基于MRI的无挑战氧提取分数映射在缺血性卒中各阶段的初步经验:与灌注和扩散映射的比较

Initial Experience of Challenge-Free MRI-Based Oxygen Extraction Fraction Mapping of Ischemic Stroke at Various Stages: Comparison With Perfusion and Diffusion Mapping.

作者信息

Zhang Shun, Cho Junghun, Nguyen Thanh D, Spincemaille Pascal, Gupta Ajay, Zhu Wenzhen, Wang Yi

机构信息

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Department of Radiology, Weill Cornell Medicine, New York, NY, United States.

出版信息

Front Neurosci. 2020 Sep 16;14:535441. doi: 10.3389/fnins.2020.535441. eCollection 2020.

Abstract

MRI-based oxygen extraction fraction imaging has a great potential benefit in the selection of clinical strategies for ischemic stroke patients. This study aimed to evaluate the performance of a challenge-free oxygen extraction fraction (OEF) mapping in a cohort of acute and subacute ischemic stroke patients. Consecutive ischemic stroke patients (a total of 30 with 5 in the acute stage, 19 in the early subacute stage, and 6 in the late subacute stage) were recruited. All subjects underwent MRI including multi-echo gradient echo (mGRE), diffusion weighted imaging (DWI), and 3D-arterial spin labeling (ASL). OEF maps were generated from mGRE phase + magnitude data, which were processed using quantitative susceptibility mapping (QSM) + quantitative blood oxygen level-dependent (qBOLD) imaging with cluster analysis of time evolution. Cerebral blood flow (CBF) and apparent diffusion coefficient (ADC) maps were reconstructed from 3D-ASL and DWI, respectively. Further, cerebral metabolic rate of oxygen (CMRO) was calculated as the product of CBF and OEF. OEF, CMRO, CBF, and ADC values in the ischemic cores (absolute values) and their contrasts to the contralateral regions (relative values) were evaluated. One-way analysis of variance (ANOVA) was used to compare OEF, CMRO, CBF, and ADC values and their relative values among different stroke stages. The OEF value of infarct core showed a trend of decrease from acute, to early subacute, and to late subacute stages of ischemic stroke. Significant differences among the three stroke stages were only observed in the absolute OEF ( = 6.046, = 0.005) and relative OEF ( = 5.699, = 0.009) values of the ischemic core, but not in other measurements (absolute and relative CMRO, CBF, ADC values, all values of > 0.05). In conclusion, the challenge-free QSM + qBOLD-generated OEF mapping can be performed on stroke patients. It can provide more information on tissue viability that was not available with CBF and ADC and, thus, may help to better manage ischemic stroke patients.

摘要

基于磁共振成像(MRI)的氧摄取分数成像在为缺血性中风患者选择临床策略方面具有巨大的潜在益处。本研究旨在评估一种无需挑战的氧摄取分数(OEF)映射在一组急性和亚急性缺血性中风患者中的性能。招募了连续的缺血性中风患者(共30例,其中急性期5例,亚急性早期19例,亚急性晚期6例)。所有受试者均接受了MRI检查,包括多回波梯度回波(mGRE)、扩散加权成像(DWI)和三维动脉自旋标记(ASL)。OEF图由mGRE相位+幅度数据生成,这些数据使用定量磁化率映射(QSM)+定量血氧水平依赖(qBOLD)成像并进行时间演化聚类分析进行处理。脑血流量(CBF)和表观扩散系数(ADC)图分别从三维动脉自旋标记(3D-ASL)和扩散加权成像(DWI)重建。此外,脑氧代谢率(CMRO)计算为CBF与OEF的乘积。评估了缺血核心区的OEF、CMRO、CBF和ADC值(绝对值)及其与对侧区域的对比(相对值)。采用单因素方差分析(ANOVA)比较不同中风阶段的OEF、CMRO、CBF和ADC值及其相对值。梗死核心区的OEF值在缺血性中风的急性期、亚急性早期和亚急性晚期呈现下降趋势。仅在缺血核心区的绝对OEF(F = 6.046,P = 0.005)和相对OEF(F = 5.699,P = 0.009)值中观察到三个中风阶段之间存在显著差异,而在其他测量值(绝对和相对CMRO、CBF、ADC值,所有P值>0.05)中未观察到显著差异。总之,无需挑战的QSM + qBOLD生成的OEF映射可用于中风患者。它可以提供更多关于组织活力的信息,而这些信息是CBF和ADC所无法提供的,因此可能有助于更好地管理缺血性中风患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d64/7525031/f3d28944fc68/fnins-14-535441-g001.jpg

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