{"title":"估计大血管闭塞的低灌注组织体积：伪连续动脉自旋标记与动态敏感性对比灌注加权成像。","authors":"Chenxi Zhao, Chen Cao, Lei Ren, Huiying Wang, Gemuer Wu, Dingwei Fu, Jinxia Zhu, Chao Chai, Yu Guo, Shuang Xia","doi":"10.21037/qims-24-1560","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Currently, the selection of patients with acute anterior large vessel occlusions (LVOs) for endovascular thrombectomy (EVT) is primarily based on dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) or computed tomography (CT) perfusion imaging. This study investigated the consistency between hypoperfused tissue (HPT) (time to maximum >6 s, Tmax >6 s) volumes estimated by corrected and uncorrected multidelay pseudo-continuous arterial spin labeling (pCASL) and DSC-PWI in patients with anterior LVOs and also evaluated the diagnostic performances in selecting patients with acute LVOs for EVT.</p><p><strong>Methods: </strong>This retrospective study enrolled patients with acute (n=108) and symptomatic chronic (n=90) LVOs. Shapiro-Wilk tests and receiver operating characteristic (ROC) analyses were used. Intraclass correlation coefficient (ICC) compared the consistency of HPT volume calculated by DSC-PWI and multidelay pCASL.</p><p><strong>Results: </strong>Multidelay pCASL with different thresholds in acute LVOs were 128.8 [interquartile range (IQR), 76.2-181.1] mL in uncorrected relative cerebral blood flow (rCBF) <40%, 84.1 (IQR, 36.8-133.9) mL in uncorrected CBF <20 mL·100 g<sup>-1</sup>·min<sup>-1</sup> <i>,</i> and 74.4 (IQR, 26.2-118.0) mL in corrected CBF <20 mL·100 g<sup>-1</sup>·min<sup>-1</sup>, which were comparable to the volume of 69.5 (IQR, 20.0-121.4) mL automatically determined by Tmax >6 s in DSC-PWI, and showed substantial consistency after correction (ICC =0.742). Multidelay pCASL with different thresholds in symptomatic chronic LVOs was 78.3 (IQR, 53.5-129.4) mL, 59.8 (IQR, 16.6-98.5) mL and 36.4 (IQR, 10.1-85.3) mL, which were comparable to the volume of 0 (IQR, 0-36.4) mL in DSC-PWI, and showed substantial consistency after correction (ICC =0.617). Using DEFUSE 3 as the reference standard, the CBF corrected by arterial transit time (ATT) showed good performance in selecting patients for EVT (area under the curve 0.804, 95% confidence interval: 0.717-0.891).</p><p><strong>Conclusions: </strong>The volume of HPT defined by corrected CBF <20 mL·100 g<sup>-1</sup>·min<sup>-1</sup> is consistent with that of DSC-PWI in acute and chronic symptomatic LVOs patients. Multidelay pCASL adjusted by ATT is more applicable to clinical routine.</p>","PeriodicalId":54267,"journal":{"name":"Quantitative Imaging in Medicine and Surgery","volume":"15 3","pages":"2053-2064"},"PeriodicalIF":2.9000,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948376/pdf/","citationCount":"0","resultStr":"{\"title\":\"Estimation of hypoperfused tissue volume in large vessel occlusions: pseudo-continuous arterial spin labeling versus dynamic susceptibility contrast perfusion-weighted imaging.\",\"authors\":\"Chenxi Zhao, Chen Cao, Lei Ren, Huiying Wang, Gemuer Wu, Dingwei Fu, Jinxia Zhu, Chao Chai, Yu Guo, Shuang Xia\",\"doi\":\"10.21037/qims-24-1560\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Currently, the selection of patients with acute anterior large vessel occlusions (LVOs) for endovascular thrombectomy (EVT) is primarily based on dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) or computed tomography (CT) perfusion imaging. This study investigated the consistency between hypoperfused tissue (HPT) (time to maximum >6 s, Tmax >6 s) volumes estimated by corrected and uncorrected multidelay pseudo-continuous arterial spin labeling (pCASL) and DSC-PWI in patients with anterior LVOs and also evaluated the diagnostic performances in selecting patients with acute LVOs for EVT.</p><p><strong>Methods: </strong>This retrospective study enrolled patients with acute (n=108) and symptomatic chronic (n=90) LVOs. Shapiro-Wilk tests and receiver operating characteristic (ROC) analyses were used. Intraclass correlation coefficient (ICC) compared the consistency of HPT volume calculated by DSC-PWI and multidelay pCASL.</p><p><strong>Results: </strong>Multidelay pCASL with different thresholds in acute LVOs were 128.8 [interquartile range (IQR), 76.2-181.1] mL in uncorrected relative cerebral blood flow (rCBF) <40%, 84.1 (IQR, 36.8-133.9) mL in uncorrected CBF <20 mL·100 g<sup>-1</sup>·min<sup>-1</sup> <i>,</i> and 74.4 (IQR, 26.2-118.0) mL in corrected CBF <20 mL·100 g<sup>-1</sup>·min<sup>-1</sup>, which were comparable to the volume of 69.5 (IQR, 20.0-121.4) mL automatically determined by Tmax >6 s in DSC-PWI, and showed substantial consistency after correction (ICC =0.742). Multidelay pCASL with different thresholds in symptomatic chronic LVOs was 78.3 (IQR, 53.5-129.4) mL, 59.8 (IQR, 16.6-98.5) mL and 36.4 (IQR, 10.1-85.3) mL, which were comparable to the volume of 0 (IQR, 0-36.4) mL in DSC-PWI, and showed substantial consistency after correction (ICC =0.617). Using DEFUSE 3 as the reference standard, the CBF corrected by arterial transit time (ATT) showed good performance in selecting patients for EVT (area under the curve 0.804, 95% confidence interval: 0.717-0.891).</p><p><strong>Conclusions: </strong>The volume of HPT defined by corrected CBF <20 mL·100 g<sup>-1</sup>·min<sup>-1</sup> is consistent with that of DSC-PWI in acute and chronic symptomatic LVOs patients. Multidelay pCASL adjusted by ATT is more applicable to clinical routine.</p>\",\"PeriodicalId\":54267,\"journal\":{\"name\":\"Quantitative Imaging in Medicine and Surgery\",\"volume\":\"15 3\",\"pages\":\"2053-2064\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-03-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948376/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Quantitative Imaging in Medicine and Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/qims-24-1560\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/2/26 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Quantitative Imaging in Medicine and Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/qims-24-1560","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/26 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Estimation of hypoperfused tissue volume in large vessel occlusions: pseudo-continuous arterial spin labeling versus dynamic susceptibility contrast perfusion-weighted imaging.
Background: Currently, the selection of patients with acute anterior large vessel occlusions (LVOs) for endovascular thrombectomy (EVT) is primarily based on dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI) or computed tomography (CT) perfusion imaging. This study investigated the consistency between hypoperfused tissue (HPT) (time to maximum >6 s, Tmax >6 s) volumes estimated by corrected and uncorrected multidelay pseudo-continuous arterial spin labeling (pCASL) and DSC-PWI in patients with anterior LVOs and also evaluated the diagnostic performances in selecting patients with acute LVOs for EVT.
Methods: This retrospective study enrolled patients with acute (n=108) and symptomatic chronic (n=90) LVOs. Shapiro-Wilk tests and receiver operating characteristic (ROC) analyses were used. Intraclass correlation coefficient (ICC) compared the consistency of HPT volume calculated by DSC-PWI and multidelay pCASL.
Results: Multidelay pCASL with different thresholds in acute LVOs were 128.8 [interquartile range (IQR), 76.2-181.1] mL in uncorrected relative cerebral blood flow (rCBF) <40%, 84.1 (IQR, 36.8-133.9) mL in uncorrected CBF <20 mL·100 g-1·min-1, and 74.4 (IQR, 26.2-118.0) mL in corrected CBF <20 mL·100 g-1·min-1, which were comparable to the volume of 69.5 (IQR, 20.0-121.4) mL automatically determined by Tmax >6 s in DSC-PWI, and showed substantial consistency after correction (ICC =0.742). Multidelay pCASL with different thresholds in symptomatic chronic LVOs was 78.3 (IQR, 53.5-129.4) mL, 59.8 (IQR, 16.6-98.5) mL and 36.4 (IQR, 10.1-85.3) mL, which were comparable to the volume of 0 (IQR, 0-36.4) mL in DSC-PWI, and showed substantial consistency after correction (ICC =0.617). Using DEFUSE 3 as the reference standard, the CBF corrected by arterial transit time (ATT) showed good performance in selecting patients for EVT (area under the curve 0.804, 95% confidence interval: 0.717-0.891).
Conclusions: The volume of HPT defined by corrected CBF <20 mL·100 g-1·min-1 is consistent with that of DSC-PWI in acute and chronic symptomatic LVOs patients. Multidelay pCASL adjusted by ATT is more applicable to clinical routine.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
