Department of Neurology, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Department of Radiology and Nuclear Medicine, Amsterdam University Medical Center, Amsterdam, The Netherlands.
Neuroimage Clin. 2022;36:103142. doi: 10.1016/j.nicl.2022.103142. Epub 2022 Aug 4.
Arterial spin labeling (ASL) magnetic resonance imaging (MRI) may be a promising technique to evaluate the presence of cerebral atherosclerosis. We tested whether the new and easily calculated ASL MRI parameter for vascular and tissue signal distribution - 'spatial coefficient of variation' (ASL-sCoV) - is a better radiological marker for atherosclerotic risk than the more conventional markers of white matter hyperintensity (WMH) volume and cerebral blood flow (ASL-CBF).
Participants of the preDIVA trial (n = 195), aged 72-80 years with systolic hypertension (>140 mmHg) underwent two MRI scans two to three years apart. WMH volume was derived from 3D FLAIR-MRI; gray matter ASL-CBF and ASL-sCoV from ASL-MRI. Atherosclerotic risk was operationalized as 10-year cardiovascular risk by the Systematic COronary Risk Evaluation Older Persons (SCORE O.P) and calculated at baseline and follow-up. Data were analyzed using linear regression.
ASL-CBF was associated with atherosclerotic risk scores at baseline (standardized-beta = -0.26, 95 %CI = -0.40 to -0.13, p < 0.001) but not at follow-up (standardized-beta = -0.14, 95 %CI = -0.33 to 0.04, p = 0.12). ASL-sCoV was associated with atherosclerotic risk scores at both time points (baseline standardized-beta = 0.23, 95 %CI = 0.10 to 0.36, p < 0.0001, follow-up standardized beta = 0.20, 95 %CI = 0.03 to 0.36, p = 0.02). WMH volume was not associated with atherosclerotic risk scores at either time-point. There were no longitudinal associations between changes in MRI parameters and baseline atherosclerotic risk scores.
Our findings suggest that ASL-sCoV correlates better with atherosclerotic risk than the more conventional markers ASL-CBF and WMH volume. Our data reaffirm that non-invasive imaging with MRI is highly informative and could provide additional information about cerebrovascular damage.
动脉自旋标记（ASL）磁共振成像（MRI）可能是评估脑动脉粥样硬化存在的一种很有前途的技术。我们测试了新的、易于计算的 ASL MRI 血管和组织信号分布参数——“空间变异系数”（ASL-sCoV），是否比更传统的白质高信号（WMH）体积和脑血流（ASL-CBF）标记物更能作为动脉粥样硬化风险的影像学标记物。
preDIVA 试验的参与者（n=195），年龄 72-80 岁，收缩压>140mmHg，在 2-3 年内进行两次 MRI 扫描。WMH 体积来自 3D FLAIR-MRI；灰质 ASL-CBF 和 ASL-sCoV 来自 ASL-MRI。动脉粥样硬化风险通过系统冠状动脉风险评估老年人（SCORE O.P）计算，并在基线和随访时进行操作。使用线性回归分析数据。
ASL-CBF 与基线时的动脉粥样硬化风险评分相关（标准化β=-0.26，95%CI=-0.40 至-0.13，p<0.001），但与随访时无关（标准化β=-0.14，95%CI=-0.33 至 0.04，p=0.12）。ASL-sCoV 与两个时间点的动脉粥样硬化风险评分相关（基线标准化β=0.23，95%CI=0.10 至 0.36，p<0.0001，随访标准化β=0.20，95%CI=0.03 至 0.36，p=0.02）。WMH 体积与两个时间点的动脉粥样硬化风险评分均无关。MRI 参数的变化与基线动脉粥样硬化风险评分之间没有纵向关联。
我们的研究结果表明，ASL-sCoV 与动脉粥样硬化风险的相关性优于更传统的 ASL-CBF 和 WMH 体积标记物。我们的数据再次证实，MRI 等非侵入性成像具有高度信息性，可以提供有关脑血管损伤的额外信息。
