多参数 MRI（PIVOT）、多普勒超声和基于近红外光谱的骨骼肌氧合和灌注评估之间的一致性。
Agreement between multiparametric MRI (PIVOT), Doppler ultrasound, and near-infrared spectroscopy-based assessments of skeletal muscle oxygenation and perfusion.
机构信息
Penn State Heart and Vascular Institute, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, United States of America.
Department of Radiology, Pennsylvania State University College of Medicine, Milton S. Hershey Medical Center, Hershey, PA, United States of America.
出版信息
Magn Reson Imaging. 2023 Feb;96:27-37. doi: 10.1016/j.mri.2022.11.003. Epub 2022 Nov 14.
UNLABELLED
Skeletal muscle perfusion and oxygenation are commonly evaluated using Doppler ultrasound and near-infrared spectroscopy (NIRS) techniques. However, a recently developed magnetic resonance imaging (MRI) sequence, termed PIVOT, permits the simultaneous collection of skeletal muscle perfusion and T2* (an index of skeletal muscle oxygenation).
PURPOSE
To determine the level of agreement between PIVOT, Doppler ultrasound, and NIRS-based assessments of skeletal muscle perfusion and oxygenation.
METHODS
Twelve healthy volunteers (8 females, 25 ± 3 years, 170 ± 11 cm, 71.5 ± 8.0 kg) performed six total reactive hyperemia protocols. During three of these reactive hyperemia protocols, Tissue Saturation Index (TSI) and oxygenated hemoglobin (OHb) were recorded from the medial gastrocnemius (MG) and tibialis anterior (TA), and blood flow velocity was recorded from the popliteal artery (BFv) via Doppler Ultrasound. The other three trials were performed inside the bore of a 3 T MRI scanner, and the PIVOT sequence was used to assess perfusion (PIVOT) and oxygenation (T2*) of the medial gastrocnemius and tibialis anterior muscles. Positive incremental areas under the curve (iAUC) and times to peak (TTP) were calculated for each variable, and the level of agreement between collection methods was evaluated via Bland-Altman analyses and Spearman's Rho correlation analyses.
RESULTS
The only significant bivariate relationships observed were between the T2* vs. TSI iAUC and PIVOT vs. BFv values recorded from the MG. Significant mean differences were observed for all comparisons (all P ≤ 0.038), and significant proportional biases were observed for the PIVOT vs. tHb TTP (R = 0.848, P < 0.001) and T2* vs. TSI TTP comparisons in the TA (R = 0.488, P = 0.011), and the PIVOT vs. BFv iAUC (R = 0.477, P = 0.013) and time to peak (R = 0.851, P < 0.001) comparisons in the MG.
CONCLUSIONS
Our findings suggest that the PIVOT technique has, at best, a moderate level of agreement with Doppler ultrasound and NIRS assessment methods and is subject to significant proportional bias. These findings do not challenge the accuracy of either measurement technique but instead reflect differences in the vascular compartments, sampling volumes, and parameters being evaluated.
目的
确定 PIVOT 与多普勒超声和基于近红外光谱 (NIRS) 的骨骼肌灌注和氧合评估之间的一致性水平。
方法
12 名健康志愿者（8 名女性，25 ± 3 岁，170 ± 11cm，71.5 ± 8.0kg）进行了 6 次总反应性充血试验。在其中 3 次反应性充血试验中，从内侧腓肠肌 (MG) 和胫骨前肌 (TA) 记录组织饱和度指数 (TSI) 和氧合血红蛋白 (OHb)，并通过多普勒超声记录腘动脉血流速度 (BFv)。另外 3 次试验在 3T MRI 扫描仪内进行，使用 PIVOT 序列评估内侧腓肠肌和胫骨前肌的灌注 (PIVOT) 和氧合 (T2*)。为每个变量计算阳性增量曲线下面积 (iAUC) 和达峰时间 (TTP)，并通过 Bland-Altman 分析和 Spearman's Rho 相关性分析评估采集方法之间的一致性水平。
结果
仅观察到 T2与 TSI iAUC 和 PIVOT 与 MG 记录的 BFv 之间存在显著的双变量关系。所有比较均观察到显著的平均差异（均 P≤0.038），并且在 PIVOT 与 tHb TTP 比较中观察到显著的比例偏差（R=0.848，P<0.001）和 T2与 TSI TTP 比较在 TA（R=0.488，P=0.011），以及 PIVOT 与 BFv iAUC（R=0.477，P=0.013）和达峰时间（R=0.851，P<0.001）在 MG 中。
结论
我们的发现表明，PIVOT 技术与多普勒超声和 NIRS 评估方法的一致性充其量只是中等水平，并且容易受到显著的比例偏差的影响。这些发现并没有挑战任何一种测量技术的准确性，而是反映了血管腔室、采样体积和评估参数的差异。
Zotero 插件