Garzelli Lorenzo, Felli Eric, Al-Taher Mahdi, Barberio Manuel, Agnus Vincent, Plaforet Vincent, Bonvalet Fanny, Baiocchini Andrea, Nuzzo Alexandre, Paulatto Luisa, Vilgrain Valérie, Gallix Benoit, Diana Michele, Ronot Maxime
Université Paris Cité, Paris, France & Department of Radiology, Beaujon Hospital, APHP.Nord, Clichy, France.
IHU Strasbourg - Image Guided Surgery, Strasbourg University, Strasbourg, France.
J Magn Reson Imaging. 2023 Mar;57(3):918-927. doi: 10.1002/jmri.28344. Epub 2022 Jul 19.
MRI is the reference for the diagnosis of arterial cerebral ischemia, but its role in acute mesenteric ischemia (AMI) is poorly known.
To assess MRI detection of early ischemic bowel lesions in a porcine model of arterial AMI.
Prospective/cohort.
Porcine model of arterial AMI obtained by embolization of the superior mesenteric artery (seven pigs).
FIELD STRENGTH/SEQUENCE: A 5-T. T1 gradient-echo-weighted-imaging (WI), half-Fourier-acquisition-single-shot-turbo-spin-echo, T2 turbo-spin-echo, true-fast-imaging-with-steady-precession (True-FISP), diffusion-weighted-echo-planar (DWI).
T1-WI, T2-WI, and DWI were performed before and continuously after embolization for 6 hours. The signal intensity (SI) of the ischemic bowel was assessed visually and quantitatively on all sequences. The apparent diffusion coefficient (ADC) was assessed.
Paired Student's t-test or Mann-Whitney U-test, significance at P < 0.05.
One pig died from non-AMI-related causes. The remaining pigs underwent a median 5 h53 (range 1 h24-6 h01) of ischemia. Visually, the ischemic bowel showed signal hyperintensity on DWI-b800 after a median 85 (57-276) minutes compared to the nonischemic bowel. DWI-b800 SI significantly increased after 2 hours (+19%) and the ADC significant decrease within the first hour (-31%). The ischemic bowel was hyperintense on precontrast T1-WI after a median 87 (70-171) minutes with no significant quantitative changes over time (P = 0.46-0.93). The ischemic bowel was hyperintense on T2-WI in three pigs with a significant SI increase on True-FISP after 1 and 2 hours.
Changes in SI and ADC can be seen early after the onset of arterial AMI with DWI. The value of T2-WI appears to be limited.
1 TECHNICAL EFFICACY: Stage 2.
磁共振成像（MRI）是诊断脑动脉缺血的金标准，但其在急性肠系膜缺血（AMI）中的作用尚不清楚。
评估MRI在动脉性AMI猪模型中对早期缺血性肠病变的检测能力。
前瞻性/队列研究。
通过栓塞肠系膜上动脉建立的动脉性AMI猪模型（7头猪）。
场强/序列：5-T。T1梯度回波加权成像（WI）、半傅里叶采集单次激发快速自旋回波、T2快速自旋回波、稳态进动快速成像（True-FISP）、扩散加权回波平面成像（DWI）。
在栓塞前及栓塞后连续6小时进行T1-WI、T2-WI和DWI检查。在所有序列上对缺血肠段的信号强度（SI）进行视觉和定量评估。评估表观扩散系数（ADC）。
配对学生t检验或曼-惠特尼U检验，P<0.05为有统计学意义。
1头猪死于非AMI相关原因。其余猪的缺血时间中位数为5小时53分钟（范围1小时24分钟至6小时01分钟）。肉眼观察，与非缺血肠段相比，缺血肠段在DWI-b800上的信号在中位数85分钟（57-276分钟）后呈高信号。DWI-b800的SI在2小时后显著增加（+19%），ADC在第1小时内显著降低（-31%）。缺血肠段在中位数87分钟（70-171分钟）后的对比前T1-WI上呈高信号，随时间无显著定量变化（P=0.46-0.93）。3头猪的缺血肠段在T2-WI上呈高信号，在1小时和2小时后True-FISP上的SI显著增加。
动脉性AMI发病后早期，DWI可显示SI和ADC的变化。T2-WI的价值似乎有限。
1 技术效能：2级
