山东大学耳鼻喉眼学报 ›› 2020, Vol. 34 ›› Issue (4): 16-22.doi: 10.6040/j.issn.1673-3770.1.2020.053

• 眼缺血综合征多学科精准诊疗 专家笔谈 • 上一篇    下一篇

磁共振动脉自旋标记技术在缺血性疾病中的应用研究

周卓华综述李红阳, 黄映湘, 王艳玲审校   

  1. 周卓华 综述 李红阳, 黄映湘, 王艳玲 审校首都医科大学附属北京友谊医院 眼科, 北京 100050
  • 收稿日期:2020-05-29 出版日期:2020-07-20 发布日期:2020-08-28
  • 基金资助:
    国家自然科学基金资助(81870686);首都卫生发展科研专项资助(首发2018-1-2021)

The application of arterial spin labeling in ischemic diseasesZHOU Zhuohua Overview LI Hongyang, HUANG Yingxiang, WANG Yanling Guidance Department of Ophthalmology, Beijing Friendship Hospital affiliated to Capital Medical University, Beijing 100050, ChinaAbstract:

Arterial spin labeling(ASL)is a non-invasive imaging technique that permits the quantitative analysis of tissue perfusion without contrast agents, and it has been widely used in ischemic disease research. This paper introduces the application of ASL in the assessment of ischemic ophthalmopathy and encephalopathy and compares it with other common examination techniques of the eye and brain. ASL can be used to monitor changes in cerebral blood flow and predict ischemic events, and it has been widely used in the study of ischemic encephalopathy. It can directly reflect the dynamics of blood flow through the chorioretinal vasculature, and it can be used as a reliable method for quantifying ocular blood perfusion. ASL is also relevant for the pathophysiological studies of chorioretinal diseases, which may contribute to the early diagnosis of ischemic ophthalmopathies. Currently, the application of ASL in ophthalmology is still limited, and further studies are needed to establish the utility of ASL in assessing ischemic ophthalmopathy.   

  1. Key words: Ischemic ophthalmopathy;
    Arterial spin labeling;
    Ischemic encephalopathy;
    Diagnosis;
    Magnetic resonance imaging缺血性疾病(如缺血性眼病、缺血性脑病)具有高发病率的特点, 且部分早期症状不典型, 早期发现、早期诊断可使患者得到及时治疗, 对于降低致残率和死亡率具有重要意义。随着影像学技术的发展, 该类疾病的检查手段多种多样, 磁共振动脉自旋标记(arterial spin labeling, ASL)技术作为一项新的成像技术应用于缺血性疾病的早期诊断, 在有些方面已经取得了可见的成效。现就ASL在缺血性疾病中的临床应用进行综述。
  • Received:2020-05-29 Online:2020-07-20 Published:2020-08-28

摘要: 磁共振动脉自旋标记技术(ASL)是一种非侵入性的影像学技术, 无需造影剂即可定量分析组织的血流灌注情况, 可重复性高, 对血流动力学相关指标敏感。本文主要介绍ASL在缺血性眼病及脑病中的应用, 并与眼部、脑部其他常用的血管造影等检查进行比较。ASL能够对脑部血流状态变化进行监测, 可预测脑部缺血性事件的发生, 目前已广泛应用于缺血性脑病的研究。研究表明ASL能够直接反映脉络膜视网膜组织的供血状况, 可作为定量眼部血流灌注的可靠方法, 同时对脉络膜视网膜疾病的病理生理研究具有一定意义, 可对缺血性眼病进行早期诊断。目前ASL在眼部的应用尚少, 尚需进一步研究以明确ASL在缺血性眼病中的效用。

关键词: 缺血性眼病, 磁共振动脉自旋标记, 缺血性脑病, 诊断, 磁共振成像

Abstract: Arterial spin labeling(ASL)is a non-invasive imaging technique that permits the quantitative analysis of tissue perfusion without contrast agents, and it has been widely used in ischemic disease research. This paper introduces the application of ASL in the assessment of ischemic ophthalmopathy and encephalopathy and compares it with other common examination techniques of the eye and brain. ASL can be used to monitor changes in cerebral blood flow and predict ischemic events, and it has been widely used in the study of ischemic encephalopathy. It can directly reflect the dynamics of blood flow through the chorioretinal vasculature, and it can be used as a reliable method for quantifying ocular blood perfusion. ASL is also relevant for the pathophysiological studies of chorioretinal diseases, which may contribute to the early diagnosis of ischemic ophthalmopathies. Currently, the application of ASL in ophthalmology is still limited, and further studies are needed to establish the utility of ASL in assessing ischemic ophthalmopathy.

Key words: Ischemic ophthalmopathy, Arterial spin labeling, Ischemic encephalopathy, Diagnosis, Magnetic resonance imaging

中图分类号: 

  • R77
[1] Ho ML. Arterial spin labeling: Clinical applications[J]. J Neuroradiol, 2018, 45(5): 276-289. doi: 10.1016/j.neurad.2018.06.003.
[2] Havsteen I, Damm Nybing J, Christensen H, et al. Arterial spin labeling: a technical overview[J]. Acta Radiol, 2018, 59(10): 1232-1238. doi:10.1177/028418-5117752552.
[3] Haller S, Zaharchuk G, Thomas DL, et al. Arterial spin labeling perfusion of the brain: emerging clinical applications[J]. Radiology, 2016, 281(2): 337-356. doi:10.1148/radiol.2016150789.
[4] Bokkers RP, Bremmer JP, van Berckel BN, et al. Arterial spin labeling perfusion MRI at multiple delay times: a correlative study with H(2)(15)O positron emission tomography in patients with symptomatic carotid artery occlusion[J]. J Cereb Blood Flow Metab, 2010, 30(1): 222-229. doi:10.1038/jcbfm.2009.204.
[5] Telischak NA, Detre JA, Zaharchuk G. Arterial spin labeling MRI: clinical applications in the brain[J]. J Magn Reson Imaging, 2015, 41(5): 1165-1180. doi:10.1002/jmri.24751.
[6] 郑罡, 张健康, 胥巧丽. 多延迟动脉自旋标记技术的量化原理及其临床研究[J]. 南京航空航天大学学报, 2017, 49(5): 753-756. doi: 10.16356/j.1005-2615.2017.05.020. ZHENG Gang, ZHANG J iankang, XU Qiaoli,. Quantization principle and clinical research of multi-delay arterial spin labeling technique[J]. Journal of Nanjing University of Aeronautics & Astronautics, 2017, 49(5): 753-756. doi: 10.16356/j.1005-2615.2017.05.020.
[7] 曾艳, 钱银锋. 动脉自旋标记技术的临床应用进展[J]. 国际医学放射学杂志, 2015, 38(5):446-449. doi: 10.3874 / j.issn.1674-1897.2015.05.Z0508. ZENG Yan, QIAN Yinfeng. The progress in clinical applications of arterial spin labeling technique[J]. Int J Med Radiol, 2015, 38(5):446-449. doi: 10.3874 / j.issn.1674-1897.2015.05.Z0508.
[8] Nael K, Meshksar A, Liebeskind DS, et al. Periprocedural arterial spin labeling and dynamic susceptibility contrast perfusion in detection of cerebral blood flow in patients with acute ischemic syndrome[J]. Stroke, 2013, 44(3): 664-670. doi:10.1161/strokeaha.112.672956.
[9] Qiao XJ, Salamon N, Wang DJ, et al. Perfusion deficits detected by arterial spin-labeling in patients with Tia with negative diffusion and vascular imaging[J]. AJNR Am J Neuroradiol, 2013, 34(11): 2125-2130. doi:10.3174/ajnr.A3551.
[10] 杨秀芬, 李红阳, 赵露, 等. 眼缺血综合征的临床及影像学特点分析[J]. 山东大学耳鼻喉眼学报, 2019, 33(4): 119-123. doi: 10.6040/j.issn.1673-3770.0.2018.526. YANG Xiufen, LI Hongyang, ZHAO Lu, et al. Clinical and imaging characteristics in patients with ocular ischemic syndrome[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(4): 119-123. doi: 10.6040/j.issn.1673-3770.0.2018.526.
[11] Hassenstein A, Meyer CH. Clinical use and research applications of Heidelberg retinal angiography and spectral-domain optical coherence tomography—a review[J]. Clin Experiment Ophthalmol, 2009, 37(1): 130-143. doi:10.1111/j.1442-9071.2009.02017.x.
[12] Spaide RF, Koizumi H, Pozzoni MC, et al. Enhanced depth imaging spectral-domain optical coherence tomography[J]. Am J Ophthalmol, 2008, 146(4): 496-500. doi:10.1016/j.ajo.2008.05.032.
[13] Fujiwara T, Imamura Y, Margolis R, et al. Enhanced depth imaging optical coherence tomography of the choroid in highly myopic eyes[J]. Am J Ophthalmol, 2009, 148(3): 445-450. doi:10.1016/j.ajo.2009.04.029.
[14] de Carlo TE, Romano A, Waheed NK, et al. A review of optical coherence tomography angiography(OCTA)[J]. Int J Retina Vitreous, 2015, 1: 5. doi:10.1186/s40942-015-0005-8.
[15] Kang HM, Lee CS, Lee SC. Thinner subfoveal choroidal thickness in eyes with ocular ischemic syndrome than in unaffected contralateral eyes[J]. Graefes Arch Clin Exp Ophthalmol, 2014, 252(5): 851-852. doi:10.1007/s00417-014-2609-3.
[16] Vaghefi E, Pontré B. Application of arterial spin labelling in the assessment of ocular tissues[J]. Biomed Res Int, 2016, 2016: 1-13. doi:10.1155/2016/6240504.
[17] Muir ER, De La Garza B, Duong TQ. Blood flow and anatomical MRI in a mouse model of retinitis pigmentosa[J]. Magn Reson Med, 2013, 69(1): 221-228. doi:10.1002/mrm.24232.
[18] Li G, Shih YY, Kiel JW, et al. MRI study of cerebral, retinal and choroidal blood flow responses to acute hypertension[J]. Exp Eye Res, 2013, 112: 118-124. doi:10.1016/j.exer.2013.04.003.
[19] Muir ER, Rentería RC, Duong TQ. Reduced ocular blood flow as an early indicator of diabetic retinopathy in a mouse model of diabetes[J]. Invest Ophthalmol Vis Sci, 2012, 53(10):6488-6494. doi:10.1167/iovs.12-9758.
[20] Khanal S, Turnbull PRK, Vaghefi E, et al. Repeatability of arterial spin labeling MRI in measuring blood perfusion in the human eye[J]. J Magn Reson Imaging, 2019, 49(4): 966-974. doi:10.1002/jmri.26323.
[21] Emeterio Nateras OS, Harrison JM, Muir ER, et al. Choroidal blood flow decreases with age: an MRI study[J]. Curr Eye Res, 2014, 39(10): 1059-1067. doi: 10.3109/02713683.2014.892997.
[22] Zhang Y, San Emeterio Nateras O, Peng Q, et al. Blood flow MRI of the human retina/choroid during rest and isometric exercise[J]. Invest Ophthalmol Vis Sci, 2012, 53(7): 4299-4305. doi:10.1167/iovs.11-9384.
[23] Vaghefi E, Kauv K, Pan W, et al. Application of arterial spin labelling in detecting retinal ischemia[J]. Case Rep Ophthalmol. 2017, 8(3): 545-557. doi:10.1159/000485316.
[24] Zhang Y, Harrison JM, Nateras OS, et al. Decreased retinal-choroidal blood flow in retinitis pigmentosa as measured by MRI[J]. Doc Ophthalmol, 2013, 126(3): 187-197. doi:10.1007/s10633-013-9374-1.
[25] 赵露, 谢国丽, 王佳琳, 等. 视网膜血管管径与颈动脉狭窄患者脑梗死发生的相关性分析[J]. 中华眼底病杂志, 2016, 32(4): 387-390. doi: 10.3760/cma.j.issn.1005-1015.2016.04.010. ZHAO Lu, XIE Guoli, WANG Jialin, et al. Relation between retinal vessel diameters and carotid artery stenosis patients with cerebral infarction[J]. Chinese Journal of Ocular Fundus Diseases, 2016, 32(4): 387-390. doi: 10.3760/cma.j.issn.1005-1015.2016.04.010.
[26] 李红阳, 王惠, 张晓洁, 等. 视网膜血管形态及眼血流状态与颈内动脉狭窄的相关性研究[J]. 中华眼科杂志, 2016(12): 905-910. doi: 10.3760/cma.j.issn.0412-4081.2016.12.007. LI Hongyang, WANG Hui, ZHANG Xiaojie, et al. Study on correlation between retinal vessel morphology or ocular hemodynamic parameter and internal carotid artery Stenosis[J]. Chinese Journal of Ophthalmology, 2016(12): 905-910. doi: 10.3760/cma.j.issn.0412-4081.2016.12.007.
[27] Duncan RO, Sample PA, Bowd C, et al. Arterial spin labeling fMRI measurements of decreased blood flow in primary visual cortex correlates with decreased visual function in human Glaucoma[J]. Vision Res, 2012, 60: 51-60. doi:10.1016/j.visres.2012.03.012.
[28] Wang Q, Chen WW, Qu XX, et al. Reduced cerebral blood flow in the visual cortex and its correlation with glaucomatous structural damage to the Retina in patients with mild to moderate primary open-angle Glaucoma[J]. J Glaucoma, 2018, 27(9): 816-822. doi:10.1097/IJG.0000000000001017.
[29] Dan HD, Shen Y, Huang X, et al. Arterial spin labeling perfusion magnetic resonance imaging reveals resting cerebral blood flow alterations specific to retinitis pigmentosa patients[J]. Curr Eye Res, 2019, 44(12): 1353-1359. doi:10.1080/02713683.2019.1649702.
[30] Musuka TD, Wilton SB, Traboulsi M, Hill MD. Diagnosis and management of acute ischemic stroke: speed is critical[J]. CMAJ. 2015, 187(12): 887-893. doi:10.1503/cmaj.140355.
[31] Feigin VL, Krishnamurthi RV, Parmar P, et al. Update on the global burden of ischemic and hemorrhagic stroke in 1990-2013: the GBD 2013 study[J]. Neuroepidemiology, 2015, 45(3): 161-176. doi:10.1159/00044-1085.
[32] Tan S, Zhang L, Chen XY, et al. Comparison of the Chinese ischemic stroke subclassification and Trial of Org 10172 in acute stroke treatment systems in minor stroke[J]. BMC Neurol, 2016, 16(1): 162. doi:10.1186/s12883-016-0688-y.
[33] Adams HP Jr, Bendixen BH, Kappelle LJ, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment[J]. Stroke, 1993, 24(1): 35-41. doi:10.1161/01.str.24.1.35.
[34] 罗荣芳, 张东升. 3D-ASL脑灌注成像技术在缺血性脑血管疾病临床诊断中的应用价值[J]. 泰山医学院学报, 2018, 39(9): 1002-1004. doi: CNKI:SUN:TSYX.0.2018-09-012. LUO Rongfang, ZHANG Dongsheng. Clinical value of 3D-ASL cerebral perfusion imaging technique in the diagnosis of ischemic cerebrovascular diseases[J]. Journal of Taishan Medical College, 2018, 39(9): 1002-1004. doi: CNKI:SUN:TSYX.0.2018-09-012.
[35] 杨雷振, 吕丽敏. 3D-ASL联合MRA在缺血性脑血管疾病诊断中的应用价值[J]. 实用中西医结合临床, 2020, 20(2): 117-119. doi: 10.13638/j.issn.1671-4040.2020.02.061.
[36] Kılıç Çoban E. The review of transient ischemic attack patients; an experience of a clinic about diagnosis and follow-up[J]. Sisli Etfal, 2018. doi:10.14744/semb.2018.20438.
[37] Gennai S, Giordano-Orsini G, Lefour S, et al. Accident Ischémique Transitoire: limites et enjeux de la prise en charge initialeTransient Ischemic Attack: Limits and challenges of early management[J]. La Press Médicale, 2018, 47(11/12): 934-937. doi:10.1016/j.lpm.2018.09.008.
[38] Zaharchuk G. Arterial spin label imaging of acute ischemic stroke and transient ischemic attack[J]. Neuroimaging Clin N Am, 2011, 21(2): 285-301. x. doi:10.1016/j.nic.2011.01.003.
[39] 张梦雪, 王成伟, 范炜. 磁共振3D-ASL灌注成像技术在短暂性脑缺血发作中的应用研究[J]. 吉林医学, 2018, 39(11): 2054-2057. doi: CNKI:SUN:JLYX.0.2018-11-024. ZHANG Mengxue, WANG Chengwei, FAN Wei. Application of 3D-ASL perfusion-weighted imaging in Study of transient ischemic attack[J]. Jilin Medical Journal, 2018, 39(11): 2054-2057. doi: CNKI:SUN:JLYX.0.2018-11-024.
[40] Nam KW, Kim CK, Ko SB, et al. Regional arterial spin labeling perfusion defect is associated with early ischemic recurrence in patients with a transient ischemic attack[J]. Stroke, 2020, 51(1): 186-192. doi:10.1161/STROKEAHA.119.026556.
[41] 李杰, 李颖, 吴立梅. MR三维动脉自旋标记灌注成像联合ABCD~2评分在TIA发作早期发生脑梗死预测的价值[J].中国医学装备,2020,17(3):62-66. doi:10.3696/J.ISSN.1672-8270.2020.03.016
[42] Havsteen I, Willer L, Ovesen C, et al. Significance of arterial spin labeling perfusion and susceptibility weighted imaging changes in patients with transient ischemic attack: a prospective cohort study[J]. BMC Med Imaging, 2018, 18(1): 24. doi:10.1186/s12880-018-0264-6.
[43] Lv Y, Wei W, Song YL, et al. Non-invasive evaluation of cerebral perfusion in patients with transient ischemic attack: an fMRI study[J]. J Neurol, 2019, 266(1): 157-164. doi:10.1007/s00415-018-9113-3.
[44] Makris K, Haliassos A, Chondrogianni M, et al. Blood biomarkers in ischemic stroke: potential role and challenges in clinical practice and research[J]. Crit Rev Clin Lab Sci, 2018, 55(5): 294-328. doi:10.1080/10408363.2018.1461190.
[45] Antonucci MU, Yazdani M. A helpful tool in diagnosing stroke mimics: arterial spin labeled perfusion magnetic resonance imaging[J]. J Emerg Med, 2020, 58(3): 439-443. doi:10.1016/j.jemermed.2019.12.019.
[46] Long B, Koyfman A. Clinical mimics: an emergency medicine-focused review of stroke mimics[J]. J Emerg Med, 2017, 52(2): 176-183. doi:10.1016/j.jemermed.2016.09.021.
[47] 符沁芯. 3D-ASL联合DWI及MRA评价急性脑梗死缺血半暗带[D]. 大连: 大连医科大学, 2018.
[48] Kohno N, Okada K, Yamagata S, et al. Distinctive patterns of three-dimensional arterial spin-labeled perfusion magnetic resonance imaging in subtypes of acute ischemic stroke[J]. J Stroke Cerebrovasc Dis, 2016, 25(7): 1807-1812. doi:10.1016/j.jstrokecerebrovasdis.2016.03.035.
[49] Griebe M, Kern R, Eisele P, et al. Continuous magnetic resonance perfusion imaging acquisition during systemic thrombolysis in acute stroke[J]. Cerebrovasc Dis, 2013, 35(6): 554-559. doi:10.1159/000351146.
[50] Mirasol RV, Bokkers RP, Hernandez DA, et al. Assessing reperfusion with whole-brain arterial spin labeling: a noninvasive alternative to gadolinium[J]. Stroke, 2014, 45(2): 456-461. doi:10.1161/STROKEAHA.113.004001.
[51] Yu SL, Liebeskind DS, Dua S, et al. Postischemic hyperperfusion on arterial spin labeled perfusion MRI is linked to hemorrhagic transformation in stroke[J]. J Cereb Blood Flow Metab, 2015, 35(4): 630-637. doi:10.1038/jcbfm.2014.238.
[52] Morofuji Y, Horie N, Tateishi Y, et al. Arterial spin labeling magnetic resonance imaging can identify the occlusion site and collateral perfusion in patients with acute ischemic stroke: comparison with digital subtraction angiography[J]. Cerebrovasc Dis, 2019, 48(1/2): 70-76. doi:10.1159/000503090.
[53] Kang KM, Sohn CH, Choi SH, et al. Detection of crossed cerebellar diaschisis in hyperacute ischemic stroke using arterial spin-labeled MR imaging[J]. PLoS One, 2017, 12(3): e0173971. doi:10.1371/journal.pone.0173971.
[54] Kanazawa Y, Arakawa S, Shimogawa T, et al. Arterial spin labeling magnetic resonance imaging for differentiating acute ischemic stroke from epileptic disorders[J]. J Stroke Cerebrovasc Dis, 2019, 28(6): 1684-1690. doi:10.1016/j.jstrokecerebrovasdis.2019.02.020.
[55] Wazni W, Farooq S, Cox JA, et al. Use of arterial spin-labeling in patients with aneurysmal sub-arachnoid hemorrhage[J]. J Vasc Interv Neurol, 2019, 10(3): 10‐14. PMCID: PMC6613486.
[56] Zhang JG, Xia CC, Liu Y, et al. Comparative study of MR mTI-ASL and DSC-PWI in evaluating cerebral hemodynamics of patients with Moyamoya disease[J]. Medicine(Baltimore), 2018, 97(47):e13497. doi:10.1097/MD.0000000000012768.
[57] 陈传玉, 邓克学, 邱峻, 等. 动脉自旋标记技术对缺血型和出血型烟雾病患者脑灌注情况的评估[J]. 中华全科医学, 2019, 17(12): 2001-2003, 2012. CHEN Chuanyu, DENG Kexue, QIU Jun. Evaluation of cerebral perfusion in patients with ischemic and hemorrhagic moyamoya disease by arterial spin labeling[J]. Chinese Journal of General Practice, 2019, 17(12): 2001-2003, 2012.
[58] Ramachandran S, Mukherjee D, Delf J, et al. A comparison of arterial spin labelling with catheter angiography in evaluating arteriovenous malformations: a systematic review[J]. Br J Radiol, 2020, 93(1110): 20190830. doi:10.1259/bjr.20190830.
[59] Tian B, Liu Q, Wang XR, et al. Chronic intracranial artery Stenosis: Comparison of whole-brain arterial spin labeling with CT perfusion[J]. Clin Imaging, 2018, 52: 252-259. doi:10.1016/j.clinimag.2018.08.005.
[60] Yoo RE, Yun TJ, Yoon BW, et al. Identification of cerebral perfusion using arterial spin labeling in patients with seizures in acute settings[J]. PLoS One, 2017, 12(3): e0173538. doi:10.1371/journal.pone.0173538.
[61] Chen ZY, Chen XY, Liu MY, et al. Evaluation of gray matter perfusion in episodic migraine using voxel-wise comparison of 3D pseudo-continuous arterial spin labeling[J]. J Headache Pain, 2018, 19(1): 36. doi:10.1186/s10194-018-0866-y.
[62] Barzgari A, Sojkova J, Maritza Dowling N, et al. Arterial spin labeling reveals relationships between resting cerebral perfusion and motor learning in Parkinsons disease[J]. Brain Imaging Behav, 2019, 13(3): 577-587. doi:10.1007/s11682-018-9877-1.
[63] Zhang N, Gordon ML, Goldberg TE. Cerebral blood flow measured by arterial spin labeling MRI at resting state in normal aging and Alzheimers disease[J]. Neurosci Biobehav Rev, 2017, 72: 168-175. doi:10.1016/j.neubiorev.2016.11.023.
[64] Landes V, Javed A, Jao T, et al. Improved velocity-selective labeling pulses for myocardial ASL[J]. Magn Reson Med, 2020, 84(4): 1909-1918. doi:10.1002/mrm.28253.
[65] Nichelli L, Dormont D, Pyatigorskaya N. Subdural brain metastasis of lung adenocarcinoma on arterial spin labeling(ASL)MRI[J]. Diagn Interv Imaging, 2020, 101(2): 119-120. doi:10.1016/j.diii.2019.06.006.
[66] Taso M, Papadopoulou F, Smith MP, et al. Pancreatic perfusion modulation following glucose stimulation assessed by noninvasive arterial spin labeling(ASL)MRI[J]. J Magn Reson Imaging, 2020, 51(3): 854-860. doi:10.1002/jmri.26899.
[67] Buchanan CE, Cox EF, Francis ST. Evaluation of 2D imaging schemes for pulsed arterial spin labeling of the human kidney cortex[J]. Diagnostics(Basel), 2018, 8(3): E43. doi:10.3390/diagnostics8030043.
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