Document Detail


Symptomatic carotid artery stenosis: impairment of cerebral autoregulation measured at the brain tissue level with arterial spin-labeling MR imaging.
MedLine Citation:
PMID:  20574097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To measure the cerebral autoregulatory status of the brain tissue supplied by the individual brain-feeding arteries in patients with symptomatic stenosis of the internal carotid artery (ICA) by using arterial spin-labeling (ASL) magnetic resonance (MR) imaging and to compare this status with that in healthy controls. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained. Twenty-three patients (mean age, 69.3 years +/- 8.0 [standard deviation]) with unilateral symptomatic stenosis of the ICA and 20 healthy controls (mean age, 66.8 years +/- 6.3 [standard deviation]) underwent perfusion and flow territory-selective ASL MR imaging before and after intravenous administration of acetazolamide. Cerebrovascular reactivity was measured throughout the brain in the gray matter that is supplied by the individual ICAs and the basilar artery. Data were analyzed with paired and unpaired t tests. RESULTS: In patients with symptomatic stenosis of the ICA, the flow territory of the symptomatic ICA was smaller than that of the asymptomatic ICA. After administration of acetazolamide, a significant increase in cerebral blood flow at the brain tissue level was measured in both control subjects and patients in all perfusion territories. Mean cerebrovascular reactivity values were 35.9% +/- 3.0% (standard error) and 44.6% +/- 3.5% (standard error) in the flow territories of the patients with symptomatic ICAs and those with asymptomatic ICAs, respectively, and 47.9% +/- 3.1% (standard error) in the control subjects. Cerebrovascular reactivity was lower in the flow territory of the symptomatic ICA than in the arteries of control participants (mean difference, -12.0%; 95% confidence interval: -20.7%, -3.3%). CONCLUSION: In patients with symptomatic stenosis of the ICA, vasodilatory capacity in the flow territories of the major cerebral arteries can be visualized and quantified at the brain tissue level with ASL MR imaging.
Authors:
Reinoud P H Bokkers; Matthias J P van Osch; H Bart van der Worp; Gert J de Borst; Willem P T M Mali; Jeroen Hendrikse
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Radiology     Volume:  256     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-24     Completed Date:  2010-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  201-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, University Medical Center Utrecht, HP E.01.132, Heidelberglaan 100, Utrecht, the Netherlands. r.p.h.bokkers@umcutrecht.nl
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MeSH Terms
Descriptor/Qualifier:
Acetazolamide / administration & dosage
Aged
Blood Flow Velocity / physiology
Carbonic Anhydrase Inhibitors / administration & dosage
Carotid Stenosis / physiopathology*
Case-Control Studies
Cerebrovascular Circulation / physiology
Cerebrovascular Disorders / physiopathology*
Chi-Square Distribution
Female
Humans
Least-Squares Analysis
Magnetic Resonance Angiography
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Spin Labels*
Chemical
Reg. No./Substance:
0/Carbonic Anhydrase Inhibitors; 0/Spin Labels; 59-66-5/Acetazolamide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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