背景:在治疗慢性威胁肢体缺血的患者时,有关足部组织灌注的信息很重要。本研究旨在测试测量足部灌注时不同磁共振序列的可靠性。
方法:16名健康志愿者在测试/重测研究中使用6种不同的磁共振序列(BOLD,多回波梯度回波(mGRE),2D和3DpCASL,PASLFAIR,和具有体素内不相干运动(IVIM)的DWI,并对灌注进行定量测量。对于五个序列,测量袖带引起的缺血,然后是过度活跃的反应。将脚的图像分割成血管体,并从五个血管体中提取灌注数据。
结果:大胆,PASLFAIR,mGRE,与IVIM的DWI在第一次和第二次扫描之间具有较低的平均差异,而2D和3DpCASL的结果差异最大。基于配对t检验,大胆,和FAIR能够区分所有p值低于0.01的血管小体中的灌注和无灌注。对于在所有血管小体中p值高于0.05的2D和3DpCASL,情况并非如此。mGRE无法区分足外侧的灌注和无灌注。
结论:大胆,mGRE,pASLFAIR,与2D和3DpCASL相比,使用IVIM的DWI似乎给出了更强大的结果。对外周动脉疾病患者的进一步研究应探索在评估组织缺血和血运重建结果时这些序列是否具有临床相关性。
结论:本研究提供了可用于改善慢性威胁肢体缺血患者的诊断的知识,以探索组织灌注。
BACKGROUND: Information on tissue perfusion in the foot is important when treating patients with chronic limb-threatening ischemia. This study aims to test the reliability of different magnetic resonance sequences when measuring perfusion in the foot.
METHODS: Sixteen healthy volunteers had their right foot scanned in a test/retest study with six different magnetic resonance sequences (
BOLD, multi-echo gradient echo (mGRE), 2D and 3D pCASL, PASL FAIR, and DWI with intravoxel incoherent motion (IVIM) with quantitative measurements of perfusion. For five sequences, cuff-induced ischemia followed by a hyperactive response was measured. Images of the feet were segmented into angiosomes and perfusion data were extracted from the five angiosomes.
RESULTS: BOLD, PASL FAIR, mGRE, and DWI with IVIM had low mean differences between the first and second scans, while the results of 2D and 3D pCASL had the highest differences. Based on a paired t-test,
BOLD, and FAIR were able to distinguish between perfusion and no perfusion in all angiosomes with p-values below 0.01. This was not the case with 2D and 3D pCASL with p-values above 0.05 in all angiosomes. The mGRE could not distinguish between perfusion and no perfusion in the lateral side of the foot.
CONCLUSIONS: BOLD, mGRE, pASL FAIR, and DWI with IVIM seem to give more robust results compared to 2D and 3D pCASL. Further studies on patients with peripheral artery disease should explore if the sequences can have clinical relevance when assessing tissue ischemia and results of revascularization.
CONCLUSIONS: This study provides knowledge that could be used to improve the diagnosis of patient with chronic limb-threatening ischemia to explore tissue perfusion.