Vascular space occupancy(VASO) cerebral blood volume-weighted MRI identifies hemodynamic impairment in patients with carotid artery disease

Manus J. Donahue, Peter Jan Van Laar, Peter C.M. Van Zijl, Robert D. Stevens, Jeroen Hendrikse

Research output: Contribution to journalArticle

Abstract

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 ofunilateral and bilateral ICAstenosis 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 plusmn; 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.

Original languageEnglish (US)
Pages (from-to)718-724
Number of pages7
JournalJournal of Magnetic Resonance Imaging
Volume29
Issue number3
DOIs
StatePublished - Mar 2009

Keywords

  • Autoregulation
  • CBF
  • CBV
  • Stenosis
  • Stroke
  • VASO

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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