Wu Liheng, Liu Yanghui, Zhu Liangfu, Li Tianxiao, Wang Li'na, Zhang Yang, Zhou Zhilong, Xing Ying, Wang Meiyun, Gao Bulang
Department of Cerebrovascular Diseases, National Advanced Stroke Center, Henan Provincial People's Hospital, People's Hospital of Henan University, Zhengzhou, China.
Department of Imaging, Henan Provincial People's Hospital, People's Hospital of Henan University, Zhengzhou, China.
Front Neurosci. 2023 Mar 3;17:1105816. doi: 10.3389/fnins.2023.1105816. eCollection 2023.
To investigate the value of the MRI arterial spin labeling (ASL) in evaluating the blood-brain barrier permeability of anterior circulation ischemic lesions in subacute ischemic stroke (SIS) and the risk of hemorrhage transformation (HT) after endovascular recanalization.
Patients with anterior circulation SIS treated with endovascular recanalization were prospectively enrolled. The imaging presentations in the MRI ASL sequences, dynamic contrast-enhanced (DCE) sequence, and Xper CT were studied. The relative cerebral blood flow (rCBF), volume transfer constant (Ktrans), and the weighted Kappa coefficient (rKtrans) were analyzed.
Among 27 eligible patients, HT occurred in 7 patients (25.92%). Patients with HT had significantly higher rCBF value (1.56 ± 0.16 vs. 1.16 ± 0.16), Ktrans, (0.08 ± 0.03 min vs. 0.03 ± 0.01 min) and rKtrans (3.02 ± 0.89 vs. 1.89 ± 0.56). The ASL imaging sequence had a high consistency with the DCE sequence and Xper CT with a high weighted Kappa coefficient of 0.91 for the DCE sequence and 0.70 for the Xper CT imaging. The DCE sequence was also highly consistent with the Xper CT in imaging classification with a high weighted Kappa coefficient of 0.78. The rCBF value in the 21 patients with the subcortical and basal ganglia infarction was significantly lower than that in the other 6 patients with the cortical infarction (1.222 ± 0.221 vs. 1.413 ± 0.259, = 1.795, = 0.004).
The MRI ASL sequence has an important role in evaluating the blood-brain barrier permeability and the risk of hemorrhagic transformation of anterior circulation SIS following endovascular recanalization.
探讨磁共振成像动脉自旋标记（ASL）在评估亚急性缺血性卒中（SIS）前循环缺血性病变血脑屏障通透性及血管内再通术后出血转化（HT）风险中的价值。
前瞻性纳入接受血管内再通治疗的前循环SIS患者。研究磁共振成像ASL序列、动态对比增强（DCE）序列及Xper CT的影像表现。分析相对脑血流量（rCBF）、容积转移常数（Ktrans）及加权Kappa系数（rKtrans）。
27例符合条件的患者中，7例（25.92%）发生HT。发生HT的患者rCBF值（1.56±0.16对1.16±0.16）、Ktrans（0.08±0.03 min对0.03±0.01 min）及rKtrans（3.02±0.89对1.89±0.56）显著更高。ASL成像序列与DCE序列及Xper CT具有高度一致性，与DCE序列的加权Kappa系数为0.91，与Xper CT成像的加权Kappa系数为0.70。DCE序列与Xper CT在影像分类上也具有高度一致性，加权Kappa系数为0.78。21例皮质下和基底节梗死患者的rCBF值显著低于其他6例皮质梗死患者（1.222±0.221对1.413±0.259，t=1.795，P=0.004）。
磁共振成像ASL序列在评估血管内再通术后前循环SIS的血脑屏障通透性及出血转化风险中具有重要作用。
