Velasco Gonzalez Aglae, Görlich Dennis, Buerke Boris, Sauerland Cristina, Meier Norbert, Fobker Manfred, McCarthy Ray, Jeibmann Astrid, Heindel Walter, Faldum Andreas, Kugel Harald
Clinic for Radiology, Neuroradiology, University of Münster and University Hospital Münster, 48149, Münster, Albert-Schweitzer-Campus 1, Building A1, Germany.
Institute of Biostatistics and Clinical Research, University of Münster, 48149, Münster, Schmeddingstraße 56, Germany.
Sci Rep. 2025 Jan 2;15(1):103. doi: 10.1038/s41598-024-83916-0.
This study aims to improve our understanding of acute ischemic stroke clot imaging by integrating CT attenuation information with MRI susceptibility signal of thrombi. For this proof-of-principle experimental study, fifty-seven clot analogs were produced using ovine venous blood with a broad histological spectrum. Each clot analog was analyzed to determine its RBC content and chemical composition, including water, Fe III, sodium, pH, and pO2. Non-contrast CT and a susceptibility-weighted MRI sequence were used for imaging. The study found that RBC content correlated more accurately than iron content with clot attenuation on CT. There was a strong correlation between Fe III content and RBC percentage in clots. Specifically, changes in RBC content accounted for 64% of the variance in Fe III content (R2 = 0.640; p < .0001). Thrombi with blooming artifacts (BA) displayed higher attenuation on non-contrast CT than those without (73.4 vs. 40 HU, p < .0001) and had the highest RBC and iron contents. The cut-off value of 1242 µg/g of iron predicted blooming artifacts with high sensitivity and specificity. The pH level strongly affected the appearance of blooming artifacts, particularly for negative clots with high RBC content. These findings provide significant insights into the imaging behavior of acute ischemic stroke clots across both imaging modalities and could potentially improve the diagnosis and treatment of acute stroke patients. Furthermore, these results open the possibility for future research aimed at developing pH-modulated therapeutic strategies based on the acid-base state of thrombi.
本研究旨在通过整合CT衰减信息与血栓的MRI敏感性信号，提高我们对急性缺血性中风血栓成像的理解。在这项原理验证实验研究中，使用具有广泛组织学谱的羊静脉血制作了57个血栓模拟物。对每个血栓模拟物进行分析，以确定其红细胞含量和化学成分，包括水、铁离子（Fe III）、钠、pH值和氧分压（pO2）。使用非增强CT和敏感性加权MRI序列进行成像。研究发现，红细胞含量与CT上血栓衰减的相关性比铁含量更准确。血栓中铁离子（Fe III）含量与红细胞百分比之间存在很强的相关性。具体而言，红细胞含量的变化占铁离子（Fe III）含量方差的64%（R2 = 0.640；p < 0.0001）。有磁敏感伪影（BA）的血栓在非增强CT上的衰减高于无磁敏感伪影的血栓（73.4 vs. 40 HU，p < 0.0001），且红细胞和铁含量最高。铁含量为1242 µg/g的临界值对磁敏感伪影具有较高的敏感性和特异性。pH值水平强烈影响磁敏感伪影的表现，特别是对于红细胞含量高的阴性血栓。这些发现为两种成像方式下急性缺血性中风血栓的成像行为提供了重要见解，并可能改善急性中风患者的诊断和治疗。此外，这些结果为未来基于血栓酸碱状态开发pH调节治疗策略的研究开辟了可能性。
