Xu Huimin, Han Hualu, Liu Ying, Huo Ran, Lang Ning, Yuan Huishu, Wang Tao, Zhao Xihai
Department of Radiology, Peking University Third Hospital, Beijing, China.
Department of Biomedical Engineering, Center for Biomedical Imaging Research, School of Medicine, Tsinghua University, Beijing, China.
Front Neurosci. 2023 Sep 14;17:1200273. doi: 10.3389/fnins.2023.1200273. eCollection 2023.
Arterial spin labeling (ASL) is a non-invasive technique for measuring cerebral perfusion. Its accuracy is affected by the arterial transit time. This study aimed to (1) evaluate the accuracy of ASL in measuring the cerebral perfusion of patients who underwent carotid endarterectomy (CEA) and (2) determine a better postlabeling delay (PLD) for pre- and postoperative perfusion imaging between 1.5 and 2.0 s.
A total of 24 patients scheduled for CEA due to severe carotid stenosis were included in this study. All patients underwent ASL with two PLDs (1.5 and 2.0 s) and computed tomography perfusion (CTP) before and after surgery. Cerebral blood flow (CBF) values were measured on the registered CBF images of ASL and CTP. The correlation in measuring perioperative relative CBF (rCBF) and difference ratio of CBF (DR) between ASL with PLD of 1.5 s (ASL) or 2.0 s (ASL) and CTP were also determined.
There were no significant statistical differences in preoperative rCBF measurements between ASL and CTP ( = 0.17) and between ASL and CTP ( = 0.42). Similarly, no significant differences were found in rCBF between ASL and CTP ( = 0.59) and between ASL and CTP ( = 0.93) after CEA. The DR measured by CTP was found to be marginally lower than that measured by ASL ( = 0.06) and significantly lower than that measured by ASL ( = 0.01), ASL ( = 0.03), and ASL1 ( = 0.007). There was a strong correlation in measuring perioperative rCBF and DR between ASL and CTP (r = 0.67-0.85, < 0.001). Using CTP as the reference standard, smaller bias can be achieved in measuring rCBF by ASL (-0.02) than ASL (-0.07) before CEA. In addition, the same bias (0.03) was obtained by ASL and ASL after CEA. The bias of ASL (0.31) and ASL (0.32) on DR measurement was similar, and both were smaller than that of ASL (0.60) and ASL (0.60).
Strong correlation can be found in assessing perioperative cerebral perfusion between ASL and CTP. During perioperative ASL imaging, the PLD of 2.0 s is better than 1.5 s for preoperative scan, and both 1.5 and 2.0 s are suitable for postoperative scan.
动脉自旋标记（ASL）是一种用于测量脑灌注的非侵入性技术。其准确性受动脉通过时间的影响。本研究旨在：（1）评估ASL在测量接受颈动脉内膜切除术（CEA）患者脑灌注方面的准确性；（2）确定在1.5至2.0秒之间用于术前和术后灌注成像的更好的标记后延迟（PLD）。
本研究纳入了24例因严重颈动脉狭窄计划行CEA的患者。所有患者在手术前后均接受了两种PLD（1.5和2.0秒）的ASL检查以及计算机断层扫描灌注（CTP）检查。在ASL和CTP的配准脑血流量（CBF）图像上测量CBF值。还确定了PLD为1.5秒（ASL）或2.0秒（ASL）的ASL与CTP在测量围手术期相对CBF（rCBF）和CBF差异率（DR）方面的相关性。
术前ASL与CTP之间的rCBF测量值（=0.17）以及ASL与CTP之间的rCBF测量值（=0.42）无显著统计学差异。同样，CEA术后ASL与CTP之间的rCBF（=0.59）以及ASL与CTP之间的rCBF（=0.93）也无显著差异。发现CTP测量的DR略低于ASL测量的DR（=0.06），且显著低于ASL测量的DR（=0.01）、ASL（=0.03）和ASL1（=0.007）。ASL与CTP在测量围手术期rCBF和DR方面存在强相关性（r=0.67 - 0.85，<0.001）。以CTP作为参考标准，CEA术前ASL测量rCBF时的偏差（-0.02）比ASL（-0.07）小。此外，CEA术后ASL和ASL获得的偏差相同（0.03）。ASL（0.31）和ASL（0.32）在DR测量上的偏差相似，且均小于ASL（0.60）和ASL（0.60）。
ASL与CTP在评估围手术期脑灌注方面存在强相关性。在围手术期ASL成像期间，术前扫描时2.0秒的PLD优于1.5秒，而1.5秒和2.0秒均适用于术后扫描。
Zotero 插件