3.0T MRI联合低浓度对比剂CE-MRA和灌注成像在急性缺血性脑卒中的应用价值

Abstract
Figure/Table
References (20)
Related Citation (11)

Download: PDF (648 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective To explore application value of low-dose contrast-enhanced MRA (CE-MRA) and dynamic susceptibility contrast perfusion imaging (DSC-PWI) at 3.0T in patients with acute ischemic stroke. Methods Thirty patients with acute ischemic stroke in Nanjing First Hospital from October 2017 to March 2018 were enrolled. All the patients underwent low-dose CE-MRA and DSC-PWI examination, and DSA examination was performed within 24 h. Half-dose contrast agent concentration (0.05 mmol/kg) was used in both CE-MRA and DSC-PWI. The accuracy of CE-MRA in the diagnosis of arterial stenosis was evaluated by comparing with DSA. Inter-observer agreement tests for diagnosis of arterial stenosis with CE-MRA and mismatched areas with DSC-PWI were tested by Kappa analysis. Results The sensitivity, specificity, positive predictive value and negative predictive value of CE-MRA in the diaognosis of low grade (＜50%) and high grade (＞50%) arterial stenosis of the intracranial and cervical arteries were 82.4%, 100%, 100%, 93.8%, 100% and 82.4%, 93.8%, 100%, respectively. The inter-observer agreements in the diagnosis of arterial stenosis with CE-MRA and mismatch area with DSC-PWI were both excellent (κ = 0.87, 0.86). Conclusion Low-dose CE-MRA and DSC-PWI combination at 3.0T MRI is a feasible MRI scanning protocal for patinets with acute ischemic stroke.

Key words： Acute ischemic stroke Magnetic resonance imaging Gadolinium contrast agents Intracranial and cervical arteries

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	JIANG Hailong MAO Cunnan CHEN Qian CHEN Guozhong YIN Xindao

Cite this article:

JIANG Hailong MAO Cunnan CHEN Qian CHEN Guozhong YIN Xindao. Application value of low-dose contrast-enhanced MR angiography and perfusion imaging at 3.0T in patients with acute ischemic stroke[J]. 中国医药导报, 2019, 16(10): 150-153.

URL:

http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I10/150

[1] Jovin TG，Chamorro A，Cobo E，et al. Thrombectomy within 8 Hours after Symptom Onset in Ischemic Stroke [J]. N Engl J Med，2015，372（24）：2296-2306.
[2] Goyal M，Demchuk AM，Menon BK，et al. Randomized assessment of rapid endovascular treatment of ischemic stroke [J]. N Engl J Med，2015，372（11）：1019-1030.
[3] Campbell BCV，Mitchell PJ，Kleinig TJ，et al. Endovascular Therapy for Ischemic Stroke with Perfusion-Imaging Selection [J]. N Engl J Med，2015，372（11）：1009-1018.
[4] Tomasian A，Salamon N，Lohan DG，et al. Supraaortic arteries：contrast material dose reduction at 3.0-T high-spatial-resolution MR angiography-feasibility study [J]. Radiology，2008，249（3）：980-990.
[5] Ramalho M，Ramalho J，Burke LM，et al. Gadolinium Retention and Toxicity-An Update [J]. Adv Chronic Kidney Dis，2017，24（3）：138-146.
[6] Mcdonald RJ，Mcdonald JS，Kallmes DF，et al. Gadolinium Deposition in Human Brain Tissues after Contrast-enhanced MR Imaging in Adult Patients without Intracranial Abnormalities [J]. Radiology，2017，285（2）：546-554.
[7] Boujan T，Neuberger U，Pfaff J，et al. Value of Contrast-Enhanced MRA versus Time-of-Flight MRA in Acute Ischemic Stroke MRI [J]. AJNR Am J Neuroradiol，2018，39（9）：1710-1716.
[8] Powers WJ，Rabinstein AA，Ackerson T，et al. 2018 Guidelines for the Early Management of Patients With Acute Ischemic Stroke：A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association [J]. Stroke，2018，49（3）：e46-e110.
[9] Song S. Advanced Imaging in Acute Ischemic Stroke [J]. Semin Neurol，2014，33（5）：436-440.
[10] Isoda H，Takehara Y，Isogai S，et al. MRA of intracranial aneurysm models：a comparison of contrast-enhanced three-dimensional MRA with time-of-flight MRA [J]. J Comput Assist Tomogr，2000，24（2）：308-315.
[11] Lin W，Tkach JA，Haacke EM，et al. Intracranial MR angiography：application of magnetization transfer contrast and fat saturation to short gradient-echo，velocity-compensated sequences [J]. Radiology，1993，186（3）：753-761.
[12] Nael K，Moriarty JM，Finn JP. Low dose CE-MRA [J]. Eur J Radiol，2011，80（1）：2-8.
[13] de Zwart JA，Ledden PJ，van Gelderen P，et al. Signal-to-noise ratio and parallel imaging performance of a 16-channel receive-only brain coil array at 3.0 Tesla [J]. Magn Reson Med，2004，51（1）：22-26.
[14] Rinck PA，Muller RN. Field strength and dose dependence of contrast enhancement by gadolinium-based MR contrast agents [J]. Eur Radiol，1999，9（5）：998-1004.
[15] Nael K，Meshksar A，Ellingson B，et al. Combined Low-Dose Contrast-Enhanced MR Angiography and Perfusion for Acute Ischemic Stroke at 3T：A More Efficient Stroke Protocol [J]. Am J Neuroradiol，2014，35（6）：1078-1084.
[16] 苏文，陈谦，毛存南，等.3.0T MRI使用双流高压注射器进行低浓度对比剂头颈部CE-MRA成像的应用价值[J].中国医学计算机成像杂志，2018，24（2）：169-172.
[17] Kassner A，Merali Z. Assessment of Blood-Brain Barrier Disruption in Stroke [J]. Stroke，2015，46（11）：3310-3315.
[18] Tarpley J，Franc D，Tansy AP，et al. Use of Perfusion Imaging and Other Imaging Techniques to Assess Risks/Benefits of Acute Stroke Interventions [J]. Curr Atheroscler Rep，2013，15（7）：336.
[19] Moustafa RR，Baron JC. Clinical review：Imaging in ischaemic stroke-implications for acute management [J]. Crit Care，2007，11（5）：227.
[20] Nael K，Mossadeghi B，Boutelier T，et al. Bayesian estimation of cerebral perfusion using reduced-contrast-dose dynamic susceptibility contrast perfusion at 3T [J]. Am J Neuroradiol，2015，36（4）：710-718.