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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Detection of impaired cerebrovascular reactivity in patients with chronic cerebral ischemia using whole-brain 7T MRA
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Detection of impaired cerebrovascular reactivity in patients with chronic cerebral ischemia using whole-brain 7T MRA

机译：用全脑7T MRA检测慢性脑缺血患者患者患者受损的障碍

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Background: Cerebrovascular reactivity (CVR) to acetazolamide (ACZ) on single-photon emission computed tomography (SPECT) can be used to assess the severity of chronic cerebral ischemia; however, this is an invasive method. We examined whether whole-brain magnetic resonance angiography (MRA) at 7T could non-invasively detect impaired CVR in patients with chronic cerebral ischemia by demonstrating the leptomeningeal collaterals (LMCs). Methods: Fifty-seven patients with symptomatic unilateral cervical stenosis underwent whole-brain time-of-flight MRA at 7T and cerebral perfusion SPECT before/after the ACZ challenge. MRA images were visually assessed based on 6-point grading systems to evaluate the development of LMCs toward the middle cerebral artery (MCA) and antegrade flow of MCA. CVR of the affected side was calculated from the SPECT data. Subsequently, we compared the LMC grades on MRA with CVR on SPECT. Results: CVR was significantly lower in grades >= 2 of LMCs than in grades 0-1 (P < 0.05) when applying LMCs from the anterior cerebral artery (ACA) and/or posterior cerebral artery (PCA). These differences were more evident than those in the grading of the antegrade MCA flow. The LMC grades from ACA/PCA readily detected reduced CVR (< 18.4%) with a sensitivity/specificity of 0.79/0.82. Conclusion: The development of LMCs on whole-brain MRA at 7T can non-invasively detect reduced CVR with a high sensitivity/specificity in patients with unilateral cervical stenosis. (c) 2020 Elsevier Inc. All rights reserved.
机译：背景：单光子发射计算机断层扫描（SPECT）显示脑血管对乙酰唑胺（ACZ）的反应性（CVR）可用于评估慢性脑缺血的严重程度；然而，这是一种侵入性的方法。我们通过展示软脑膜侧支循环（LMC），研究了7T全脑磁共振血管造影（MRA）是否能无创检测慢性脑缺血患者的CVR受损。方法：57例症状性单侧颈椎管狭窄症患者在ACZ激发前后进行了7T全脑飞行时间MRA和脑灌注SPECT检查。基于6点分级系统对MRA图像进行视觉评估，以评估LMC向大脑中动脉（MCA）的发展和MCA的顺行流动。根据SPECT数据计算患侧CVR。随后，我们比较了MRA上的LMC分级和SPECT上的CVR分级。结果：当从大脑前动脉（ACA）和/或大脑后动脉（PCA）应用LMC时，>=2级LMC的CVR显著低于0-1级（P<0.05）。这些差异比顺行MCA血流分级更明显。ACA/PCA的LMC分级很容易检测到CVR降低（<18.4%），敏感性/特异性为0.79/0.82。结论：在7T全脑MRA上建立LMC可以无创检测单侧颈椎管狭窄患者CVR降低，具有较高的敏感性/特异性。（c） 2020爱思唯尔公司版权所有。

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