Suo Shiteng, Tang Hui, Lu Qing, Zhang Lan, Ni Qihong, Cao Mengqiu, Chen Zengai, Zhao Huilin, Sun Beibei, Xu Jianrong
Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.
Magn Reson Med. 2021 Mar;85(3):1590-1601. doi: 10.1002/mrm.28495. Epub 2020 Sep 16.
Stress blood oxygenation level-dependent (BOLD) cardiovascular magnetic resonance allows for quantitative evaluation of blood flow reserve in skeletal muscles. This study aimed to prospectively compare three commonly used skeletal BOLD cardiovascular magnetic resonance paradigms in healthy adults: gas inhalation, cuff compression-induced ischemia and postocclusive reactive hyperemia, and exercise.
Twelve young (22 ± 0.9 years) and 10 elderly (58 ± 5.0 years) healthy subjects underwent BOLD cardiovascular magnetic resonance under the three paradigms. signal intensity time curves were generated and quantitative parameters were calculated. Meanwhile, stress transcutaneous oxygen pressure measurements were obtained as comparison. Measurement reproducibility was assessed with intraclass correlation coefficients. Differences in the BOLD variation, the correlation with transcutaneous oxygen pressure, and the age-related change between paradigms were statistically analyzed.
Minimum ischemic value and maximum hyperemic peak value showed the highest interobserver and interscan reproducibilities (intraclass correlation coefficient >0.90). The plantar dorsiflexion exercise paradigm elicited the largest BOLD variation (15.48% ± 10.56%), followed by ischemia (8.30% ± 6.33%). Negligible to weak changes were observed during gas inhalation. Correlations with transcutaneous oxygen pressure measurements were found in the ischemic phase (r = 0.966; P < .001) and in the postexercise phase (r = -0.936; P < .001). Minimum ischemic value, maximum hyperemic peak value, maximum postexercise value, and slope of postexercise signal decay showed significant differences between young and elderly subjects (P < .01).
Ischemia and reactive hyperemia have superior reproducibility, and exercise could induce the largest variation. Key parameters from the two paradigms show age-related differences.
应激血氧水平依赖（BOLD）心血管磁共振成像可对骨骼肌血流储备进行定量评估。本研究旨在对健康成年人中三种常用的骨骼肌BOLD心血管磁共振成像模式进行前瞻性比较：气体吸入、袖带压迫诱导缺血和闭塞后反应性充血，以及运动。
12名年轻（22±0.9岁）和10名老年（58±5.0岁）健康受试者在这三种模式下接受BOLD心血管磁共振成像检查。生成信号强度时间曲线并计算定量参数。同时，获取应激经皮氧分压测量值作为对照。用组内相关系数评估测量的可重复性。对各模式之间BOLD变化、与经皮氧分压的相关性以及年龄相关变化的差异进行统计学分析。
最小缺血值和最大充血峰值显示出最高的观察者间和扫描间可重复性（组内相关系数>0.90）。足底背屈运动模式引起的BOLD变化最大（15.48%±10.56%），其次是缺血（8.30%±6.33%）。气体吸入期间观察到的变化可忽略不计至微弱。在缺血期（r = 0.966；P <.001）和运动后阶段（r = -0.936；P <.001）发现与经皮氧分压测量值存在相关性。年轻和老年受试者之间的最小缺血值、最大充血峰值、最大运动后值和运动后信号衰减斜率存在显著差异（P <.01）。
缺血和反应性充血具有更高的可重复性，运动可诱导最大的变化。这两种模式的关键参数显示出与年龄相关的差异。
