Resting-state Functional Magnetic Resonance Imaging Identifies Cerebrovascular Reactivity Impairment in Patients With Arterial Occlusive Diseases: A Pilot Study

Neurosurgery ◽  
2018 ◽  
Vol 85 (5) ◽  
pp. 680-688 ◽  
Author(s):  
Sei Nishida ◽  
Toshihiko Aso ◽  
Shigetoshi Takaya ◽  
Yuki Takahashi ◽  
Takayuki Kikuchi ◽  
...  
Keyword(s):  
At Risk ◽  
Resting State ◽  
Photon Emission ◽  
Blood Oxygenation ◽  
Cerebrovascular Reactivity ◽  
Emission Computed Tomography ◽  
Temporal Shift ◽  
Major Interest ◽  
Hemodynamic State ◽  
Arterial Occlusive Diseases

Abstract BACKGROUND The development of noninvasive approaches for identifying hypoperfused brain tissue at risk is of major interest. Recently, the temporal-shift (TS) maps estimated from resting-state blood oxygenation level-dependent (BOLD) signals have been proposed for determining hemodynamic state. OBJECTIVE To examine the equivalency of the TS map and the cerebrovascular reactivity (CVR) map derived from acetazolamide-challenged single-photon emission computed tomography (SPECT) in identifying hemodynamic impairment in patients with arterial occlusive diseases. METHODS Twenty-three patients with arterial occlusive diseases who underwent SPECT were studied. With a recursive TS analysis of low-frequency fluctuation of the BOLD signal, a TS map relative to the global signal was created for each patient. The voxel-by-voxel correlation coefficient was calculated to examine the image similarity between TS and SPECT-based cerebral blood flow (CBF) or CVR maps in each patient. Furthermore, simple linear regression analyses were performed to examine the quantitative relationship between the TS of BOLD signals and CVR in each cerebrovascular territory. RESULTS The within-patient, voxel-by-voxel comparison revealed that the TS map was more closely correlated with SPECT-CVR map ([Z(r)] = 0.42 ± 0.18) than SPECT-CBF map ([Z(r)] = 0.058 ± 0.11; P < .001, paired t-test). The regression analysis showed a significant linear association between the TS of BOLD signals and CVR in the anterior circulation where the reduction of CVR was evident in the patient group. CONCLUSION BOLD TS analysis has potential as a noninvasive alternative to current methods based on CVR for identification of tissue at risk of ischemic stroke.

scholarly journals Hyperpolarized 129Xe Time-of-Flight MR Imaging of Perfusion and Brain Function

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 630
Author(s):  
Yurii Shepelytskyi ◽  
Francis T. Hane ◽  
Vira Grynko ◽  
Tao Li ◽  
Ayman Hassan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Signal To Noise Ratio ◽  
Neurological Diseases ◽  
Photon Emission ◽  
Time Of Flight ◽  
Hemodynamic Response ◽  
Dynamic Imaging ◽  
Blood Oxygenation ◽  
Emission Computed Tomography

Perfusion measurements can provide vital information about the homeostasis of an organ and can therefore be used as biomarkers to diagnose a variety of cardiovascular, renal, and neurological diseases. Currently, the most common techniques to measure perfusion are 15O positron emission tomography (PET), xenon-enhanced computed tomography (CT), single photon emission computed tomography (SPECT), dynamic contrast enhanced (DCE) MRI, and arterial spin labeling (ASL) MRI. Here, we show how regional perfusion can be quantitively measured with magnetic resonance imaging (MRI) using time-resolved depolarization of hyperpolarized (HP) xenon-129 (129Xe), and the application of this approach to detect changes in cerebral blood flow (CBF) due to a hemodynamic response in response to brain stimuli. The investigated HP 129Xe Time-of-Flight (TOF) technique produced perfusion images with an average signal-to-noise ratio (SNR) of 10.35. Furthermore, to our knowledge, the first hemodynamic response (HDR) map was acquired in healthy volunteers using the HP 129Xe TOF imaging. Responses to visual and motor stimuli were observed. The acquired HP TOF HDR maps correlated well with traditional proton blood oxygenation level-dependent functional MRI. Overall, this study expands the field of HP MRI with a novel dynamic imaging technique suitable for rapid and quantitative perfusion imaging.

scholarly journals Use of Cerebrovascular Reactivity in Patients with Symptomatic Major Cerebral Artery Occlusion to Predict 5-Year Outcome: Comparison of Xenon-133 and Iodine-123-IMP Single-Photon Emission Computed Tomography

2002 ◽  
Vol 22 (9) ◽  
pp. 1142-1148 ◽  
Author(s):  
Kuniaki Ogasawara ◽  
Akira Ogawa ◽  
Kazunori Terasaki ◽  
Hiroaki Shimizu ◽  
Teiji Tominaga ◽  
...  
Keyword(s):  
Cerebral Artery ◽  
Single Photon ◽  
Independent Predictor ◽  
Photon Emission ◽  
Survival Rates ◽  
Artery Occlusion ◽  
Cerebrovascular Reactivity ◽  
Emission Computed Tomography ◽  
Percent Change ◽  
Cerebral Artery Occlusion

The aim of this prospective study was to investigate whether decreased cerebrovascular reactivity to acetazolamide, as determined by single-photon emission computed tomography (SPECT), is an independent predictor of the 5-year risk of subsequent stroke in patients with symptomatic major cerebral artery occlusion. Cerebrovascular reactivity to acetazolamide in the middle cerebral artery (MCA) territory ipsilateral to the occluded artery was determined on the basis of two different methodologies: cerebral blood flow (CBF) percent change obtained quantitatively from xenon-133 (133Xe) SPECT, and asymmetry index (AI) percent change obtained qualitatively from N-isopropyl- p-[123I]-iodoamphetamine (IMP) SPECT. Seventy patients with unilateral internal carotid artery or MCA occlusion were divided into two groups within each SPECT methodology (normal or decreased CBF percent change and AI percent change) and followed up for 5 years. Cumulative recurrence-free survival rates for patients with decreased CBF percent change were significantly lower than for those with normal CBF percent change ( P = 0.0205). There was no significant difference in cumulative recurrence-free survival rates between patients with decreased AI percent change and those with normal AI percent change. Only decreased CBF percent change was a significant independent predictor of stroke recurrence ( P = 0.0051). The present study demonstrated that decreased cerebrovascular reactivity to acetazolamide determined quantitatively by Xe SPECT is an independent predictor of the 5-year risk of subsequent stroke in patients with symptomatic major cerebral artery occlusion, and that the qualitative method using I-IMP SPECT is a poor predictor of the risk of subsequent stroke in this type of patient.

scholarly journals Estimation of Cerebral Perfusion Reserve by Blood Oxygenation Level—Dependent Imaging: Comparison with Single-Photon Emission Computed Tomography

2003 ◽  
Vol 23 (1) ◽  
pp. 121-135 ◽  
Author(s):  
Akihiko Shiino ◽  
Yasuo Morita ◽  
Atsushi Tsuji ◽  
Kengo Maeda ◽  
Ryuta Ito ◽  
...  
Keyword(s):  
Single Photon ◽  
Photon Emission ◽  
Blood Oxygenation ◽  
Reserve Capacity ◽  
Emission Computed Tomography ◽  
Cerebrovascular Reserve ◽  
Oxygenation Level ◽  
The Mean ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Measurement of cerebrovascular reserve capacity predicts the risk of ischemic insult in patients with major vessel occlusion. Blood oxygenation level-dependent (BOLD) imaging has the potential to estimate reserve capacity of the cerebral circulation noninvasively based on changes in the signal that reflect differences in the magnetic susceptibility of intravascular oxyhemoglobin and deoxyhemoglobin. The authors examined the feasibility of using the BOLD technique to assess cerebrovascular reserve capacity in patients with cerebrovascular occlusive disease by comparing results with an established method of measuring CBF. Ten patients with severe or complete occlusion of the internal carotid artery were compared with 17 healthy subjects to evaluate regional differences and identify variables that indicate a change in the BOLD signal. Dilation of cerebral vessels was induced by breath holding, and the R2* change was examined with gradient-echo, echo-planar imaging. Before measuring the regional change in the BOLD signal, actual timing of “activated” and “rest” periods was corrected by shifting the phase of a sine-wave template to obtain the largest correlation coefficient. Percent signal change was calculated on a pixel-by-pixel basis and was compared with CBF measured by single-photon emission computed tomography (SPECT) before and after acetazolamide challenge. The degree of impairment and the distribution of impaired areas detected by the BOLD study correlated with the results of SPECT. Overall sensitivity and specificity of the BOLD technique by visual inspection were 100% and 98.4%, respectively. A negative response (decreased CBF) frequently was observed in areas of exhausted reserve capacity, suggesting that a “steal” phenomenon exists. The percent change and the ΔCBF were well correlated ( P < 0.01). The mean percent change in most areas of impaired reserve capacity was more than 2 SD below the mean values in healthy subjects. The present method of semiquantitative BOLD analysis can be used to create a map of the cerebral hemodynamic state. Furthermore, the development of reliable, generally accessible techniques for evaluating cerebral hemodynamics opens the door for clinical studies to monitor and treat patients with compromised reserve. This study is an attempt to develop such analysis.

scholarly journals Intraoperative BOLD-fMRI Cerebrovascular Reactivity Assessment

2021 ◽  
pp. 139-143
Author(s):  
Giovanni Muscas ◽  
Christiaan Hendrik Bas van Niftrik ◽  
Martina Sebök ◽  
Giuseppe Esposito ◽  
Luca Regli ◽  
...  
Keyword(s):  
Cerebrovascular Diseases ◽  
Blood Oxygenation ◽  
Cerebrovascular Reactivity ◽  
Hemodynamic State ◽  
Neurosurgical Patients ◽  
Blood Oxygenation Level ◽  
Oxygenation Level ◽  
Ischemic Cerebrovascular Diseases ◽  
Brain Gliomas ◽  
The Brain

AbstractBlood oxygenation-level dependent cerebrovascular reactivity (BOLD-CVR) has gained attention in recent years as an effective way to investigate CVR, a measure of the hemodynamic state of the brain, with high spatial and temporal resolution. An association between impaired CVR and diverse pathologies has been observed, especially in ischemic cerebrovascular diseases and brain gliomas. The ability to obtain this information intraoperatively is novel and has not been widely tested. We report our first experience with this intraoperative technique in vascular and oncologic neurosurgical patients, discuss the results of its feasibility, and the possible developments of the intraoperative employment of BOLD-CVR.

scholarly journals The Role of Cerebrovascular-Reactivity Mapping in Functional MRI: Calibrated fMRI and Resting-State fMRI

2021 ◽  
Vol 12 ◽  
Author(s):  
J. Jean Chen ◽  
Claudine J. Gauthier
Keyword(s):  
Functional Mri ◽  
Resting State ◽  
Resting State Fmri ◽  
Blood Oxygenation ◽  
Cerebrovascular Reactivity ◽  
Resting State Functional Connectivity ◽  
Non Invasive ◽  
Oxygenation Level ◽  
Calibrated Fmri

Task and resting-state functional MRI (fMRI) is primarily based on the same blood-oxygenation level-dependent (BOLD) phenomenon that MRI-based cerebrovascular reactivity (CVR) mapping has most commonly relied upon. This technique is finding an ever-increasing role in neuroscience and clinical research as well as treatment planning. The estimation of CVR has unique applications in and associations with fMRI. In particular, CVR estimation is part of a family of techniques called calibrated BOLD fMRI, the purpose of which is to allow the mapping of cerebral oxidative metabolism (CMRO2) using a combination of BOLD and cerebral-blood flow (CBF) measurements. Moreover, CVR has recently been shown to be a major source of vascular bias in computing resting-state functional connectivity, in much the same way that it is used to neutralize the vascular contribution in calibrated fMRI. Furthermore, due to the obvious challenges in estimating CVR using gas challenges, a rapidly growing field of study is the estimation of CVR without any form of challenge, including the use of resting-state fMRI for that purpose. This review addresses all of these aspects in which CVR interacts with fMRI and the role of CVR in calibrated fMRI, provides an overview of the physiological biases and assumptions underlying hypercapnia-based CVR and calibrated fMRI, and provides a view into the future of non-invasive CVR measurement.

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