Symptomatic Carotid Artery Stenosis: Impairment of Cerebral Autoregulation Measured at the Brain Tissue Level with Arterial Spin-labeling MR Imaging
Symptomatic Carotid Artery Stenosis: Impairment of Cerebral Autoregulation Measured at the Brain Tissue Level with Arterial Spin-labeling MR Imaging
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DOI：
10.1148/radiol.10091262
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发表时间：
2010-07-01
期刊：
影响因子：
19.7
通讯作者：
Hendrikse, Jeroen
中科院分区：
文献类型：
--
作者：
Bokkers, Reinoud P. H.;van Osch, Matthias J. P.;Hendrikse, Jeroen
目的：测量大脑自动调节状态的脑组织供应的个别脑供血动脉的颈内动脉（伊卡）症状性狭窄的患者，通过使用动脉自旋标记（ASL）磁共振（MR）成像，并比较这种状态与健康controls.Materials和方法：机构审查委员会的批准和知情同意书。23名患有单侧症状性伊卡狭窄的患者（平均年龄，69.3岁+/- 8.0 [标准差]）和20名健康对照者（平均年龄，66.8岁+/- 6.3 [标准差]）在静脉注射乙酰唑胺之前和之后接受了灌注和血流区域选择性ASL MR成像。脑血管反应性是在整个大脑的灰质中测量的，灰质由个体ICA和基底动脉供应。结果：在有症状的伊卡狭窄患者中，有症状的伊卡的血流区域小于无症状的伊卡。乙酰唑胺给药后，在脑组织水平的脑血流量显着增加，在对照组和所有灌注区的患者。有症状ICA患者和无症状ICA患者的平均脑血管反应性值分别为35.9% ± 3.0%（标准误）和44.6% ± 3.5%（标准误），对照组为47.9% ± 3.1%（标准误）。有症状伊卡的血流区域的脑血管反应性低于对照组参与者的动脉（平均差异，-12.0%; 95%置信区间：-20.7%，-3.3%）。在有症状的伊卡狭窄患者中，可以在脑组织水平上用ASL MR可视化和量化主要脑动脉流动区域的血管舒张能力显像(C)RSNA，2010年
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. (C) RSNA, 2010