脑卒中的高 b 值和超高 b 值弥散加权磁共振成像。

IF 3.3 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Journal of Magnetic Resonance Imaging Pub Date : 2024-07-29 DOI:10.1002/jmri.29547
Rifeng Jiang, ZhenXiong Wang, Jun Liu, Ting Li, YanChun Lv, Chuanmiao Xie, Changliang Su
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引用次数: 0

摘要

目的:探讨高b值和超高b值DWI在无创评估缺血性梗死中的应用价值:研究对象64例根据症状和DWI临床诊断为缺血性病变的患者:3.0T/T2加权快速自旋回波、流体衰减反转恢复、对比前T1加权磁化准备快速梯度回波序列、多b值追踪DWI和q空间取样序列:在标准 b 值 DWI(SB-DWI,1000 s/mm2)、高 b 值 DWI(HB-DWI,4000 s/mm2)和超高 b 值 DWI(UB-DWI,10,000 s/mm2)上对病变进行分割,累计分割区域即为最终异常体积。对分割后的大脑进行二值化处理后得到正常白质(WM)区域。在 47 名患者中,从对称 WM 掩膜和对侧 WM(CWM)及病变侧 WM(LWM)的病变掩膜中提取 b 值为 1000、4000 和 10,000 s/mm2 时的分数各向异性(FA)和表观扩散系数(ADC):Wilcoxon配对符号秩检验和Pearson相关分析。双尾 P 值 结果:与 SB-DWI 相比,在脑卒中中观察到 HB-/UB-DWI 的各种信号(低强度、等强度或高强度),SB-DWI 等强度的一些区域在 HB-/UB-DWI 上表现为高强度。SB-DWI 的异常体积明显小于 HB-DWI 和 UB-DWI(10.32 ± 16.45 cm3,vs 12.25 ± 19.71 cm3 和 11.83 ± 19.41 cm3),而 HB-DWI 和 UB-DWI 的异常体积无明显差异(P = 0.32)。在 CWM 中,FA 与 ADC4000 和 ADC10,000 显著相关(最大 r = -0.51 和 -0.64),但与 ADC1000 没有显著相关(最大 r = -0.20,P = 0.17)。LWM 的 ADC1000 或 ADC4000 与 CWM 的 FA 无明显相关性(最大 r = -0.28,P = 0.06),而 LWM 的 ADC10,000 与 CWM 的 FA 有明显相关性(最大 r =-0.46):数据结论:HB- 和 UB-DWI 有可能成为临床上对卒中病灶进行无创评估的辅助工具。
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High b-Value and Ultra-High b-Value Diffusion Weighted MRI in Stroke.

Purpose: To explore the application value of high-b-value and ultra-high b-value DWI in noninvasive evaluation of ischemic infarctions.

Study type: Prospective.

Subjects: Sixty-four patients with clinically diagnosed ischemic lesions based on symptoms and DWI.

Field strength/sequence: 3.0 T/T2-weighted fast spin-echo, fluid-attenuated inversion recovery, pre-contrast T1-weighted magnetization prepared rapid gradient echo sequence, multi-b-value trace DWI and q-space sampling sequences.

Assessment: Lesions were segmented on standard b-value DWI (SB-DWI, 1000 s/mm2), high b-value DWI (HB-DWI, 4000 s/mm2) and ultra-high b-value DWI (UB-DWI, 10,000 s/mm2), and cumulative segmented areas were the final abnormality volumes. Normal white matter (WM) areas were obtained after binarization of segmented brain. In 47 patients, fractional anisotropy (FA) and apparent diffusion coefficients (ADCs) at b values of 1000, 4000, and 10,000 s/mm2 were extracted from symmetrical WM masks and lesion masks of contralateral WM (CWM) and lesion-side WM (LWM).

Statistical tests: Wilcoxon matched-pairs signed-rank test and Pearson correlation analysis. Two-tailed P-values <0.05 were considered statistically significant.

Results: Various signals of HB-/UB-DWI (hypo-, iso- or hyper-intensity) were observed in strokes compared with SB-DWI, and some areas with iso-intensity of SB-DWI manifested with hyper-intensity on HB-/UB-DWI. Abnormality volumes from SB-DWI were significantly smaller than those from HB-DWI and UB-DWI (10.32 ± 16.45 cm3, vs. 12.25 ± 19.71 cm3 and 11.83 ± 19.41 cm3), while no significant difference exist in volume between HB-DWI and UB-DWI (P = 0.32). In CWM, FA significantly correlated with ADC4000 and ADC10,000 (maximum r = -0.51 and -0.64), but did not significantly correlate with ADC1000 (maximum r = -0.20, P = 0.17). ADC1000 or ADC4000 of LWM not significant correlated with FA of CWM (maximum r = -0.28, P = 0.06), while ADC10,000 of LWM significantly correlated with FA of CWM (maximum r = -0.46).

Data conclusion: HB- and UB-DWI have potential to be supplementary tools for the noninvasive evaluation of stroke lesions in clinics.

Evidence level: 2 TECHNICAL EFFICACY: Stage 2.

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来源期刊
CiteScore
9.70
自引率
6.80%
发文量
494
审稿时长
2 months
期刊介绍: The Journal of Magnetic Resonance Imaging (JMRI) is an international journal devoted to the timely publication of basic and clinical research, educational and review articles, and other information related to the diagnostic applications of magnetic resonance.
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