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7-T 磁共振成像在后溶栓治疗脑卒中患者中的亚急性血管壁成像。

Subacute vessel wall imaging at 7-T MRI in post-thrombectomy stroke patients.

机构信息

Medical Imaging Department, Neuroradiology, Skåne University Hospital, 22185, Lund, Sweden.

Department of Clinical Sciences, Lund University, Lund, Sweden.

出版信息

Neuroradiology. 2019 Oct;61(10):1145-1153. doi: 10.1007/s00234-019-02242-9. Epub 2019 Jun 25.

Abstract

PURPOSE

Reports from 3-T vessel wall MRI imaging have shown contrast enhancement following thrombectomy for acute stroke, suggesting potential intimal damage. Comparisons have shown higher SNR and more lesions detected by vessel wall imaging when using 7 T compared with 3 T. The aim of this study was to investigate the vessel walls after stent retriever thrombectomy using high-resolution vessel wall imaging at 7 T.

METHODS

Seven patients with acute stroke caused by occlusion of the distal internal carotid artery (T-occlusion), or proximal medial cerebral artery, and treated by stent retriever thrombectomy with complete recanalization were included and examined by 7-T MRI within 2 days. The MRI protocol included a high-resolution black blood sequence with prospective motion correction (iMOCO), acquired before and after contrast injection. Flow measurements were performed in the treated and untreated M1 segments.

RESULTS

All subjects completed the MRI examination. Image quality was independently rated as excellent by two neuroradiologists for all cases, and the level of motion artifacts did not impair diagnostic quality, despite severe motion in some cases. Contrast enhancement correlated with the deployment location of the stent retrievers. Flow data showed complete restoration of flow after treatment.

CONCLUSION

Vessel wall imaging with prospective motion correction can be performed in patients following thrombectomy with excellent imaging quality at 7 T. We show that vessel wall contrast enhancement is the normal post-operative state and corresponds to the deployment location of the stent retriever.

摘要

目的

3T 血管壁 MRI 成像的报告显示,急性脑卒中取栓后出现对比增强,提示可能存在内膜损伤。与 3T 相比,7T 血管壁成像显示 SNR 更高,检测到的病变更多。本研究旨在探讨支架取栓术后血管壁的情况,采用 7T 高分辨率血管壁成像。

方法

纳入 7 例因颈内动脉远端(T 闭塞)或大脑中动脉近端闭塞导致急性脑卒中的患者,采用支架取栓术进行治疗,并在术后 2 天内行 7T MRI 检查。MRI 方案包括前瞻性运动校正的高分辨率黑血序列(iMOCO),在注射对比剂前后采集。在治疗和未治疗的 M1 段进行血流测量。

结果

所有患者均完成 MRI 检查。两位神经放射科医生对所有病例的图像质量均独立评为优秀,尽管在某些情况下运动较为剧烈,但运动伪影的程度并未影响诊断质量。对比增强与支架取栓器的部署位置相关。血流数据显示治疗后血流完全恢复。

结论

在支架取栓术后患者中,采用前瞻性运动校正的血管壁成像可以在 7T 上获得优异的成像质量。我们发现,血管壁对比增强是术后的正常状态,与支架取栓器的部署位置相对应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a7e2/6754352/3f348b052951/234_2019_2242_Fig1_HTML.jpg

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