Quantification of Collateral Supply with Local-AIF Dynamic Susceptibility Contrast MRI Predicts Infarct Growth.

Mira M Liu, Niloufar Saadat, Steven P Roth, Marek A Niekrasz, Mihai Giurcanu, Timothy J Carroll, Gregory A Christoforidis
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Abstract

Background and purpose: In ischemic stroke, leptomeningeal collaterals can provide delayed and dispersed compensatory blood flow to tissue-at-risk despite an occlusion and can impact treatment response and infarct growth. The purpose of this work is to test the hypothesis that inclusion of this delayed and dispersed flow with an appropriately calculated Local Arterial Input Function (Local-AIF) is needed to quantify the degree of collateral blood supply in tissue distal to an occlusion.

Materials and methods: Seven experiments were conducted in a pre-clinical middle cerebral artery occlusion model. Dynamic susceptibility contrast MRI was imaged and post-processed to yield quantitative cerebral blood flow (qCBF) maps with both a traditionally chosen single arterial input function applied globally to the whole brain (i.e. "Global-AIF") and a delay and dispersion corrected AIF (i.e. "Local-AIF") that is sensitive to retrograde flow. Leptomeningeal collateral arterial recruitment was quantified with a pial collateral score from x-ray angiograms, and infarct growth calculated from serially acquired diffusion weighted MRI scans.

Results: The degree of collateralization at x-ray correlated more strongly with qCBF using the Local-AIF in the ischemic penumbra (R2=0.81) than traditionally chosen Global-AIF (R2=0.05). qCBF using a Local-AIF was negatively correlated (less infarct progression as perfusion increased) with infarct growth (R2 = 0.79) more strongly than a Global-AIF (R2=0.02).

Conclusions: In acute stroke, qCBF calculated with a Local-AIF is more accurate for assessing tissue status and collateral supply than traditionally chosen Global-AIFs. These findings support use of a Local-AIF that corrects for delayed and dispersed retrograde flow in determining quantitative tissue perfusion with collateral supply in occlusive disease.

Abbreviations: MRI = magnetic resonance imaging; DSC = dynamic susceptibility contrast; PCS = pial collateral score; MCAO = middle cerebral artery occlusion; MCA = middle cerebral artery; AIF = arterial input function; rCBF = relative cerebral blood flow; qCBF = quantitative cerebral blood flow.

利用局部-AIF 动态感知对比 MRI 对侧支供应进行量化可预测梗塞的发展。
背景和目的:在缺血性脑卒中中,尽管存在闭塞,但脑叶脑膜侧支可为高危组织提供延迟和分散的代偿血流,并可影响治疗反应和梗死的生长。这项工作的目的是验证以下假设:要量化闭塞远端组织的侧支血流供应程度,需要将这种延迟和分散的血流与适当计算的局部动脉输入函数(Local-AIF)结合起来:在临床前大脑中动脉闭塞模型中进行了七项实验。对动态感性对比核磁共振成像进行成像和后处理,得出定量脑血流(qCBF)图,其中既有传统上选择的适用于全脑的单一动脉输入函数(即 "全局-AIF"),也有对逆流敏感的延迟和弥散校正 AIF(即 "局部-AIF")。根据X光血管造影的髓侧动脉评分对侧脑动脉募集情况进行量化,并根据连续获取的弥散加权核磁共振扫描结果计算梗死生长情况:采用局部-AIF的qCBF与缺血半影的qCBF(R2=0.81)的负相关(灌注增加时梗死进展较小)比采用全局-AIF的qCBF(R2=0.02)更强:结论:在急性卒中中,用局部-AIF 计算的 qCBF 比传统的全局-AIF 更能准确评估组织状态和侧支供应。这些研究结果支持在确定闭塞性疾病的定量组织灌注和侧支供应时使用校正延迟和分散逆行血流的局部-AIF:缩写:MRI = 磁共振成像;DSC = 动态感性对比;PCS = 髓侧支评分;MCAO = 大脑中动脉闭塞;MCA = 大脑中动脉;AIF = 动脉输入功能;rCBF = 相对脑血流;qCBF = 定量脑血流。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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