应用动脉自旋标记和乙酰唑胺激发法评估烟雾病患者的脑血管储备

Q4 Medicine Neurographics Pub Date : 2022-10-01 DOI:10.3174/ng.2100070
E. McConnell, M. Tivarus, H.Z. Wang
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引用次数: 0

摘要

动脉旋转标记是一种安全、无创、无对比度的MR成像技术,可用于评估CBF。在这篇综述中,我们将简要讨论动脉旋转标记与先前建立的脑灌注成像模式的优缺点,总结动脉旋转标记所需的材料和方法,并提供了临床病例实例,其中动脉旋转标记结合乙酰唑胺激发的应用被安全地用于改善Moyamoya病患者的预后。动脉旋转标记利用动脉血流的方向性,通过射频脉冲标记患者颈部内的内源性水,并在适当延迟后对下游大脑进行成像。该工具允许对CBF进行可重复的会话内和会话间估计,以更好地评估脑血管功能障碍患者的干预后结果。动脉旋转标记实用性的一个具体例子是通过选择和分层最有可能从手术干预中受益的患者,将其应用于莫亚莫亚病患者。动脉自旋标记与乙酰唑胺激发相结合是评估Moyamoya病脑血管储备的有效方法,并且可以很容易地在临床3T MR成像扫描仪上使用市售的动脉自旋标记脉冲序列来生成增强和窃取图。在常规临床环境中,整个研究只需20分钟即可完成。学习目的:描述动脉旋转标记结合乙酰唑胺激发的实施和解释
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Assessment of Cerebrovascular Reserve in the Setting of Moyamoya Disease Using Arterial Spin-Labeling and Acetazolamide Challenge
Arterial spin-labeling is a safe, noninvasive, contrast-free MR imaging technique that can be used to assess CBF. In this review, we will briefly discuss the advantages and disadvantages of arterial spin-labeling juxtaposed to previously established modalities of cerebral perfusion imaging, summarize the materials and methods required for arterial spin-labeling, and provide clinical case examples in which application of arterial spin-labeling combined with an acetazolamide challenge was used safely to improve patient outcomes in the setting of Moyamoya disease. Arterial spin-labeling takes advantage of the directionality of arterial blood flow by labeling the patient's own endogenous water within the neck via radiofrequency pulse and imaging of the downstream brain after an appropriate delay. This tool allows repeatable intra- and intersession estimation of CBF to better assess postinterventional outcomes in patients with cerebrovascular dysfunction. One specific example of the utility of arterial spin-labeling is its application in patients with Moyamoya disease by selection and stratification of those most likely to benefit from surgical intervention. The combination of arterial spin-labeling with acetazolamide challenge is an effective way to assess cerebrovascular reserve in Moyamoya disease and is easily adaptable on a clinical 3T MR imaging scanner using a commercially available arterial spin-labeling pulse sequence to generate augmentation and steal maps. The entire study can be completed in only 20 minutes in a routine clinical setting.Learning Objective: To describe the implementation and interpretation of arterial spin-labeling combined with an acetazolamide challenge
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Neurographics
Neurographics Medicine-Radiology, Nuclear Medicine and Imaging
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12
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