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Quantitative Perfusionsbildgebung in der Magnetresonanztomographie

Quantitative perfusion imaging in magnetic resonance imaging

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Zusammenfassung

Klinisches/methodisches Problem

Die Magnetresonanztomographie (MRT) zeichnet sich durch einen überlegenen Gewebekontrast aus, während sie nichtinvasiv und frei von ionisierender Strahlung ist. Sie bietet Zugang zu Gewebe- und Organfunktion. Eine dieser funktionellen bildgebenden Verfahren ist die Perfusionsbildgebung. Mit dieser Technik können u. a. Gewebeperfusion und Kapillarpermeabilität aus dynamischen Bilddaten bestimmt werden.

Radiologische Standardverfahren

Perfusionsbildgebung mithilfe der MRT kann durch 2 Ansätze, nämlich „arterial spin labeling“ (ASL) und dynamische kontrastverstärkte (DCE-)MRT durchgeführt werden. Während die erste Methode magnetisch markierte Wasserprotonen im arteriellen Blut als endogenen Tracer verwendet, erfolgt bei der DCE-MRT eine Injektion eines Kontrastmittels, üblicherweise Gadolinium (Gd) als Tracer für die Berechnung hämodynamischer Parameter.

Leistungsfähigkeit

Aus Studien werden das Potenzial und die Möglichkeiten der MRT-Perfusionsbildgebung deutlich, sei es in Bezug auf die Diagnostik oder aber auch zunehmend im Bereich des Therapiemonitorings.

Bewertung

Nutzung und Anwendung der MRT-Perfusionsbildgebung beschränken sich jedoch auf spezialisierte Zentren wie Universitätskliniken. Eine breite Anwendung der Technik ist bisher leider nicht erfolgt.

Empfehlung für die Praxis

Die MRT-Perfusionsbildgebung ist ein wertvolles Tool, das im Rahmen europäischer und internationaler Standardisierungsbemühungen für die Praxis zukünftig einsetzbar werden sollte.

Abstract

Clinical/methodical issue

Magnetic resonance imaging (MRI) is recognized for its superior tissue contrast while being non-invasive and free of ionizing radiation. Due to the development of new scanner hardware and fast imaging techniques during the last decades, access to tissue and organ functions became possible. One of these functional imaging techniques is perfusion imaging with which tissue perfusion and capillary permeability can be determined from dynamic imaging data.

Standard radiological methods

Perfusion imaging by MRI can be performed by two approaches, arterial spin labeling (ASL) and dynamic contrast-enhanced (DCE) MRI. While the first method uses magnetically labelled water protons in arterial blood as an endogenous tracer, the latter involves the injection of a contrast agent, usually gadolinium (Gd), as a tracer for calculating hemodynamic parameters.

Performance

Studies have demonstrated the potential of perfusion MRI for diagnostics and also for therapy monitoring.

Achievements

The utilization and application of perfusion MRI are still restricted to specialized centers, such as university hospitals. A broad application of the technique has not yet been implemented.

Practical recommendations

The MRI perfusion technique is a valuable tool that might come broadly available after implementation of standards on European and international levels. Such efforts are being promoted by the respective professional bodies.

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Danksagung

Diese Arbeit wurde in Teilen unterstützt durch den Forschungscampus M2OLIE der mit Mitteln des Bundesministeriums für Bildung und Forschung (BMBF) innerhalb der Förderinitiative „Forschungscampus: öffentlich-private Partnerschaft für Innovationen“ unter dem Förderkennzeichen 13GW0092D gefördert.

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Authors and Affiliations

  1. Computerunterstützte Klinische Medizin, Medizinische Fakultät Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1–3, 68167, Mannheim, Deutschland

    F. G. Zöllner, T. Gaa & F. Zimmer

  2. Institut für Klinische Radiologie und Nuklearmedizin, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland

    M. M. Ong, P. Riffel, D. Hausmann, S. O. Schoenberg & M. Weis

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  1. F. G. Zöllner
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  2. T. Gaa
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Correspondence to F. G. Zöllner.

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F.G. Zöllner, T. Gaa, F. Zimmer, M.M. Ong, P. Riffel, D. Hausmann, S.O. Schoenberg und M. Weis geben an, dass kein Interessenkonflikt besteht.

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Zöllner, F.G., Gaa, T., Zimmer, F. et al. Quantitative Perfusionsbildgebung in der Magnetresonanztomographie. Radiologe 56, 113–123 (2016). https://doi.org/10.1007/s00117-015-0068-4

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