Arterial Spin-Labeling Evaluation of Cerebrovascular Reactivity to Acetazolamide in Healthy Subjects

Background: The cerebrovascular reactivity (CVR) results of blood oxygen level-dependent (BOLD) and arterial spin labeling (ASL) MRI studies performed in patients with cerebrovascular disease (steno-occlusive vascular disease or stroke) were systematically reviewed. Summary: Thirty-one articles were included. Twenty-three (74.2%) studies used BOLD MRI to evaluate the CVR, 4 (12.9%) studies used ASL MRI and 4 (12.9%) studies used both BOLD and ASL MRI. Thirteen studies (3 significant) found a lower BOLD CVR, 2 studies found a similar CVR and 3 studies found a higher CVR in the ipsilateral compared to the contralateral hemisphere. Nine (5 significant) out of 10 studies found a lower BOLD CVR in the ipsilateral hemispheres of patients compared to controls. Six studies (2 significant) found a lower ASL CVR in the ipsilateral compared to the contralateral hemispheres. Three out of 5 studies found a significant lower ASL CVR in the ipsilateral hemispheres of patients compared to controls. Key Messages: This review brings support for a reduced BOLD and ASL CVR in the ipsilateral hemisphere of patients with cerebrovascular disease. We suggest that future studies will be performed in a uniform way so reference values can be established and could be used to guide treatment decisions in patients with cerebrovascular disease.

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Absolute and regional cerebral perfusion assessment feasibility in head-down position with arterial spin-labeling magnetic resonance. A preliminary report on healthy subjects

Journal of Neuroradiology ◽

10.1016/j.neurad.2016.03.003 ◽

2016 ◽

Vol 43 (6) ◽

pp. 392-397 ◽

Cited By ~ 7

Author(s):

Aude Pavilla ◽

Alessandro Arrigo ◽

Sylvie Colombani ◽

Mehdi Mejdoubi

Keyword(s):

Magnetic Resonance ◽

Healthy Subjects ◽

Arterial Spin Labeling ◽

Cerebral Perfusion ◽

Preliminary Report ◽

Spin Labeling ◽

Perfusion Assessment

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Evaluation of Intracranial Vasculatures in Healthy Subjects with Arterial-Spin-Labeling-Based 4D-MR Angiography at 3T

Magnetic Resonance in Medical Sciences ◽

10.2463/mrms.tn.2015-0081 ◽

2016 ◽

Vol 15 (3) ◽

pp. 335-339 ◽

Cited By ~ 3

Author(s):

Yasuhiko IRYO ◽

Toshinori HIRAI ◽

Masanobu NAKAMURA ◽

Machiko TATEISHI ◽

Eri HAYASHIDA ◽

...

Keyword(s):

Healthy Subjects ◽

Arterial Spin Labeling ◽

Mr Angiography ◽

Spin Labeling

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Abstract MP42: Arterial Spin Labeling Imaging Assessment of Cerebrovascular Reactivity in Hypertensive Small Vessel Disease

Stroke ◽

10.1161/str.52.suppl_1.mp42 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Hsin-Hsi C Tsai ◽

Bo-Ching Lee ◽

Abel Po-Hao Huang ◽

Li-Kai Tsai ◽

Ya-Fang Chen ◽

...

Keyword(s):

Basal Ganglia ◽

Arterial Spin Labeling ◽

Small Vessel Disease ◽

Vascular Dysfunction ◽

Spin Labeling ◽

Cerebrovascular Reactivity ◽

Small Vessel ◽

Disease Score ◽

Temporal Lobes ◽

Vessel Disease

Objective: Cerebrovascular reactivity (CVR) represents the phenomenon that cerebral vessels dilate or constrict in response to vasoactive stimuli, and CVR impairment may contribute to the brain injury caused by cerebral small vessel disease (SVD). We aim to determine the CVR in hypertensive intracerebral hemorrhage (ICH) and to identify its vascular dysfunction. Methods: 21 patients with spontaneous hypertensive ICH (strictly deep or mixed deep and lobar hemorrhages, mean age 62.5 ± 11.3 years) and 10 control subjects (mean age 66.1 ± 6.0) were enrolled for CVR measurement. Each participant received a brain MRI study, and CVR was calculated as cerebral blood flow (CBF) change using arterial spin labeling (ASL) sequence at baseline and 10 minutes after intravenous dipyridamole injection (0.57mg/Kg). Traditional MRI markers for SVD including cerebral microbleed, white matter hyperintensity, lacune and MRI-visible enlarged perivascular space were also evaluated to determine the total small vessel disease score. Results: Hypertensive ICH patients showed reduced CVR in the basal ganglia (CBF change 22.4 ± 22.7% vs. 41.7 ± 18.3, p=0.026), the frontal (15.1 ± 11.9 vs. 26.6 ± 9.9, p=0.013) and the temporal lobes (14.7 ± 11.1 vs. 26.2 ± 10.0, p=0.010) compared to control subjects (Figure). These differences remained significant in multivariable models after adjusting for age, sex, hypertension, diabetes, and hyperlipidemia. Within ICH groups, the CBF change in basal ganglia was significantly correlated with total small vessel disease score (R=-0.58, p=0.006), but not with individual MRI markers. Conclusion: Patients with advanced HTN-SVD demonstrated impaired vasoconstriction after dipyridamole challenge in basal ganglia, frontal and temporal lobes. Our findings provide safe approaches for whole brain CVR mapping in small vessel disease, and identify the potential physiological basis of vascular dysfunction in HTN-SVD.

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Quantitative Cerebrovascular Reactivity in Normal Aging: Comparison Between Phase-Contrast and Arterial Spin Labeling MRI

Frontiers in Neurology ◽

10.3389/fneur.2020.00758 ◽

2020 ◽

Vol 11 ◽

Author(s):

Kamil Taneja ◽

Peiying Liu ◽

Cuimei Xu ◽

Monroe Turner ◽

Yuguang Zhao ◽

...

Keyword(s):

Arterial Spin Labeling ◽

Phase Contrast ◽

Spin Labeling ◽

Normal Aging ◽

Cerebrovascular Reactivity

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Arterial Spin Labeling Imaging Assessment of Cerebrovascular Reactivity in Hypertensive Small Vessel Disease

Frontiers in Neurology ◽

10.3389/fneur.2021.640069 ◽

2021 ◽

Vol 12 ◽

Author(s):

Bo-Ching Lee ◽

Hsin-Hsi Tsai ◽

Abel Po-Hao Huang ◽

Yen-Ling Lo ◽

Li-Kai Tsai ◽

...

Keyword(s):

Basal Ganglia ◽

Arterial Spin Labeling ◽

Small Vessel Disease ◽

Vascular Dysfunction ◽

Spin Labeling ◽

Cerebrovascular Reactivity ◽

Small Vessel ◽

Disease Score ◽

Vessel Disease ◽

Control Subjects

Objective: Cerebrovascular reactivity (CVR) represents the phenomenon where cerebral vessels dilate or constrict in response to vasoactive stimuli. CVR impairment may contribute to brain injury due to cerebral small vessel disease (SVD). We aimed to determine the CVR in hypertensive intracerebral hemorrhage (ICH) and to identify its vascular dysfunction.Methods: A total of 21 patients with spontaneous hypertensive ICH (strictly deep or mixed deep and lobar hemorrhages, mean age 62.5 ± 11.3 years) and 10 control subjects (mean age 66.1 ± 6.0 years) were enrolled for CVR measurement at least 3 months after the symptomatic ICH event. Each participant underwent a brain MRI study, and CVR was calculated as the cerebral blood flow (CBF) reduction using arterial spin labeling (ASL) between baseline and 10 min after an intravenous dipyridamole injection (0.57 mg/kg). Traditional MRI markers for SVD were also evaluated, including cerebral microbleed, white matter hyperintensity, lacune, and MRI-visible enlarged perivascular space, which were used to determine the total small vessel disease score.Results: Compared to control subjects, hypertensive ICH patients showed reduced CVR in the basal ganglia (CBF reduction 22.4 ± 22.7% vs. 41.7 ± 18.3, p = 0.026), the frontal lobe (15.1 ± 11.9 vs. 26.6 ± 9.9, p = 0.013), and the temporal lobe (14.7 ± 11.1 vs. 26.2 ± 10.0, p = 0.010). These differences remained significant in multivariable models after adjusting for age and sex. Within ICH groups, the CBF reduction in the basal ganglia was significantly correlated with the total small vessel disease score (R = 0.58, p = 0.006), but not with individual MRI markers.Conclusion: Patients with advanced hypertensive SVD demonstrated impaired vasoconstriction after dipyridamole challenge in the basal ganglia and the frontal and temporal lobes. Our findings provide safe approaches for whole-brain CVR mapping in SVD and identify a potential physiological basis for vascular dysfunction in hypertensive SVD.

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Cerebaral Hyperperfusion in General Paralysis Patients

10.21203/rs.3.rs-69300/v1 ◽

2020 ◽

Author(s):

Yali Wu ◽

jingjing li ◽

wenqing wu

Keyword(s):

Blood Flow ◽

Healthy Subjects ◽

Arterial Spin Labeling ◽

Parietal Lobe ◽

Three Dimensional ◽

Occipital Lobe ◽

Spin Labeling ◽

General Paralysis ◽

Limbic Lobe ◽

Continuous Arterial Spin Labeling

Abstract Objective This study aimed to identify the cerebral blood flow (CBF) in patients with general paralysis (GP). Methods Three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL) imaging was performed to measure the CBF in twenty patients with GP and twenty healthy subjects(NC). CBF was normalized to reduce variations among subjects. CBF was compared between the groups. Results Compared with the healthy subjects, the patients with GP exhibited increased CBF in the frontal lobe, temporal lobe, insular lobe, limbic lobe, and parietal lobe(all P<0.05). There was no difference in CBF of the occipital lobe between the GP group and the NC group(all P>0.05). Conclusions Our results suggest that the patients with GP may exhibit regional increased CBF, which may be one of the pathogenesis of general paralysis.

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Comparison of CO2 in Air Versus Carbogen for the Measurement of Cerebrovascular Reactivity with Magnetic Resonance Imaging

Journal of Cerebral Blood Flow & Metabolism ◽

10.1038/jcbfm.2013.131 ◽

2013 ◽

Vol 33 (11) ◽

pp. 1799-1805 ◽

Cited By ~ 28

Author(s):

Hannah V Hare ◽

Michael Germuska ◽

Michael E Kelly ◽

Daniel P Bulte

Keyword(s):

Arterial Spin Labeling ◽

Spin Labeling ◽

Blood Oxygen Level Dependent ◽

Cerebrovascular Reactivity ◽

Blood Oxygen ◽

Resonance Imaging ◽

Blood Oxygen Level ◽

Bold Imaging ◽

Flow Response ◽

Alternative Stimulus

Measurement of cerebrovascular reactivity (CVR) can give valuable information about existing pathology and the risk of adverse events, such as stroke. A common method of obtaining regional CVR values is by measuring the blood flow response to carbon dioxide (CO2)-enriched air using arterial spin labeling (ASL) or blood oxygen level-dependent (BOLD) imaging. Recently, several studies have used carbogen gas (containing only CO2 and oxygen) as an alternative stimulus. A direct comparison was performed between CVR values acquired by ASL and BOLD imaging using stimuli of (1) 5% CO2 in air and (2) 5% CO2 in oxygen (carbogen-5). Although BOLD and ASL CVR values are shown to be correlated for CO2 in air (mean response 0.11 ± 0.03% BOLD, 4.46 ± 1.80% ASL, n = 16 hemispheres), this correlation disappears during a carbogen stimulus (0.36 ± 0.06% BOLD, 4.97 ± 1.30% ASL). It is concluded that BOLD imaging should generally not be used in conjunction with a carbogen stimulus when measuring CVR, and that care must be taken when interpreting CVR as measured by ASL, as values obtained from different stimuli (CO2 in air versus carbogen) are not directly comparable.

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