Zhang Gui-Rong, Zhang Yan-Yan, Liang Wen-Bin, Ding Dun
Department of Medical Imaging, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710043, Shaanxi Province, China.
World J Radiol. 2024 Sep 28;16(9):429-438. doi: 10.4329/wjr.v16.i9.429.
Global and regional cerebral blood flow (CBF) changes in patients with unilateral internal carotid artery occlusion (ICAO) are unclear when the dual post-labeling delays (PLD) arterial spin labeling (ASL) magnetic resonance imaging (MRI) technique is used. Manual delineation of regions of interest for CBF measurement is time-consuming and laborious.
To assess global and regional CBF changes in patients with unilateral ICAO with the ASL-MRI perfusion technique.
Twenty hospitalized patients with ICAO and sex- and age-matched controls were included in the study. Regional CBF was measured by Dr. Brain's ASL software. The present study evaluated differences in global, middle cerebral artery (MCA) territory, anterior cerebral artery territory, and Alberta Stroke Program Early Computed Tomography Score (ASPECTS) regions (including the caudate nucleus, lentiform nucleus, insula ribbon, internal capsule, and M1-M6) and brain lobes (including frontal, parietal, temporal, and insular lobes) between ICAO patients and controls at PLD 1.5 s and PLD 2.5 s.
When comparing CBF between ICAO patients and controls, the global CBF in ICAO patients was lower at both PLD 1.5 s and PLD 2.5 s; the CBF on the occluded side was lower in 15 brain regions at PLD 1.5 s, and it was lower in 9 brain regions at PLD 2.5 s; the CBF in the contralateral hemisphere was lower in the caudate nucleus and internal capsule at PLD 1.5 s and in M6 at PLD 2.5 s. The global CBF in ICAO patients was lower at PLD 1.5 s than at PLD 2.5 s. The ipsilateral CBF at PLD 1.5 s was lower than that at PLD 2.5 s in 15 regions, whereas the contralateral CBF was lower at PLD 1.5 s than at PLD 2.5 s in 12 regions. The ipsilateral CBF was lower than the contralateral CBF in 15 regions at PLD 1.5 s, and in M6 at PLD 2.5 s.
Unilateral ICAO results in hypoperfusion in the global and MCA territories, especially in the ASPECTS area. Dual PLD settings prove more suitable for accurate CBF quantification in ICAO.
在使用双标记延迟（PLD）动脉自旋标记（ASL）磁共振成像（MRI）技术时，单侧颈内动脉闭塞（ICAO）患者的全脑和局部脑血流量（CBF）变化尚不清楚。手动勾勒用于测量CBF的感兴趣区域既耗时又费力。
采用ASL-MRI灌注技术评估单侧ICAO患者的全脑和局部CBF变化。
本研究纳入了20例住院的ICAO患者以及性别和年龄匹配的对照组。采用Dr. Brain的ASL软件测量局部CBF。本研究评估了在PLD为1.5秒和2.5秒时，ICAO患者与对照组之间在全脑、大脑中动脉（MCA）供血区、大脑前动脉供血区以及阿尔伯塔卒中项目早期CT评分（ASPECTS）区域（包括尾状核、豆状核、岛叶带、内囊和M1-M6）和脑叶（包括额叶、顶叶、颞叶和岛叶）的差异。
比较ICAO患者与对照组的CBF时，ICAO患者在PLD 1.5秒和PLD 2.5秒时的全脑CBF均较低；在PLD 1.5秒时，闭塞侧的CBF在15个脑区较低，在PLD 2.5秒时，在9个脑区较低；在PLD 1.5秒时，对侧半球的尾状核和内囊以及在PLD 2.5秒时的M6区域CBF较低。ICAO患者在PLD 1.5秒时的全脑CBF低于PLD 2.5秒时。在15个区域中，PLD 1.5秒时患侧的CBF低于PLD 2.5秒时，而在12个区域中，PLD 1.5秒时对侧的CBF低于PLD 2.5秒时。在PLD 1.5秒时，15个区域患侧的CBF低于对侧，在PLD 2.5秒时M6区域患侧的CBF低于对侧。
单侧ICAO导致全脑和MCA供血区灌注不足，尤其是在ASPECTS区域。双PLD设置更适合于准确量化ICAO患者的CBF。
