蔗糖铁作为缺血性中风模型中的磁共振成像造影剂

Iron Sucrose as MRI Contrast Agent in Ischemic Stroke Model.

作者信息

Wu Shiman, Zhang Hua, Wang Jing, Li Xiaoyan, Gao Xinyi, Fang Ziwei, Qu Jianxun, Wu Yue, Ren Yan, Rui Wenting, Zhang Junhai, Yao Zhenwei

机构信息

Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.

Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, China.

出版信息

J Magn Reson Imaging. 2020 Sep;52(3):836-849. doi: 10.1002/jmri.27109. Epub 2020 Feb 29.

DOI:10.1002/jmri.27109

PMID:32112623

Abstract

BACKGROUND

Despite the growing concern about the safety of gadolinium-based contrast agents (GBCAs), they are still the most commonly used. Ferumoxytol, as an off-label alternative MRI contrast agent, cannot be administered by a rapid bolus for dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI).

PURPOSE

To assess the feasibility of iron sucrose (IS) as a contrast agent for MR angiography (MRA) and DSC-PWI.

STUDY TYPE

Prospective animal model.

ANIMAL MODEL

Thirty-six normal rats (16 for MRA, 20 for biocompability tests) and 36 occlusion of the middle cerebral artery (MCAO) model rats.

FIELD STRENGTH/SEQUENCE: 3.0T; head and neck angiography, using a fast spoiled gradient-recalled-echo (FSPGR) sequence and DSC-MRI using echo planar imaging(EPI) sequence.

ASSESSMENT

MRA was performed on normal rats to examine the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of different doses of IS. DSC-PWI was performed on MCAO rats at 0, 24, 48, and 72 hours postreperfusion to investigate the lesion detectability of IS. Arterial spin labeling (ASL) and DSC-PWI enhanced by GBCAs were conducted on MCAO rats as controls.

STATISTICAL TESTS

Kruskal-Wallis test was used to compare qualitative assessment. One-way analysis of variance (ANOVA) was used to compare the parametric data. Pearson's r values were evaluated between relative cerebral blood flow(rCBF)-ASL, rCBF-DSC , and rCBF obtained from DSC-PWI enhanced by GBCA.

RESULTS

The mean SNR and CNR of the common carotid artery at doses of 10 mg Fe/kg of IS were comparable with the standard dose of GBCAs (SNR: 68.04 ± 12.55 vs. 67.72 ± 14.66; CNR: 23.78 ± 7.21vs. 21.63 ± 6.83). In MCAO rat models, rCBF and relative cerebral blood volume (rCBV) of ipsilateral striatum declined (0.72 ± 0.14, 0.86 ± 0.11) with prolonged relative mean transit time (rMTT) and relative time-to-peak (rTTP) (1.27 ± 0.24, 1.07 ± 0.03) following occlusion. Hyperperfusion was observed in all rats at 48 and 72 hours postreperfusion, in 4/6 rats at 24 hours postreperfusion for IS-mediated DSC-PWI.

DATA CONCLUSION

IS may be an effective contrast agent for both MRA and DSC-PWI in ischemic stroke models.

LEVEL OF EVIDENCE

1 TECHNICAL EFFICACY STAGE: 1 J. Magn. Reson. Imaging 2020;52:836-849.

摘要

背景

尽管人们对钆基造影剂（GBCAs）的安全性日益担忧，但它们仍是最常用的造影剂。作为一种未获批准的替代MRI造影剂， ferumoxytol不能通过快速推注用于动态磁敏感对比灌注加权成像（DSC-PWI）。

目的

评估蔗糖铁（IS）作为磁共振血管造影（MRA）和DSC-PWI造影剂的可行性。

研究类型

前瞻性动物模型。

动物模型

36只正常大鼠（16只用于MRA，20只用于生物相容性测试）和36只大脑中动脉闭塞（MCAO）模型大鼠。

场强/序列：3.0T；头颈部血管造影，使用快速扰相梯度回波（FSPGR）序列，DSC-MRI使用回波平面成像（EPI）序列。

评估

对正常大鼠进行MRA，以检查不同剂量IS的信噪比（SNR）和对比噪声比（CNR）。在MCAO大鼠再灌注后0、24、48和72小时进行DSC-PWI，以研究IS的病变可检测性。对MCAO大鼠进行动脉自旋标记（ASL）和GBCAs增强的DSC-PWI作为对照。

统计检验

采用Kruskal-Wallis检验进行定性评估比较。采用单因素方差分析（ANOVA）比较参数数据。评估GBCA增强的DSC-PWI获得的相对脑血流量（rCBF）-ASL、rCBF-DSC和rCBF之间的Pearson r值。

结果

IS剂量为10mg Fe/kg时，颈总动脉的平均SNR和CNR与GBCAs的标准剂量相当（SNR：68.04±12.55 vs. 67.72±14.66；CNR：23.78±7.21 vs. 21.63±6.83）。在MCAO大鼠模型中，随着闭塞后相对平均通过时间（rMTT）和相对达峰时间（rTTP）延长（1.27±0.24，1.07±0.03），同侧纹状体的rCBF和相对脑血容量（rCBV）下降（0.72±0.14，0.86±0.11）。在再灌注后48和72小时，所有大鼠均观察到高灌注，在IS介导的DSC-PWI中，再灌注后24小时，4/6大鼠出现高灌注。