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• Clinical Article •
Cerebral perfusion varieties using 3D pseudo-continuous arterial spin labeling with different PLD in patients with unilateral middle cerebral artery stenosis or occlusion
DU Hui  WANG Meng-chen  CHEN Dun-chao  SHANG Jin  LIUYANG Ying-qiu  WANG Ming-yi  SONG Qing-wei  MIAO Yan-wei 

DOI:10.12015/issn.1674-8034.2017.11.001.


[Abstract] Objective: To assess the differences of different postlabeling delay (PLD) state of cerebral blood perfusion and clinical value.Materials and Methods: Patients with unilateral middle cerebral artery stenosis or occlusion were collected (n=30), who underwent MRI, three-dimensional time of flight magnetic resonance angiography (3D-TOF-MRA), diffusion weighted imaging (DWI) and three-dimensional pulsed continuous arterial spin labeling (3D pCASL) (PLD=1.5 s, PLD=2.5 s) scanning. All patients were divided into DWI (+) and DWI (-) according to ADC value. Cerebral blood flow (CBF) values (CBF1.5, CBF2.5) and ADC values of lesions in DWI (+) andMCA territory in responsible side in DWI (-) were measured by two observers, the relative areas of low perfusion and high DWI signal region were further calculated and NIHSS scores were recorded (n=16). ICC was used to assess the consistency between the two measurers; the difference of low perfusion detection rate was analyzed by Chi-square test, the differences of CBF values between two groups were analyzed by independent sample t test, the differences of CBF values in a group and then the relative areas were analyzed by paired sample t test. Pearson and Spearman correlation analysis were used to analyze the correlation between CBF values vs. ADC values and NIHSS scores.Results: The good consistency was acquired between the two measurers (ICC=0.98, P<0.05). CBF1.5 values were lower than those of CBF2.5 in all patients or DWI (+) or DWI (-) (t=-7.207, P=0.000. t=-7.071, P=0.000. t=-3.641, P=0.004). Compared with DWI (-), CBF1.5 values and CBF2.5 values and ADC values of DWI (+) were decreased (t=-8.243, P=0.000. t=-5.536, P=0.000, t=-10.764, P=0.000). The detection rate of low perfusion was higher and the relative area value of low perfusion was larger with PLD=1.5 s than 2.5 s (χ2=7.239, P=0.007. 0.59±0.11, 0.21±0.09, t=4.20, P=0.006). The relative areas of high signal was 0.12±0.05 in DWI (+), which was lower than those of low perfusion with PLD=1.5 s, but not differed to those with PLD=2.5 s (t=4.622, P=0.001. t=2.282, P=0.71). There was moderate positive correlation between CBF2.5 values and ADC values in DWI (+) group, moreover there was a moderate negative correlation between CBF1.5 values and NIHSS scores (r=0.50, P=0.035. r=-0.547, P=0.028).Conclusions: PLD of 1.5 s is sensitive to hypoperfusion and shows large ischemic area, which is in good consistency with clinical status. The combined application of PLD of 2.5 s and 1.5 s is better to assess collateral circulation.
[Keywords] 3D pseudo-continuous arterial spin labeling；Post labeling delay；Stroke；Magnetic resonance imaging

DU Hui Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

WANG Meng-chen Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

CHEN Dun-chao Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

SHANG Jin Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

LIUYANG Ying-qiu Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

WANG Ming-yi Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

SONG Qing-wei Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

MIAO Yan-wei* Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

*Corresponding to: Miao YW, E-mail: ywmiao716@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  The research was supported by the National Natural Science Foundation of China No. 81671646
Received  2017-07-24
Accepted  2017-10-09
DOI: 10.12015/issn.1674-8034.2017.11.001
DOI:10.12015/issn.1674-8034.2017.11.001.

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