成像技术在交叉性小脑失联络检测中的研究相对较少。本研究旨在通过比较磁共振体素内不相干运动扩散加权成像、单光子发射计算机断层扫描和动脉自旋标记灌注方法的结果，评估磁共振体素内不相干运动扩散加权成像技术在亚急性缺血性脑卒中患者交叉性小脑失联络诊断中的可行性。共纳入 39 例接受磁共振体素内不相干运动扩散加权成像、动脉自旋标记和单光子发射计算机断层扫描检查的亚急性缺血性脑卒中患者。测量磁共振体素内不相干运动扩散加权成像衍生的灌注相关参数，包括快扩散系数、血管容积分数、动脉自旋标记衍生的脑血流量和单光子发射计算机断层扫描衍生的双侧小脑脑血流量。采用单光子发射计算机断层扫描计算的不对称指数≥10%判断交叉性小脑失联络阳性。在交叉性小脑失联络阳性组中，对侧小脑的快扩散系数、动脉自旋标记衍生的脑血流量和单光子发射计算机断层扫描衍生的脑血流量较同侧小脑降低，而血管容积分数显著升高。交叉性小脑失联络阳性组的美国国立卫生研究院卒中量表评分和梗死体积显著高于交叉性小脑失联络阴性组。快扩散系数不对称指数与单光子发射计算机断层扫描不对称指数、快扩散系数不对称指数和动脉自旋标记衍生的脑血流量不对称指数之间存在正相关，而血管容积分数不对称指数与单光子发射计算机断层扫描不对称指数和动脉自旋标记衍生的脑血流量不对称指数之间存在负相关。此外，动脉自旋标记衍生的脑血流量不对称指数的受试者工作特征曲线下面积值为 0.923。磁共振体素内不相干运动衍生的快扩散系数可用于评估幕上脑卒中患者的交叉性小脑失联络。
