Assessing Cerebrovascular Reactivity in Carotid Steno-Occlusive Disease Using MRI BOLD and ASL Techniques.
Assessing Cerebrovascular Reactivity in Carotid Steno-Occlusive Disease Using MRI BOLD and ASL Techniques.
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DOI：
10.1155/2012/268483
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发表时间：
2012
影响因子：
2.7
通讯作者：
Pontes-Neto OM
中科院分区：
文献类型：
--
作者：
Leoni RF;Mazzetto-Betti KC;Silva AC;Dos Santos AC;de Araujo DB;Leite JP;Pontes-Neto OM
脑血管反应性受损（CVR）是即将发生中风的预测因素，已被证明与颈动脉狭窄闭塞性疾病相关。磁共振成像 (MRI) 技术，例如血氧水平依赖性 (BOLD) 和动脉自旋标记 (ASL)，与血管活性刺激（例如呼吸任务或注射乙酰唑胺）相结合，已成为评估全脑覆盖 CVR 改变的有前景的无创工具。在正常脑血管条件下，CVR 已被证明在整个半球之间均匀分布，但在大脑区域之间存在差异。这种差异可以通过解剖学特异性和负责血管调节的不同生化机制来解释。研究表明，对于患有颈动脉狭窄闭塞性疾病的患者，MRI 技术可以检测受影响动脉供应的脑组织中受损的 CVR。此外，所得的 CVR 估计与通过更成熟的技术获得的估计具有良好的相关性，表明 BOLD 和 ASL 是评估脑血管疾病患者 CVR 的稳健可靠的方法。因此，本文旨在回顾最近使用 BOLD 和 ASL 评估健康个体和颈动脉狭窄闭塞性疾病患者 CVR 的研究，提供有关所获得结果和方法学困难的信息来源。
Impaired cerebrovascular reactivity (CVR), a predictive factor of imminent stroke, has been shown to be associated with carotid steno-occlusive disease. Magnetic resonance imaging (MRI) techniques, such as blood oxygenation level-dependent (BOLD) and arterial spin labeling (ASL), have emerged as promising noninvasive tools to evaluate altered CVR with whole-brain coverage, when combined with a vasoactive stimulus, such as respiratory task or injection of acetazolamide. Under normal cerebrovascular conditions, CVR has been shown to be globally and homogenously distributed between hemispheres, but with differences among cerebral regions. Such differences can be explained by anatomical specificities and different biochemical mechanisms responsible for vascular regulation. In patients with carotid steno-occlusive disease, studies have shown that MRI techniques can detect impaired CVR in brain tissue supplied by the affected artery. Moreover, resulting CVR estimations have been well correlated to those obtained with more established techniques, indicating that BOLD and ASL are robust and reliable methods to assess CVR in patients with cerebrovascular diseases. Therefore, the present paper aims to review recent studies which use BOLD and ASL to evaluate CVR, in healthy individuals and in patients with carotid steno-occlusive disease, providing a source of information regarding the obtained results and the methodological difficulties.