Evaluation of hemodynamic impairments in unilateral high-grade carotid artery stenosis patients and healthy age-matched participants
Evaluation of hemodynamic impairments in unilateral high-grade carotid artery stenosis patients and healthy age-matched participants
Kaczmarz, S.; Göttler, J.; Griese, V.; Petr, J.; Zimmer, C.; Sorg, C.; Preibisch, C.
Objectives:
Internal carotid-artery stenosis (ICAS) is a major public health issue, as it accounts for approximately 20% of all strokes1. However, related complex hemodynamic impairments are not well understood2. We therefore propose a multimodal MRI-protocol. The major aims were to evaluate its reliability and investigate physiological changes.
Methods:
In the ongoing clinical study, 52 subjects (29 healthy controls: 70.3±4.7y, 13 males; 23 patients with asymptomatic unilateral ICAS, NASCET>70%: 70.5±6.8y, 15 males) underwent MRI on a Philips 3T-Ingenia. We propose a combination of three different MR-based methods, accounting for cerebrovascular reactivity (CVR) by breathhold-fMRI (voxelsize 3x3x3mm3, 38 slices, TE/TR=30ms/1200ms, acq.time=5:48min), CBF by pCASL (3D-readout, voxelsize 2.7x2.8x6mm3, 16 slices, TE/TR=7.4ms/4403ms, label duration=1800ms, PLD=2000ms, acq.time 5:43min) and relative oxygen extraction fraction (rOEF) by a multi-parametric quantitative-BOLD approach3 (voxelsize 2x2x3mm3, 30 slices). For each participant, individual masks of watershed areas were defined for both hemispheres in grey-matter and mean values of all three modalities were compared.
Results:
In healthy participants, our results show no significant lateralization of all three modalities on a group level. For ICAS-patients, regionally reduced CVR (p=0.003) as well as hypoperfusion (p< 0.001) were found ipsilateral to the stenosis (figure). In accordance with the literature, we did not find ICAS-induced changes in oxygen extraction on a group level (p=0.310).4 Even though focal rOEF increases could be suspected in single patients.
Conclusions:
The presented preliminary results thus imply successful application of our multimodal-MRI approach and are highly promising with respect to gaining a deeper insight into ICAS-related physiological changes. Further investigations of the relations between the parameters are currently in progress.
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Contribution to proceedings
28rd International Symposium on Cerebral Blood Flow, Metabolism and Function, 01.04.2017, Berlin, Germany
Proceedings of the 28rd International Symposium on Cerebral Blood Flow, Metabolism and Function, 498 -
Poster
28rd International Symposium on Cerebral Blood Flow, Metabolism and Function, 01.04.2017, Berlin, Germany
Permalink: https://www.hzdr.de/publications/Publ-25394
Publ.-Id: 25394