Department of Radiology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
MR Applications and Workflow, GE Healthcare, Tokyo, Japan.
J Magn Reson Imaging. 2022 Jun;55(6):1723-1732. doi: 10.1002/jmri.27996. Epub 2021 Nov 15.
Noninvasive cerebral blood flow (CBF) monitoring using arterial spin labeling (ASL) magnetic resonance imaging is useful for managing large cerebral artery steno-occlusive diseases. However, knowledge about its measurement characteristics in comparison with reference standard perfusion imaging is limited.
To evaluate perfusion in a longitudinal manner in patients with steno-occlusive disease using ASL and compare with single-photon emission computed tomography (SPECT).
Prospective.
Moyamoya (n = 10, eight females) and atherosclerotic diseases (n = 2, two males).
FIELD STRENGTH/SEQUENCE: 3.0 T; gradient-echo three-dimensional T -weighted and spin-echo ASL.
Multi-delay ASL and [ I]-iodoamphetamine SPECT CBF measurements were performed both before and within 9 days of anterior-circulation revascularization. Reliability and sensitivity to whole-brain voxel-wise CBF changes (ΔCBF) and their postlabeling delay (PLD) dependency with varied PLDs (in milliseconds) of 1000, 2333, and 3666 were examined.
Reliability and sensitivity to ΔCBF were examined using within-subject standard deviation (Sw) and intraclass correlation coefficients (ICCs). For statistical comparisons, standard deviation of longitudinal ΔCBF within the hemisphere contralateral to surgery, and the ratio between it and average ΔCBF within the ipsilateral regions of interest were subjected to paired t tests, respectively. P < 0.05 was considered statistically significant.
ASL test-retest time interval was 31 ± 18 days. Test-retest reliability was significantly lower for SPECT (0.16 ± 0.02) than ASL (0.13 ± 0.04). Sensitivity to postoperative changes was significantly higher for ASL (2.71 ± 2.79) than SPECT (0.27 ± 0.62). Test-retest reliability was significantly higher for a PLD of 2333 (0.13 ± 0.04) than 3666 (0.19 ± 0.05), and sensitivity to ΔCBF was significantly higher for PLDs of 1000 (2.53 ± 2.50) and 2333 than 3666 (0.79 ± 1.88). ICC maps also showed higher reliability for ASL than SPECT.
Higher test-retest reliability led to better ASL sensitivity than SPECT for postoperative ΔCBF. ASL test-retest reliability and sensitivity to ΔCBF were higher with a PLD of 2333.
1 TECHNICAL EFFICACY: Stage 2.
使用动脉自旋标记（ASL）磁共振成像进行无创性脑血流（CBF）监测对于管理大的大脑动脉狭窄闭塞性疾病是有用的。然而，与参考标准灌注成像相比，其测量特性的相关知识是有限的。
使用 ASL 对狭窄闭塞性疾病患者进行纵向灌注评估，并与单光子发射计算机断层扫描（SPECT）进行比较。
前瞻性。
烟雾病（n=10，8 名女性）和动脉粥样硬化性疾病（n=2，2 名男性）。
场强/序列：3.0T；梯度回波三维 T2-加权和自旋回波 ASL。
多延迟 ASL 和[I]-碘苯丙胺 SPECT CBF 测量均在经颅血管重建术之前和之后的 9 天内进行。检查了全脑体素 CBF 变化（ΔCBF）的可靠性和敏感性，以及它们对不同后标记延迟（PLD）的敏感性，PLD 分别为 1000、2333 和 3666 毫秒。
使用个体内标准差（Sw）和组内相关系数（ICCs）检查了对ΔCBF 的可靠性和敏感性。为了进行统计学比较，分别对手术对侧半球内的纵向ΔCBF 标准差以及它与同侧感兴趣区域内平均ΔCBF 的比值进行了配对 t 检验。P＜0.05 被认为具有统计学意义。
ASL 测试-重测时间间隔为 31±18 天。SPECT（0.16±0.02）的测试-重测可靠性明显低于 ASL（0.13±0.04）。ASL 对术后变化的敏感性（2.71±2.79）明显高于 SPECT（0.27±0.62）。PLD 为 2333 时的测试-重测可靠性（0.13±0.04）明显高于 3666（0.19±0.05），PLD 为 1000（2.53±2.50）和 2333 时的 ΔCBF 敏感性明显高于 3666（0.79±1.88）。IC 图还显示了 ASL 比 SPECT 具有更高的可靠性。
与 SPECT 相比，较高的测试-重测可靠性导致 ASL 对术后 ΔCBF 的敏感性更高。ASL 的测试-重测可靠性和对 ΔCBF 的敏感性随着 PLD 为 2333 而提高。
1 技术功效：第 2 阶段。
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