Tapper Sofie, Mauritzon Stina, Martins Marcelo P, Ginstman Fredrik, Tisell Anders, Zsigmond Peter, Wårdell Karin
Department of Biomedical Engineering, Linköping University, Linköping, Sweden.
Department of Radiology in Linköping and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
Neuroimage Clin. 2025 Jun 16;47:103821. doi: 10.1016/j.nicl.2025.103821.
Subarachnoid hemorrhage (SAH) patients are monitored in the neurointensive care unit (NICU) to avoid additional brain injuries, yet methods for monitoring cerebral blood flow (CBF) are limited. The aim was to investigate the feasibility of simultaneous MRI, using arterial spin labeling (ASL) and 2D-flow MRI, and probe-based laser Doppler flowmetry (LDF) in NICU patients.
Four SAH patients, three of whom received optical probes during routine surgery, were included. Compatibility of simultaneous LDF and MRI was evaluated before performing MRI 3-4 times over several days per patient. The methods were compared using mean CBF in grey matter obtained from the absolute ASL CBF-maps, the total inflow calculated from 2D-flow MRI, and local average LDF perfusion. Additionally, regional mean CBF from ASL and each arterial flowrate was compared for each hemisphere.
Twelve MRI measurements were successfully performed, eight of which included simultaneous LDF. With careful routines and the MR scanner uniquely located in the NICU, neither patient safety nor data quality was compromised, demonstrating the feasibility of concurrent measurements. All methods showed longitudinal dynamic changes, following the same increasing or decreasing trends. In three patients, ASL and 2D-flow data were closely related, with dynamic changes within 10 %.
This novel approach offers longitudinal, simultaneous estimates of macro- and microcirculatory components locally, regionally, and globally in the human brain. This concept has potential to provide insights into the interplay of different aspects of CBF in NICU patients and thereby aid in prevention of secondary brain injuries.
蛛网膜下腔出血（SAH）患者在神经重症监护病房（NICU）接受监测以避免额外的脑损伤，但监测脑血流量（CBF）的方法有限。本研究旨在探讨在NICU患者中同时进行磁共振成像（MRI）（采用动脉自旋标记法（ASL）和二维血流MRI）以及基于探头的激光多普勒血流仪（LDF）监测的可行性。
纳入4例SAH患者，其中3例在常规手术期间接受了光学探头。在每位患者数天内进行3 - 4次MRI检查前，评估LDF与MRI同时使用的兼容性。使用从绝对ASL CBF图获得的灰质平均CBF、二维血流MRI计算的总流入量以及局部平均LDF灌注对这些方法进行比较。此外，还比较了每个半球ASL的区域平均CBF和各动脉血流速度。
成功进行了12次MRI测量，其中8次包括同时进行LDF测量。通过精心的操作流程以及将MR扫描仪专门放置在NICU中，患者安全和数据质量均未受到影响，证明了同时测量的可行性。所有方法均显示出纵向动态变化，呈现相同的上升或下降趋势。在3例患者中，ASL和二维血流数据密切相关，动态变化在10%以内。
这种新方法能够在局部、区域和整体水平上对人脑的宏观和微循环成分进行纵向、同步估计。这一概念有可能深入了解NICU患者CBF不同方面之间的相互作用，从而有助于预防继发性脑损伤。
