Perfusion-weighted magnetic resonance imaging in the assessment of haemodynamics following stent angioplasty in patients with symptomatic middle cerebral artery plaque stenosis at the M1 segment

Ran, Yuncai; Zhu, Ming; Zhang, Yong; Li, Teng‐Fei; Cheng, Jingliang

doi:10.3892/etm.2017.4747

Cited by 4 publications

(8 citation statements)

References 24 publications

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“…However, the sample size (n = 28) of the previous study (31) is smaller than our study and unusable for association analysis. Affected cerebral blood flow was observed in patients with severe steno-occlusive MCA (12,26), and there is evidence that reduced cerebral blood flow is a factor in CSVD (32). Contrastly, cerebral blood flow was not significantly affected in patients with moderate MCA stenosis (26), which might account for the negative association between moderate MCA stenosis and BG-EPVS in our study.…”

Section: Discussioncontrasting

confidence: 50%

“…Moreover, previous experimental studies showed hypoperfusion secondary to internal carotid artery ligation (33) or MCA occlusion (34) caused impaired CSF influx. Based on these findings, we propose that hypoperfusion caused by severe-occlusive MCA could trigger hypoxia (12,14,35), impair the interstitial fluid drainage system (1,3), and in turn facilitate the formation of BG-EPVS (1,8). This hypothesis needs to be tested in longitudinal studies.…”

Section: Discussionmentioning

confidence: 97%

“…Comparison of number of BG-EPVS between the affected and the unaffected side in those with only unilateral MCA stenosis or occlusion are shown in Table 4. The number of BG-EPVS was higher in the affected side than the unaffected side in patients with severe MCA stenosis (12)(13)(14) vs. 8 (6)(7)(8)(9)(10)(11), p = 0.001) and occlusion (11)(12)(13)(14) vs. 8 (5)(6)(7)(8)(9)(10)(11), p = 0.028). We found no significant difference in the number of MR-visible BG-EPVS between affected and unaffected side in patients with moderate MCA stenosis (8)(9)(10)(11) vs. 8 (5)(6)(7)(8)(9)(10)(11), p = 0.173).…”

Section: Comparison Of Numbers Of Bg-epvsmentioning

confidence: 91%

“…Recently, the importance of understanding the pathophysiology of BG-EPVS in cerebrovascular disease is highlighted by their association with cerebral small vessel disease (CSVD), large artery atherosclerosis, and risk of stroke (7)(8)(9). Middle cerebral artery (MCA) is among the common locations of intracranial artery atherosclerosis, and MCA atherosclerosis is increasingly thought to be a significant precipitant of cerebral ischemic stroke, particularly in the Asian population (10)(11)(12). Impaired arterial stiffness (13) and increased pulsatility index (14) were found in severe MCA stenosis.…”

Section: Introductionmentioning

confidence: 99%

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Association Between Steno-Occlusive Middle Cerebral Artery and Basal Ganglia Perivascular Spaces

Chen

et al. 2020

Front. Neurol.

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Objectives: Enlarged perivascular spaces in the basal ganglia (BG-EPVS) share common vascular risk factors with atherosclerosis. However, little is known about the relationship between steno-occlusive middle cerebral artery (MCA) and BG-EPVS. In this cross-sectional study, we aimed to test the hypothesis that severe MCA stenosis or occlusion is associated with increased MRI-visible BG-EPVS. Methods: We retrospectively reviewed 112 patients with a steno-occlusive MCA from Fujian Medical University Union Hospital between January 2014 and December 2018. We rated BG-EPVS, white matter hyperintensities (WMH), and lacunes as markers of cerebral small vessel disease (CSVD) on magnetic resonance image (MRI). The severity of steno-occlusive MCA was assessed by computed tomography angiography (CTA) and was classified into moderate (50-69%), severe (70-99%), and occlusion (100%). We evaluated the association of steno-occlusive MCA for >10 BG-EPVS using logistic regression model adjusted for age, gender, hypertension, MR-visible WMH, and lacunes. We also compared the number of BG-EPVS between the affected side and unaffected side in patients with only unilateral steno-occlusive MCA. Results: In multivariable logistic regression analysis, age (OR = 1.07, 95%CI: 1.03-1.13, p = 0.003), hypertension (OR = 2.77, 95%CI: 1.02-7.51, p = 0.046), severe MCA stenosis (OR = 3.65, 95%CI: 1.12-11.87, p = 0.032), or occlusion (OR = 3.67, 95%CI: 1.20-11.27, p = 0.023) were significantly associated with >10 BG-EPVS. The number of BG-EPVS in the affected side was higher than the unaffected side in patients with severe MCA stenosis (12 [9−14] vs. 8 [6−11], p = 0.001) or occlusion (11 [7−14] vs. 8 [5−11], p = 0.028). Conclusions: BG-EPVS were more prevalent in patients with severe MCA atherosclerosis. Our findings suggest a biological link between severe steno-occlusive MCA and increased BG-EPVS. These results need confirmation in prospective studies.

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Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 97%

Section: Comparison Of Numbers Of Bg-epvsmentioning

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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Association Between Steno-Occlusive Middle Cerebral Artery and Basal Ganglia Perivascular Spaces

Chen

et al. 2020

Front. Neurol.

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“…Perfusion imaging has also been used to assess collateral circulation and indirectly qualify clinical outcome ( 4 ). Transient ischemic attack and internal carotid artery blockage and stenosis are also identifiable with perfusion imaging ( 5 , 6 ).…”

Section: Introductionmentioning

confidence: 99%

A Machine Learning Approach to Perfusion Imaging With Dynamic Susceptibility Contrast MR

et al. 2018

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Background: Dynamic susceptibility contrast (DSC) MR perfusion is a frequently-used technique for neurovascular imaging. The progress of a bolus of contrast agent through the tissue of the brain is imaged via a series of T2*-weighted MRI scans. Clinically relevant parameters such as blood flow and Tmax can be calculated by deconvolving the contrast-time curves with the bolus shape (arterial input function). In acute stroke, for instance, these parameters may help distinguish between the likely salvageable tissue and irreversibly damaged infarct core. Deconvolution typically relies on singular value decomposition (SVD): however, studies have shown that these algorithms are very sensitive to noise and artifacts present in the image and therefore may introduce distortions that influence the estimated output parameters.Methods: In this work, we present a machine learning approach to the estimation of perfusion parameters in DSC-MRI. Various machine learning models using as input the raw MR source data were trained to reproduce the output of an FDA approved commercial implementation of the SVD deconvolution algorithm. Experiments were conducted to determine the effect of training set size, optimal patch size, and the effect of using different machine-learning models for regression.Results: Model performance increased with training set size, but after 5,000 samples (voxels) this effect was minimal. Models inferring perfusion maps from a 5 by 5 voxel patch outperformed models able to use the information in a single voxel, but larger patches led to worse performance. Random Forest models produced had the lowest root mean squared error, with neural networks performing second best: however, a phantom study revealed that the random forest was highly susceptible to noise levels, while the neural network was more robust.Conclusion: The machine learning-based approach produces estimates of the perfusion parameters invariant to the noise and artifacts that commonly occur as part of MR acquisition. As a result, better robustness to noise is obtained, when evaluated against the FDA approved software on acute stroke patients and simulated phantom data.

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Three-Dimensional Arterial Spin Labeling for the Evaluation of the Cerebral Hemodynamics in Ischemic and Hemorrhagic Moyamoya Disease

Bian,

Zhang,

Wang

2023

Cerebrovasc Dis

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Introduction: Moyamoya disease (MMD) is a vascular disease with significant risk of mortality due to ischemia or hemorrhage in the brain. The goal of the study was to explore three-dimensional arterial spin labeling (3D-ASL) to improve evaluation of cerebral hemodynamics in patients with MMD. Methods: Our study included 54 cases of ischemic MMD and 42 cases of hemorrhagic MMD. Dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI) and 3D-ASL were performed at 3.0 T. Based on these scans, cerebral blood flow (CBF), mean transit time (MTT), and time to peak (TTP) were calculated and compared between patients with different disease subtypes. Receiver operating characteristics analysis was used to assess the diagnostic sensitivity and specificity of different imaging procedures and parameters. Results: Our data suggested that CBF in the lesion area was more severely reduced in patients with hemorrhagic MMD than in those with ischemic MMD. The CBF parameter in 3D-ASL diagnosed hemorrhagic and ischemic MMD with a significant sensitivity and specificity of 80.59% and 57.41%, respectively, with an area under the curve (AUC) of 0.75. We also found that the relative CBF of 3D-ASL was more pronounced decreased and the relative MTT and TTP of DSC-PWI were significantly increased in patients with hemorrhagic MMD than those with ischemic MMD. Specificity and sensitivity and AUC of 3D-ASL were better than the comparison of absolute values from DSC-PWI scans. Conclusion: Our study indicated that 3D-ASL is powerful in differentiating patients with cerebral ischemic or hemorrhagic MMD, providing another diagnostic tool that could potentially improve precision medicine to monitoring MMD patients.

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Perfusion-weighted magnetic resonance imaging in the assessment of haemodynamics following stent angioplasty in patients with symptomatic middle cerebral artery plaque stenosis at the M1 segment

Cited by 4 publications

References 24 publications

Association Between Steno-Occlusive Middle Cerebral Artery and Basal Ganglia Perivascular Spaces

Association Between Steno-Occlusive Middle Cerebral Artery and Basal Ganglia Perivascular Spaces

A Machine Learning Approach to Perfusion Imaging With Dynamic Susceptibility Contrast MR

Three-Dimensional Arterial Spin Labeling for the Evaluation of the Cerebral Hemodynamics in Ischemic and Hemorrhagic Moyamoya Disease

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