Purpose

The aim of this study was to investigate whether the spatial coefficient of variation of arterial spin labeling (ASL-CoV) acquired in clinical settings can be used to estimate the hemodynamic disturbances measured with ¹⁵O-gas positron emission tomography (PET), especially an increased oxygen extraction fraction (OEF), in patients with moyamoya disease.

Methods

We evaluated 68 adult patients with moyamoya disease who underwent ASL (postlabeling delay (PLD) = 1525 ms and 2525 ms) and PET. Regional values were measured using the middle cerebral artery territorial atlas divided into proximal, middle, and distal regions based on the arterial transit time, and correlations of ASL-CoV with cerebral blood flow, cerebral blood volume, mean transit time, and OEF, as well as the relationship between increased OEF and ASL-CoV, were evaluated.

Results

Regardless of the choice of region and PLD, ASL-CoV was significantly correlated with PET-measured parameters, including OEF (|ρ|= 0.30–0.80, P < 0.001). Regions with an increased OEF showed a significantly higher ASL-CoV than regions with a nonincreased OEF (P ≤ 0.03) regardless of the choice of region and PLD. The accuracy of identification of an increased OEF was highest when using a PLD of 1525 ms and the middle region (area under the curve = 0.750; using a cutoff value of 31.27, sensitivity = 97.4%, specificity = 41.7%, negative predictive value = 92.6%, and positive predictive value = 67.9%).

Conclusion

ASL-CoV may help identify patients with increased OEF.

中文翻译：

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动脉自旋标记 MRI 的空间变异系数检测烟雾病患者 15O 气体 PET 测量的血流动力学紊乱

目的

本研究的目的是调查在临床环境中获得的动脉自旋标记 (ASL-CoV) 的空间变异系数是否可用于估计用¹⁵ O-气体正电子发射断层扫描 (PET) 测量的血流动力学干扰，尤其是烟雾病患者的氧提取分数（OEF）增加。

方法

我们评估了 68 名接受 ASL（标记后延迟 (PLD) = 1525 ms 和 2525 ms）和 PET 的烟雾病成人患者。使用大脑中动脉区域图谱测量区域值，根据动脉传输时间和 ASL-CoV 与脑血流量、脑血容量、平均传输时间和 OEF 的相关性分为近端、中间和远端区域，如以及增加的 OEF 和 ASL-CoV 之间的关系进行了评估。

结果

无论区域和 PLD 的选择如何，ASL-CoV 都与 PET 测量的参数显着相关，包括 OEF ( |ρ| = 0.30–0.80, P  < 0.001)。 无论区域和 PLD 的选择如何，OEF 增加的区域都显示出比 OEF 未增加的区域（P ≤ 0.03）显着更高的 ASL-CoV。使用 1525 ms 和中间区域（曲线下面积 = 0.750；使用截止值 31.27，灵敏度 = 97.4%，特异性 = 41.7%，阴性预测值 = 92.6%，阳性预测值 = 67.9%）。

结论

ASL-CoV 可能有助于识别 OEF 增加的患者。