https://orcid.org/0000-0003-1376-4213
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ABSTRACT
Objective
Cerebral blood flow (CBF) mapping of single-photon emission tomography (SPECT) is considered a gold standard for evaluating cerebral perfusion. However, invasiveness, high costs and strict technical requirements can limit its clinical use. We aimed to evaluate the concordance of CBF maps obtained from SPECT and pseudo-continuous arterial spin labeling magnetic resonance (PCASL-MR) imaging for evaluating cerebral perfusion.
Methods
PCASL-MR/SPECT-CBF maps were obtained from 16 eligible patients with unilateral middle cerebral artery stenosis (MCAS). Three slices (basal ganglia, semi-oval center and cerebellum) on both PCASL-MR and SPECT maps were divided into different regions of interest (ROIs) according to the ASPECT criterion, arterial territories, and cerebral hemispheres, respectively. The concordance of the two types of CBF maps and the specificity and sensitivity of PCASL-MR imaging on predicting regional hypoperfusion were calculated.
Results
A total of 448 ROIs were divided according to the ASPECT criterion, 192 ROIs partitioned in accordance with arterial territories, and 96 ROIs delineated based on cerebral hemispheres were analyzed. PCASL-MR imaging exhibited 83.78% to 100% sensitivity, 90.19% to 95.83% specificity for detection of hypoperfusion. Qualitative analyses revealed a strong concordance between PCASL-MR and SPECT on reflecting regional cerebral hypoperfusion (Kappa coefficient = 0.662–0.920, p < 0.01). Semi-quantitative analysis by ΔCBF revealed moderate consistency (Spearman correlation coefficient = 0.610–0.571).
Conclusions
Our findings suggest that PCASL-MR may be a promising non-invasive, inexpensive alternative to SPECT for evaluating cerebral perfusion accurately in patients with symptomatic MCAS.
Acknowledgments
We would like to thank all patients and doctors who participated in this study for their cooperation. This study was sponsored by the National Key R&D Program of China (2017YFC1308401), the National Natural Science Foundation of China (81371289), and the Project of Beijing Municipal Top Talent for Healthy Work of China (2014-2-015).
Compliance with ethical standards
None
Human participants and/or animals
The research involved human participants. The study has been approved by the local ethics committees of all participating centers and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
Informed consent
All patients provided their written informed consent for data collection and analysis.
Disclosure statement
No potential conflict of interest was reported by the authors.
Additional information
Funding
Notes on contributors
Jingyuan Ya
Jingyuan Ya is a student of the Neurology department in Xuanwu Hospital and she did her research work in the research team of professor Ran Meng. She obtained her master’s degree of Neurology in Capital Medical University in 2020. Her research interests include cerebral vascular disease and advanced brain image.
Da Zhou
Dr. Zhou is a senior researcher of professor Ran Meng’s team in the Neurology department of Xuanwu Hospital. He obtained his doctor’s degree of Neurology in Capital Medical University in 2019.
Jiayue Ding
Dr. Ding is a researcher of professor Ran Meng’s team in the Neurology department of Xuanwu Hospital. He obtained his doctor’s degree of Neurology in Capital Medical University in 2020.
Gary B. Rajah
Dr. Gary is a researcher of professor Yuchuan Ding’s research team in the Neurosurgery department of Wayne State University School of Medicine.
Ye Wu
Ye Wu is a student of professor Qi Yang’s research team in the radiology department of Xuanwu Hospital. She obtained her master’s degree of radiology in Capital Medical University in 2019.
Xiaoxu Yang
Xiaoxu Yang is a student of professor Qi Yang’s research team in the radiology department of Xuanwu Hospital. She obtained her master’s degree of Radiology in Capital Medical University in 2019.
Yaqin Hou
Yaqin Hou is a senior researcher in the radiology department of Xuanwu Hospital. Her research interests include nuclear medicine, cerebral vascular disease.
Kexin Jin
Kexin Jin is a under postgraduate student in professor Ran Meng’s research team in the Neurology department of Xuanwu Hospital.
Liqun Pan
Liqun Pan is a student of professor Ran Meng’s research team in the Neurology department of Xuanwu Hospital. She obtained her master’s degree in Neurology in Capital Medical University in 2020.
Yu Wu
Yu Wu is a student in professor Qi Yang’s research team in the radiology department of Xuanwu Hospital. She obtained her master’s degree of radiology in Capital Medical University in 2020.
Jingwen Du
Jingwen Du is a student of professor Qi Yang’s research team in the Radiology department of Xuanwu Hospital. She obtained her master’s degree of Radiology in Capital Medical University in 2020.
Yuchuan Ding
Dr. Yuchuan Ding is the professor of Neurosurgery department of Wayne State University School of Medicine. He currently serves as the Director of Cerebrovascular Disease Laboratories and the Associate Chair for Research in Department of Neurosurgery, at Wayne State University School of Medicine.
Xunming Ji
Dr. Xunming Ji is the professor of Neurosurgery department of Xuanwu Hospital, Capital Medical University. He currently serves as the vice-president of Capital Medical University.
Qi Yang
Dr. Qi Yang used to be the professor of Radiology department of Xuanwu Hospital, Capital Medical University. He currently serves as the director of the Radiology department in Chaoyang Hospital, Capital Medical University.
Ran Meng
Dr. Ran Meng is the professor of Neurology Department of Xuanwu Hospital, Capital Medical University. Her research interests include stroke, cerebral venous sinus outflow disturbance, remote ischemic conditioning.