Multivariate Pattern Analysis of Perfusion and Oxygenation Impairment in Asymptomatic Carotid Artery Stenosis

IF 2.3 4区 医学 Q3 CLINICAL NEUROLOGY
Jan Kufer, Christine Preibisch, Jens Göttler, Lena Schmitzer, Gabriel Hoffmann, Michael Kallmayer, Claus Zimmer, Fahmeed Hyder, Stephan Kaczmarz
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引用次数: 0

Abstract

Background and Purpose

Hemodynamic impairment may contribute to stroke risk and cognitive decline in asymptomatic internal carotid artery stenosis (ICAS). Therefore, multimodal MRI-based quantification of hemodynamic impairment could inform improved treatment decisions. While gross interhemispheric hemodynamic imbalances have been reported in ICAS, identifying more spatially resolved patterns of disease-related alterations may be promising to harness the full potential of hemodynamic MRI.

Methods

In this feasibility study, we investigated the spatial topography of ICAS-related impairments by applying scaled subprofile model principal component analysis (SSM-PCA) to cerebral blood flow (CBF), relative oxygen extraction fraction (rOEF), and oxygen extraction capacity (OEFmax) data of 21 unilateral ICAS patients and 25 healthy controls (HC).

Results

We found spatially extended, partly overlapping disease-related patterns for CBF and OEFmax, but not rOEF. CBF (area under the curve [AUC] = 0.95) but not OEFmax (AUC = 0.72) SSM-PCA scores distinguished ICAS patients and HC better than interhemispheric lateralizations (AUC = 0.75/0.73). SSM-PCA scores were only partly explained by interhemispheric lateralization (R2 = −0.27/0.38), indicating complementary information. Critically, ICAS patients with higher OEFmax SSM-PCA scores (z ≥ 1) demonstrated higher stenotic degrees and lower cognitive performance (p < 0.05) without differing in interhemispheric lateralization (p > 0.05).

Conclusions

We demonstrated the feasibility of SSM-PCA in ICAS and obtained novel insights into complex hemodynamic impairment patterns and their association with cognitive function.

Abstract Image

无症状颈动脉狭窄灌注和氧合损伤的多因素模式分析
背景与目的无症状颈内动脉狭窄(ICAS)患者血流动力学障碍可能增加卒中风险和认知能力下降。因此,基于多模态mri的血流动力学损伤量化可以为改进的治疗决策提供信息。虽然在ICAS中已经报道了严重的半球间血流动力学失衡,但识别更多空间上的疾病相关改变模式可能有望充分利用血流动力学MRI的潜力。方法采用尺度亚剖面模型主成分分析(SSM-PCA)对21例单侧ICAS患者和25例健康对照(HC)的脑血流量(CBF)、相对氧提取分数(rOEF)和氧提取容量(OEFmax)数据进行分析,探讨ICAS相关损伤的空间形态特征。结果我们发现CBF和OEFmax在空间上延伸,部分重叠的疾病相关模式,但rOEF没有。CBF(曲线下面积[AUC] = 0.95)而不是OEFmax (AUC = 0.72) SSM-PCA评分区分ICAS患者和HC优于半球间偏侧(AUC = 0.75/0.73)。SSM-PCA评分仅部分解释了半球间偏侧(R2 = - 0.27/0.38),表明信息互补。重要的是,OEFmax SSM-PCA评分(z≥1)较高的ICAS患者狭窄程度较高,认知能力较低(p < 0.05),但在半球间偏侧方面没有差异(p < 0.05)。我们证明了SSM-PCA在ICAS中的可行性,并对复杂的血流动力学损伤模式及其与认知功能的关系获得了新的见解。
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来源期刊
Journal of Neuroimaging
Journal of Neuroimaging 医学-核医学
CiteScore
4.70
自引率
0.00%
发文量
117
审稿时长
6-12 weeks
期刊介绍: Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!
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