Journal of magnetic resonance imaging : JMRI · 2009
Vascular space occupancy (VASO) cerebral blood volume-weighted MRI identifies hemodynamic impairment in patients with carotid artery disease.
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Donahue Manus J, van Laar Peter Jan, van Zijl Peter C M, Stevens Robert D, Hendrikse Jeroen
Аннотация
PURPOSE: To assess the role of vascular space occupancy (VASO) magnetic resonance imaging (MRI), a noninvasive cerebral blood volume (CBV)-weighted technique, for evaluating CBV reactivity in patients with internal carotid artery (ICA) stenosis.
MATERIALS AND METHODS: VASO reactivity, defined as a signal change in response to hypercapnic stimulus (4-second exhale, 14-second breath-hold), was measured in the left and right ICA flow territories in patients (n=10) with varying degrees of unilateral and bilateral ICA stenosis and in healthy volunteers (n=10).
RESULTS: Percent VASO reactivity was more negative (P<0.01) bilaterally in patients (ipsilateral: -3.6+/-1.5%; contralateral: -3.4+/-1.2%) compared with age-matched controls (left: -1.9+/-0.6%; right: -1.9+/-0.8%). Owing to the nature of the VASO contrast mechanism, this more negative VASO reactivity was attributed to autoregulatory CBV effects in patients. A postbreath-hold overshoot, which was absent in healthy volunteers, was observed unilaterally in a subset of patients.
CONCLUSION: More negative VASO reactivity was observed in patients with ICA stenosis and may be a marker of autoregulatory effects. Furthermore, the postbreath-hold overshoot observed in patients is consistent with compensatory microvascular vasoconstriction and may be a marker of hemodynamic impairment. Based on the results of this feasibility study, VASO should be useful for identifying CBV adjustments in patients with steno-occlusive disease of the ICA.
MATERIALS AND METHODS: VASO reactivity, defined as a signal change in response to hypercapnic stimulus (4-second exhale, 14-second breath-hold), was measured in the left and right ICA flow territories in patients (n=10) with varying degrees of unilateral and bilateral ICA stenosis and in healthy volunteers (n=10).
RESULTS: Percent VASO reactivity was more negative (P<0.01) bilaterally in patients (ipsilateral: -3.6+/-1.5%; contralateral: -3.4+/-1.2%) compared with age-matched controls (left: -1.9+/-0.6%; right: -1.9+/-0.8%). Owing to the nature of the VASO contrast mechanism, this more negative VASO reactivity was attributed to autoregulatory CBV effects in patients. A postbreath-hold overshoot, which was absent in healthy volunteers, was observed unilaterally in a subset of patients.
CONCLUSION: More negative VASO reactivity was observed in patients with ICA stenosis and may be a marker of autoregulatory effects. Furthermore, the postbreath-hold overshoot observed in patients is consistent with compensatory microvascular vasoconstriction and may be a marker of hemodynamic impairment. Based on the results of this feasibility study, VASO should be useful for identifying CBV adjustments in patients with steno-occlusive disease of the ICA.