背景:大脑中动脉(MCA)斑块是缺血性卒中(IS)的主要原因。斑块炎症对斑块稳定性至关重要,迫切需要定量检测。
目的:探讨对照混叠在高加速度(CAIPIRINHA)-Dixon时间分辨血管造影和交错随机轨迹(TWIST)(CDT)动态对比增强MRI(DCE-MRI)中并行成像结果中的应用,以评估MCA罪犯斑块炎症随中风时间和糖尿病(DM)的变化。
方法:前瞻性。
方法:94例患者(51.6±12.23岁,32名女性,23DM)合并急性IS(AIS;N=43)和非急性IS(非AIS;14天<卒中时间≤3个月;N=51)。
■3-T,CDTDCE-MRI和三维(3D)采样完美与应用优化的对比使用不同的翻转角演变(3D-SPACE)T1加权成像(T1WI)。
结果:记录卒中时间(从最初的IS症状到MRI)和DM。对于94个MCA罪犯斑块,比较CDTDCE-MRI的Ktrans和3D-SPACET1WI的增强率(ER)。
方法:Shapiro-Wilk检验,Bland-Altman分析,通过和巴洛克测试,独立t检验,Mann-WhitneyU测试,卡方检验,费希尔的精确检验,接收器工作特性(ROC)与曲线下面积(AUC),DeLong\'stest,和Spearman秩相关检验,P值显著性水平为0.05。
结果:AIS患者MCA罪犯斑块的Ktrans和ER明显高于非AIS患者(Ktrans=0.098s-1vs.0.037s-1;ER=0.86vs.0.55)。Ktrans在区分AIS和非AIS患者方面表现出更好的AUC(0.87vs.0.75),与卒中时间的负相关比ER强(r=-0.60vs.-0.34)。在IS和AIS组中,DM患者的Ktrans和ER明显高于非DM患者。
结论:通过CDTDCE-MRI成像可以定量评估卒中时间和DM的MCA罪犯斑块。
方法:2技术效果:阶段2。
BACKGROUND: Middle cerebral artery (MCA) plaques are a leading cause of ischemic stroke (IS). Plaque inflammation is crucial for plaque stability and urgently needs quantitative detection.
OBJECTIVE: To explore the utility of Controlled Aliasing in Parallel Imaging Results in Higher Acceleration (CAIPIRINHA)-Dixon-Time-resolved angiography With Interleaved Stochastic Trajectories (TWIST) (CDT) dynamic contrast-enhanced MRI (DCE-MRI) for evaluating MCA culprit plaque inflammation changes over stroke time and with diabetes mellitus (DM).
METHODS: Prospective.
METHODS: Ninety-four patients (51.6 ± 12.23 years, 32 females, 23 DM) with acute IS (AIS; N = 43) and non-acute IS (non-AIS; 14 days < stroke time ≤ 3 months; N = 51).
UNASSIGNED: 3-T, CDT DCE-MRI and three-dimensional (3D) Sampling Perfection with Application optimized Contrast using different flip angle Evolution (3D-SPACE) T1-weighted imaging (T1WI).
RESULTS: Stroke time (from initial IS symptoms to MRI) and DM were registered. For 94 MCA culprit plaques, Ktrans from CDT DCE-MRI and enhancement ratio (ER) from 3D-SPACE T1WI were compared between groups with and without AIS and DM.
METHODS: Shapiro-Wilk test, Bland-Altman analysis, Passing and Bablok test, independent t-test, Mann-Whitney U test, Chi-squared test, Fisher\'s exact test, receiver operating characteristics (ROC) with the area under the curve (AUC), DeLong\'s test, and Spearman rank correlation test with the P-value significance level of 0.05.
RESULTS: Ktrans and ER of MCA culprit plaques were significantly higher in AIS than non-AIS patients (Ktrans = 0.098 s-1 vs. 0.037 s-1; ER = 0.86 vs. 0.55). Ktrans showed better AUC for distinguishing AIS from non-AIS patients (0.87 vs. 0.75) and stronger negative correlation with stroke time than ER (r = -0.60 vs. -0.34). DM patients had significantly higher Ktrans and ER than non-DM patients in IS and AIS groups.
CONCLUSIONS: Imaging by CDT DCE-MRI may allow to quantitatively evaluate MCA culprit plaques over stroke time and DM.
METHODS: 2 TECHNICAL EFFICACY: Stage 2.