Amide proton transfer magnetic resonance imaging in detecting intracranial hemorrhage at different stages: a comparative study with susceptibility weighted imaging

Xiaoyue Ma,Jian Wang,Jinyuan Zhou,E Mark Haacke,Lun Ma,Yan Bai,Meiyun Wang,Taiyuan Liu,Yusong Lin,Xiaohua Hong

doi:10.1038/srep45696

Abstract

Amide proton transfer (APT) imaging is a noninvasive molecular magnetic resonance imaging (MRI) technique based on the chemical exchange-dependent saturation transfer mechanism. The purpose of this study was to investigate the diagnostic performance of APT MRI in detecting intracranial hemorrhage (ICH) at hyperacute, acute and subacute stages by comparing with susceptibility weighted imaging (SWI). APT MRI and SWI were performed on 33 included patients with ICH by using a 3-T MRI unit. A two-sided Mann-Whitney U test was used to detect differences in APT-weighted (APTw) and SWI signal intensities of ICH at hyperacute, acute and subacute stages. Receiver operating characteristic analysis was used to assess the diagnostic utilities of APT MRI and SWI. Our results showed that APT MRI could detect ICH at hyperacute, acute and subacute stages. Therefore, APTw signal intensity may serve as a reliable, noninvasive imaging biomarker for detecting ICH at hyperacute, acute and subacute stages. Moreover, APT MRI could provide additional information for the ICH compared with SWI.

Highlights

Amide proton transfer (APT) imaging is a noninvasive molecular magnetic resonance imaging (MRI) technique based on the chemical exchange-dependent saturation transfer mechanism[11]
The SWI signal intensity was significantly lower in the Intracranial hemorrhage (ICH) at hyperacute and acute stages than that in the contralateral normal brain tissue (p = 0.03 and 0.02, respectively), but we observed no significant difference between the subacute ICH and the contralateral normal brain tissue (p = 0.11)
Our results showed that APT MRI could detect ICH at hyperacute, acute and subacute stages

Summary

Introduction

Amide proton transfer (APT) imaging is a noninvasive molecular MRI technique based on the chemical exchange-dependent saturation transfer mechanism[11]. The APT MRI contrast is generated by endogenous mobile protein and peptide concentrations or pH changes in biological tissues[12,13]. APT MRI has been promisingly applied to patients with hyperacute and acute ischemia in previous studies[14,15]. Our previous study using the rat models of strokes showed that APT MRI has the capability for the early and simultaneous detection of ICH and cerebral ischemia[16]. To the best of our knowledge, no study of patients has yet confirmed the diagnostic capability of APT MRI in the early detection of ICH or compared APT MRI with SWI for the detection of ICH at different stages. The purpose of this study was to investigate the diagnostic performance of APT MRI in detecting ICH at hyperacute, acute and subacute stages by comparing with SWI

Objectives

Methods

Results

Conclusion