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Dynamic Contrast-Enhanced MRI Evaluation of Cerebral Cavernous Malformations

机译：动态对比增强磁共振成像评价脑海绵状畸形

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The aim of this study is to quantitatively evaluate the behavior of CNS cavernous malformations (CCMs) using a dynamic contrast-enhanced MRI (DCEMRI) technique sensitive for slow transfer rates of gadolinium. The prospective study was approved by the institutional review board and was HIPPA compliant. Written informed consent was obtained from 14 subjects with familial CCMs (4 men and 10 women, ages 22–76 years, mean 48.1 years). Following routine anatomic MRI of the brain, DCEMRI was performed for six slices, using T1 mapping with partial inversion recovery (TAPIR) to calculate T1 values, following administration of 0.025 mmol/kg gadolinium DTPA. The transfer rate (Ki) was calculated using the Patlak model, and Ki within CCMs was compared to normal-appearing white matter as well as to 17 normal control subjects previously studied. All subjects had typical MRI appearance of CCMs. Thirty-nine CCMs were studied using DCEMRI. Ki was low or normal in 12 lesions and elevated from 1.4 to 12 times higher than background in the remaining 27 lesions. Ki ranged from 2.1E−6 to 9.63E−4 min−1, mean 3.55E−4. Normal-appearing white matter in the CCM patients had a mean Ki of 1.57E−4, not statistically different from mean WM Ki of 1.47E−4 in controls. TAPIR-based DCEMRI technique permits quantifiable assessment of CCMs in vivo and reveals considerable differences not seen with conventional MRI. Potential applications include correlation with biologic behavior such as lesion growth or hemorrage, and measurement of drug effects.
机译：这项研究的目的是使用对contrast的缓慢转移速率敏感的动态对比增强MRI（DCEMRI）技术定量评估中枢神经系统海绵状畸形（CCM）的行为。前瞻性研究已获得机构审查委员会的批准，并且符合HIPPA。书面知情同意书来自14位患有家族性CCM的受试者（4名男性和10名女性，年龄22-76岁，平均48.1岁）。在常规的脑部解剖MRI之后，对DCEMRI进行了六个切片，使用T1映射和部分反转恢复（TAPIR）来计算T1值，然后再加入0.025 mmol / kg DTPA。使用Patlak模型计算转移速率（Ki），并将CCM中的Ki与正常出现的白质以及先前研究的17名正常对照受试者进行比较。所有受试者均具有典型的CCM MRI表现。使用DCEMRI研究了39个CCM。在12个病灶中Ki较低或正常，在其余27个病灶中，Ki比背景高1.4至12倍。 Ki范围从2.1E-6到9.63E-4min-1，平均值为3.55E-4。 CCM患者中出现正常的白质的平均Ki为1.57E-4，与对照组的平均WM Ki为1.47E-4在统计学上没有差异。基于TAPIR的DCEMRI技术可对体内CCM进行定量评估，并揭示了常规MRI所未见的显着差异。潜在的应用包括与生物学行为（如病灶生长或出血）的相关性以及药物作用的测量。

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