单侧颅内动脉闭塞患者静息状态BOLD MRI评价脑血管反应性损伤。

IF 2.8 Q3 CLINICAL NEUROLOGY

Cerebral circulation - cognition and behavior Pub Date : 2026-01-01 Epub Date: 2026-02-07 DOI:10.1016/j.cccb.2026.100532

Yi Shan , Ya-yan Yin , Bi-xiao Cui , Shao-zhen Yan , Yue Zhang , Bin Yang , Yan Ma , Jie Lu

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引用次数: 0

摘要

目的：脑血管反应性（CVR）是症状性大脑中动脉(MCA)/颈内动脉（ICA）闭塞患者预后不良的独立预测因子。本研究使用静息状态血氧水平依赖（RS BOLD） MRI评估该人群的CVR损伤，旨在确定可行的术前标记。方法：研究对象为45例单侧MCA/ICA闭塞患者和20例健康对照。其中16例行颅外-颅内（EC-IC）旁路手术，随访MRI。RS BOLD数据采用3.0 T PET/MR系统采集。使用一般线性模型计算逐体素CVR图，并计算MCA灌注区域的平均CVR。评估CVR半球间不对称指数（CVR- ai）。分析组间差异，采用ROC分析评价CVR的诊断效能。Pearson相关性用于评估基线CVR与术后变化之间的关系。结果：患侧CVR明显低于对侧及对照组（P < 0.01）。个体分析显示，患侧和对侧CVR下降、正常和增加的比例有显著差异（P < 0.0001）。CVR-AI在区分患者和对照组方面显示出较高的预测效率（AUC = 0.762）。术后患侧CVR显著升高，CVR- ai降低，但仍高于对照组（P < 0.05）。术前CVR- ai与术后患侧CVR升高（R = 0.725）、CVR- ai降低（R = 0.635）呈正相关。结论：本研究提出CVR-AI可作为单侧颅内动脉闭塞患者术前评估的一种新型影像学指标。

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Evaluation of cerebrovascular reactivity impairment using resting-state BOLD MRI in symptomatic patients with unilateral intracranial artery occlusion

Objectives

Cerebral vascular reactivity (CVR) is an independent predictor of poor prognosis for patients with symptomatic middle cerebral artery (MCA)/internal carotid artery (ICA) occlusion. This study assessed CVR impairment using resting-state blood oxygenation level-dependent (RS BOLD) MRI in this population and aimed to identify feasible pre-surgical markers.

Methods

The study included 45 patients with symptomatic unilateral MCA/ICA occlusion and 20 healthy controls. Of these, 16 underwent extracranial-intracranial (EC-IC) bypass with follow-up MRI. RS BOLD data were collected using a 3.0 T PET/MR system. Voxel-wise CVR maps were computed with a general linear model, and the mean CVR in the MCA perfusion territory was calculated. Interhemispheric CVR asymmetry index (CVR-AI) was assessed. Group differences were analyzed, and ROC analysis was used to evaluate CVR's diagnostic performance. Pearson correlation was used to assess relationships between baseline CVR and post-surgical changes.

Results

Affected-side CVR was significantly lower compared to the contralateral side and controls (P < 0.01). Individual analysis showed significant differences in the proportions of decreased, normal, and increased CVR between the affected and contralateral sides (P < 0.0001). CVR-AI showed high predictive efficiency for discriminating patients from controls (AUC = 0.762). Post-surgery, the affected-side CVR increased significantly, whereas CVR-AI decreased but remained higher than in controls (P < 0.05). Preoperative CVR-AI positively correlated with post-surgery affected-side CVR increase (R = 0.725) and CVR-AI decrease (R = 0.635).