Kontopodis Eleftherios, Marias Kostas, Manikis Georgios C, Nikiforaki Katerina, Venianaki Maria, Maris Thomas G, Mastorodemos Vasileios, Papadakis Georgios Z, Papadaki Efrosini
Foundation for Research and Technology - Hellas, Institute of Computer Science, Computational Bio-Medicine Laboratory, N. Plastira 100, Vassilika Vouton, GR-700 13 Heraklion, Crete, Greece.
Department of Radiology, Medical School, University of Crete, P. O. Box 2208, Heraklion, Crete, Greece.
Open Med (Wars). 2020 Jun 8;15(1):520-530. doi: 10.1515/med-2020-0100. eCollection 2020.
This study aims to examine a time-extended dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) protocol and report a comparative study with three different pharmacokinetic (PK) models, for accurate determination of subtle blood-brain barrier (BBB) disruption in patients with multiple sclerosis (MS). This time-extended DCE-MRI perfusion protocol, called Snaps, was applied on 24 active demyelinating lesions of 12 MS patients. Statistical analysis was performed for both protocols through three different PK models. The Snaps protocol achieved triple the window time of perfusion observation by extending the magnetic resonance acquisition time by less than 2 min on average for all patients. In addition, the statistical analysis in terms of adj- goodness of fit demonstrated that the Snaps protocol outperformed the conventional DCE-MRI protocol by detecting 49% more pixels on average. The exclusive pixels identified from the Snaps protocol lie in the low range, potentially reflecting areas with subtle BBB disruption. Finally, the extended Tofts model was found to have the highest fitting accuracy for both analyzed protocols. The previously proposed time-extended DCE protocol, called Snaps, provides additional temporal perfusion information at the expense of a minimal extension of the conventional DCE acquisition time.
本研究旨在检验一种时间延长的动态对比增强磁共振成像（DCE-MRI）方案，并报告一项针对三种不同药代动力学（PK）模型的对比研究，以准确测定多发性硬化症（MS）患者细微的血脑屏障（BBB）破坏情况。这种被称为Snaps的时间延长的DCE-MRI灌注方案应用于12例MS患者的24个活动性脱髓鞘病灶。通过三种不同的PK模型对两种方案进行了统计分析。Snaps方案通过将所有患者的磁共振采集时间平均延长不到2分钟，实现了灌注观察窗口时间延长两倍。此外，在拟合优度调整方面的统计分析表明，Snaps方案平均检测到的像素比传统DCE-MRI方案多49%，表现更优。从Snaps方案中识别出的独特像素处于低范围，可能反映了存在细微BBB破坏的区域。最后，发现扩展的Tofts模型对两种分析方案的拟合精度最高。先前提出的被称为Snaps的时间延长的DCE方案，以传统DCE采集时间的最小延长为代价，提供了额外的时间灌注信息。
