Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Song pa-gu, Seoul, 138-736, South Korea.
Department of Neurology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Eur Radiol. 2020 Jan;30(1):346-356. doi: 10.1007/s00330-019-06285-7. Epub 2019 Jul 23.
To investigate whether clinical condition, imaging session, and locations affect repeatability of amide proton transfer-weighted (APTw) magnetic resonance imaging (MRI) in the brain.
Three APTw MRI data sets were acquired, involving two intrasession scans and one intersession scan for 19 healthy, 15 glioma, and 12 acute stroke adult participants (mean age 53.8, 54.6, and 68.5, respectively) on a 3T MR scanner. The mean APTw signals from five locations in healthy brain (supratentorial and infratentorial locations) and from entire tumor and stroke lesions (supratentorial location) were calculated. The within-subject coefficient of variation (wCV) and intraclass correlation coefficient (ICC) were calculated for each clinical conditions, image sessions, and anatomic locations. Differences in APTw signals between sessions were analyzed using repeated-measures analysis of variance.
The ICC and wCV were 0.96 (95% confidence interval [CI], 0.91-0.99) and 16.1 (12.6-21.3) in glioma, 0.93 (0.82-0.98) and 15.0 (11.4-20.6) in stroke, and 0.84 (0.72-0.91) and 34.0 (28.7-41.0) in healthy brain. There were no significant differences in APTw signal between three sessions, irrespective of disease condition and location. The ICC and wCV were 0.85 (0.68-0.94) and 27.4 (21.8-35.6) in supratentorial, and 0.44 (- 0.18 to 0.76) and 32.7 (25.9 to 42.9) in infratentorial locations. There were significant differences in APTw signal between supra- (mean, 0.49%; 95% CI, 0.38-0.61) and infratentorial locations (1.09%, 0.98-1.20; p < 0.001).
The repeatability of APTw signal was excellent in supratentorial locations, while it was poor in infratentorial locations due to severe B0 inhomogeneity and susceptibility which affects MTR asymmetry.
• In supratentorial locations, APTw MRI showed excellent intrasession and intersession repeatability in brains of healthy controls and patients with glioma, as well as in stroke-affected regions. • APTw MRI showed excellent repeatability in supratentorial locations, but poor repeatability in infratentorial locations. • Considering poor repeatability in the infratentorial locations, the use of APTw MRI in longitudinal assessment in infratentorial locations is not indicated.
探讨临床状况、成像阶段和部位是否会影响脑酰胺质子转移加权（APTw）磁共振成像（MRI）的重复性。
在 3T 磁共振扫描仪上，对 19 名健康成年人、15 名胶质瘤患者和 12 名急性卒中患者进行了三次 APTw MRI 数据采集，包括两次内扫描和一次外扫描（平均年龄分别为 53.8、54.6 和 68.5 岁）。计算健康脑（幕上和幕下部位）和整个肿瘤及卒中病变（幕上部位）的五个部位的平均 APTw 信号。对于每个临床条件、图像阶段和解剖部位，计算了受试者内变异系数（wCV）和组内相关系数（ICC）。使用重复测量方差分析来分析两次扫描之间的 APTw 信号差异。
在胶质瘤中，ICC 和 wCV 分别为 0.96（95%置信区间[CI]，0.91-0.99）和 16.1（12.6-21.3），在卒中患者中分别为 0.93（0.82-0.98）和 15.0（11.4-20.6），在健康脑患者中分别为 0.84（0.72-0.91）和 34.0（28.7-41.0）。无论疾病状况和部位如何，三次扫描之间的 APTw 信号均无显著差异。在幕上部位，ICC 和 wCV 分别为 0.85（0.68-0.94）和 27.4（21.8-35.6），在幕下部位，ICC 和 wCV 分别为 0.44（-0.18 至 0.76）和 32.7（25.9 至 42.9）。幕上（平均 0.49%；95%CI，0.38-0.61）和幕下（1.09%，0.98-1.20；p<0.001）部位的 APTw 信号存在显著差异。
APTw 信号在幕上部位的重复性极好，而在幕下部位由于严重的 B0 不均匀性和对 MTR 不对称性有影响的磁化率各向异性，重复性较差。
在幕上部位，APTw MRI 在健康对照者和胶质瘤患者以及卒中受累区域的脑内表现出极好的内、外扫描重复性。
APTw MRI 在幕上部位具有极好的重复性，但在幕下部位的重复性较差。
考虑到幕下部位的重复性较差，在幕下部位的纵向评估中不建议使用 APTw MRI。
