Values of arterial spin labeling in evaluating blood-brain barrier permeability in cerebral infarction lesions and predicting hemorrhage transformation after endovascular recanalization
10.3760/cma.j.cn115354-20220516-00343
- VernacularTitle:ASL评估脑梗死灶血脑屏障通透性及预测血管开通后出血转化的价值
- Author:
Yanghui LIU
1
;
Tianxiao LI
;
Liangfu ZHU
;
Li'na WANG
;
Yang ZHANG
;
Liheng WU
;
Zhilong ZHOU
;
Ying XING
;
Meiyun WANG
Author Information
1. 河南大学人民医院，河南省人民医院脑血管病科，国家高级卒中中心，郑州 450003
- Keywords:
Ischemic stroke;
Subacute;
Arterial spin labeling;
Dynamic contrast enhancement;
Xper CT;
Blood-brain barrier permeability;
Hemorrhagic transformation
- From:
Chinese Journal of Neuromedicine
2022;21(9):870-878
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the role of arterial spin labeling (ASL) in detecting the blood-brain barrier (BBB) permeability of cerebral infarction lesions in patients with anterior circulation subacute ischemic stroke (SIS), and to evaluate the value of ASL in predicting hemorrhagic transformation (HT) of SIS patients after endovascular recanalization.Methods:A prospective analysis was performed. Patients with anterior circulation SIS who received endovascular treatment (EVT) in our hospital from January 2021 to September 2021 were enrolled. At 24 h before EVT and immediately after EVT, MRI scans of ASL sequences and dynamic contrast-enhanced magnetic resonance (DCE) sequence were completed, and Xper CT was performed; accordingly, imaging typing was performed. Head CT scan was performed 24-48 h after EVT to observe HT; according to the presence or absence of HT, these patients were divided into HT group and non-HT group; the relative cerebral blood flow (rCBF) values of ASL sequence parameters, volume transfer constant (K trans) of DCE sequence parameters and the differences of ASL, DCE and Xper CT imaging types between the two groups were compared. The weighted Kappa coefficient was used to test the consistency among ASL, DCE and Xper CT imaging types. Results:Among 22 eligible patients, 5 patients occurred HT (5/22, 22.72%). As compared with those in the non-HT group (1.14±0.04; 0.032[0.024, 0.039]/min), patients in the HT group had significantly higher rCBF value (1.57±0.18) and K trans (0.072[0.0455, 0.117]/min, P<0.05). There were significant differences in the distribution of ASL, DCE and Xper CT imaging types between the two groups ( P<0.05); among them, 4 out of 6 patients with ASL imaging type III, 4 out of 6 patients with DCE imaging type III, and 4 out of 5 patients with Xper CT imaging type III had HT. ASL sequence and DCE sequence had a high consistency in the imaging types (Kappa coefficient=0.941, 95%CI: 0.862-1.020, P<0.001). Conclusion:ASL can effectively evaluate the BBB permeability of cerebral infarction lesions in patients with anterior circulation SIS; patients with ASL imaging type III have a relatively high risk of HT.
