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Article Dans Une Revue Journal de Neuroradiologie / Journal of Neuroradiology Année : 2023

Cerebral perfusion using ASL in patients with COVID-19 and neurological manifestations: A retrospective multicenter observational study

François-Daniel Ardellier (1, 2, 3) , Seyyid Baloglu (1, 2) , Magdalena Sokolska (4) , Vincent Noblet (3) , François Lersy (2, 1) , Olivier Collange (1, 5) , Jean-Christophe Ferré (6, 7) , Adel Maamar (8) , Béatrice Carsin-Nicol (8) , Julie Helms (9, 1) , Maleka Schenck (1, 2) , Antoine Khalil (10) , Augustin Gaudemer (11) , Sophie Caillard (12, 13) , Julien Pottecher (14, 2) , Nicolas Lefèbvre , Pierre-Emmanuel Zorn (1) , Muriel Matthieu (1) , Jean Christophe Brisset (15) , Clotilde Boulay (1, 16) , Véronique Mutschler (1) , Yves Hansmann (12) , Paul-Michel Mertes (12) , Francis Schneider (12) , Samira Fafi-Kremer (12) , Mickael Ohana (12) , Ferhat Meziani (12) , Nicolas Meyer (3, 12) , Tarek Yousry (4) , Mathieu Anheim (17) , François Cotton (17) , Hans Rolf Jäger (4) , Stéphane Kremer (4, 12) , Fabrice Bonneville (18) , Gilles Adam (18) , Guillaume Martin-Blondel (18) , Jérémie Pariente (18) , Thomas Geeraerts (18) , Hélène Oesterlé (19) , Federico Bolognini (19) , Julien Messie (19) , Ghazi Hmeydia (20) , Joseph Benzakoun (20) , Catherine Oppenheim (20) , Jean-Marc Constans (21, 22, 23) , Serge Metanbou (21) , Adrien Heintz (21) , Blanche Bapst (24) , Imen Megdiche (24) , Lavinia Jager (25) , Patrick Nesser (25) , Yannick Talla Mba (25) , Thomas Tourdias (26) , Juliette Coutureau (26) , Céline Hemmert (27) , Philippe Feuerstein (27) , Nathan Sebag (27) , Sophie Carre (28) , Manel Alleg (28) , Claire Lecocq (28) , Emmanuel Schmitt (29) , René Anxionnat (29) , François Zhu (29) , Géraud Forestier (30) , Aymeric Rouchaud (30) , Pierre-Olivier Comby (31) , Frederic Ricolfi (31) , Pierre Thouant (31) , Sylvie Grand (32) , Alexandre Krainik (32) , Isaure de Beaurepaire (33) , Grégoire Bornet (33) , Audrey Lacalm (34) , Patrick Miailhes (34) , Julie Pique (34) , Claire Boutet (35) , Xavier Fabre (35) , Béatrice Claise (36) , Sonia Mirafzal (36) , Laure Calvet (36) , Hubert Desal (37) , Jérome Berge (37) , Grégoire Boulouis (37) , Apolline Kazemi (37) , Nadya Pyatigorskaya (37) , Augustin Lecler (37) , Suzana Saleme (37) , Myriam Edjlali-Goujon (37) , Basile Kerleroux (37) , Jean-Christophe Brisset (37) , Samir Chenaf
1 HUS - Les Hôpitaux Universitaires de Strasbourg
2 Hôpital de Hautepierre [Strasbourg]
3 ICube - Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie
4 UCL - University College of London [London]
5 Nouvel Hôpital Civil de Strasbourg
6 Département de Neuroradiology [Rennes]
7 EMPENN - Neuroimagerie: méthodes et applications
8 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
9 Service de Médecine Intensive et Réanimation [Strasbourg]
10 DR- Bichat - Département de Radiologie [Bichat]
11 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
12 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
13 IRM - Immuno-Rhumatologie Moléculaire
14 FMTS - Fédération de Médecine Translationnelle de Strasbourg
15 OFSEP - Observatoire Français de la Sclérose En Plaques [Lyon]
16 Inserm U964 - CNRS UMR7104 - IGBMC - Centre for Integrative Biology - CBI
17 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
18 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
19 CH Colmar - Hôpital Louis Pasteur [Colmar]
20 Hôpital Sainte-Anne [Paris]
21 CHU Amiens-Picardie
22 CHIMERE - CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516
23 SFNR-COVID Group
24 CHU Henri Mondor [Créteil]
25 CHIC Unisanté+ - Hôpital Marie Madeleine [Forbach]
26 CHU de Bordeaux Pellegrin [Bordeaux]
27 CH E.Muller Mulhouse - Centre Hospitalier Emile Muller [Mulhouse]
28 Centre Hospitalier de Haguenau
29 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
30 Hôpital Dupuytren [CHU Limoges]
31 CHU Dijon - Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
32 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
33 Hôpital privé d’Antony
34 HCL - Hospices Civils de Lyon
35 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
36 CHU Clermont-Ferrand
37 SFNR - Société Française de Neuroradiologie [Paris]
Antoine Khalil
Nicolas Lefèbvre
  • Fonction : Auteur
François Cotton
Samir Chenaf
  • Fonction : Auteur

Résumé

Background and purpose: Cerebral hypoperfusion has been reported in patients with COVID-19 and neurological manifestations in small cohorts. We aimed to systematically assess changes in cerebral perfusion in a cohort of 59 of these patients, with or without abnormalities on morphological MRI sequences. Methods: Patients with biologically-confirmed COVID-19 and neurological manifestations undergoing a brain MRI with technically adequate arterial spin labeling (ASL) perfusion were included in this retrospective multicenter study. ASL maps were jointly reviewed by two readers blinded to clinical data. They assessed abnormal perfusion in four regions of interest in each brain hemisphere: frontal lobe, parietal lobe, posterior temporal lobe, and temporal pole extended to the amygdalo-hippocampal complex. Results: Fifty-nine patients (44 men (75%), mean age 61.2 years) were included. Most patients had a severe COVID-19, 57 (97%) needed oxygen therapy and 43 (73%) were hospitalized in intensive care unit at the time of MRI. Morphological brain MRI was abnormal in 44 (75%) patients. ASL perfusion was abnormal in 53 (90%) patients, and particularly in all patients with normal morphological MRI. Hypoperfusion occurred in 48 (81%) patients, mostly in temporal poles (52 (44%)) and frontal lobes (40 (34%)). Hyperperfusion occurred in 9 (15%) patients and was closely associated with post-contrast FLAIR leptomeningeal enhancement (100% [66.4%-100%] of hyperperfusion with enhancement versus 28.6% [16.6%-43.2%] without, p=0.002). Studied clinical parameters (especially sedation) and other morphological MRI anomalies had no significant impact on perfusion anomalies. Conclusion: Brain ASL perfusion showed hypoperfusion in more than 80% of patients with severe COVID-19, with or without visible lesion on conventional MRI abnormalities.

Dates et versions

hal-03958604 , version 1 (26-01-2023)

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Citer

François-Daniel Ardellier, Seyyid Baloglu, Magdalena Sokolska, Vincent Noblet, François Lersy, et al.. Cerebral perfusion using ASL in patients with COVID-19 and neurological manifestations: A retrospective multicenter observational study. Journal de Neuroradiologie / Journal of Neuroradiology, 2023, ⟨10.1016/j.neurad.2023.01.005⟩. ⟨hal-03958604⟩
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