使用7T非增强磁共振血管造影测量年龄相关性黄斑变性患者眼动脉和颈内动脉的血流改变
Altered Blood Flow in the Ophthalmic and Internal Carotid Arteries in Patients with Age-Related Macular Degeneration Measured Using Noncontrast MR Angiography at 7T.
作者信息
Hibert M L, Chen Y I, Ohringer N, Feuer W J, Waheed N K, Heier J S, Calhoun M W, Rosenfeld P J, Polimeni J R
机构信息
From the Athinoula A. Martinos Center for Biomedical Imaging (M.L.H., Y.I.C., N. O., J.R.P.), Massachusetts General Hospital, Charlestown, Massachusetts.
Department of Radiology (Y.I.C., J.R.P.), Harvard Medical School, Boston, Massachusetts.
出版信息
AJNR Am J Neuroradiol. 2021 Sep;42(9):1653-1660. doi: 10.3174/ajnr.A7187. Epub 2021 Jul 1.
BACKGROUND AND PURPOSE
Age-related macular degeneration is associated with reduced perfusion of the eye; however, the role of altered blood flow in the upstream ophthalmic or internal carotid arteries is unclear. We used ultra-high-field MR imaging to investigate whether the diameter of and blood flow in the ophthalmic artery and/or the ICA are altered in age-related macular degeneration and whether any blood flow changes are associated with disease progression.
MATERIALS AND METHODS
Twenty-four patients with age-related macular degeneration and 13 similarly-aged healthy controls participated. TOF and high-resolution dynamic 2D phase-contrast MRA (0.26 × 0.26 × 2mm, 100-ms effective sampling rate) was acquired at 7T. Vessel diameters were calculated from cross-sectional areas in phase-contrast acquisitions. Blood flow time-series were measured across the cardiac cycle.
RESULTS
The ophthalmic artery vessel diameter was found to be significantly smaller in patients with age-related macular degeneration than in controls. Volumetric flow through the ophthalmic artery was significantly lower in patients with late age-related macular degeneration, with a significant trend of decreasing volumetric ophthalmic artery flow rates with increasing disease severity. The resistance index was significantly greater in patients with age-related macular degeneration than in controls in the ophthalmic artery. Flow velocity through the ophthalmic artery and ICA was significantly higher in patients with age-related macular degeneration. Ophthalmic artery blood flow as a percentage of ipsilateral ICA blood flow was nearly double in controls than in patients with age-related macular degeneration.
CONCLUSIONS
These findings support the hypothesis that vascular changes upstream to the eye are associated with the severity of age-related macular degeneration. Additional investigation into the potential causality of this relationship and whether treatments that improve ocular circulation slow disease progression is warranted.
背景与目的
年龄相关性黄斑变性与眼部血流灌注减少有关；然而，眼动脉或颈内动脉上游血流改变的作用尚不清楚。我们使用超高场磁共振成像来研究年龄相关性黄斑变性患者眼动脉和/或颈内动脉的直径及血流是否发生改变，以及血流变化是否与疾病进展相关。
材料与方法
24例年龄相关性黄斑变性患者和13例年龄相仿的健康对照者参与研究。在7T场强下进行时间飞跃法（TOF）和高分辨率动态二维相位对比磁共振血管造影（0.26×0.26×2mm，有效采样率100ms）。根据相位对比采集的横截面面积计算血管直径。在心动周期内测量血流时间序列。
结果
发现年龄相关性黄斑变性患者的眼动脉血管直径显著小于对照组。晚期年龄相关性黄斑变性患者通过眼动脉的容积流量显著降低，且随着疾病严重程度增加，眼动脉容积流量率有显著下降趋势。年龄相关性黄斑变性患者眼动脉的阻力指数显著高于对照组。年龄相关性黄斑变性患者通过眼动脉和颈内动脉的血流速度显著更高。对照组中眼动脉血流占同侧颈内动脉血流的百分比几乎是年龄相关性黄斑变性患者的两倍。
结论
这些发现支持这样的假设，即眼部上游的血管变化与年龄相关性黄斑变性的严重程度相关。有必要进一步研究这种关系的潜在因果性，以及改善眼部循环的治疗是否能减缓疾病进展。
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