Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Apruzzese, A. Articles by Simonetti, G. Search for Related Content PubMed PubMed Citation Articles by Apruzzese, A. Articles by Simonetti, G.

American Journal of Neuroradiology 22:1062-1067 (6 2001)
© 2001 American Society of Neuroradiology

ARTICLE

Cerebral Hemodynamics in Asymptomatic Patients with Internal Carotid Artery Occlusion: A Dynamic Susceptibility Contrast MR and Transcranial Doppler Study

Alessio Apruzzese^a, Mauro Silvestrini^a, Roberto Floris^a, Fabrizio Vernieri^a, Alessandro Bozzao^a, Gisela Hagberg^a, Carlo Caltagirone^a, Salvatore Masala^a and Giovanni Simonetti^a

^a From the Istituto Neurotraumatologico Italiano (A.A.), Grottaferrata, Rome, the Department of Radiology (R.F., A.B., S.M., G.S.), University of Rome Tor Vergata, the Department of Neurology (M.S., F.V., C.C.), University of Rome Tor Vergata, and the Foundation S. Lucia (G.H., C.C.), Rome, Italy.

BACKGROUND AND PURPOSE: Perfusion imaging with dynamic susceptibility contrast MR imaging (DSC-MRI) has been used to evaluate hemodynamic status in patients with symptomatic occlusive cerebrovascular disease. The aim of the present study was to determine the hemodynamic changes occurring in asymptomatic patients with unilateral internal carotid artery (ICA) occlusion by use of DSC-MRI with transcranial Doppler (TCD) measurement of the breath-holding index (BHI).

METHODS: Nine patients with asymptomatic unilateral ICA occlusion underwent DSC-MRI and TCD examination. One patient was excluded from final analysis because of severe movement artifacts. On a separate workstation, regional cerebral blood volume (rCBV), regional cerebral blood flow (rCBF), and regional mean time to peak (rMTT) were calculated on the basis of signal decay rate during the passage of gadolinium bolus through the sampled volume in the territory of the middle cerebral artery. TCD-BHI was calculated in all patients. Six healthy subjects underwent the same MR protocol as the patients.

RESULTS: Compared with control subjects, patients with unilateral ICA occlusions had hemodynamic changes in the ipsilateral hemisphere: rCBF was significantly lower than in controls (P < .01), and r MTT was significantly increased in both white (WM) and gray matter (GM) in the affected side (WM: P < .01; GM: P < .05). No statistically significant difference in rCBV was found in the group of patients (occluded versus contralateral, P < .1) or between the patient and control groups (occluded side versus controls, P < .1). The correlation of rCBV and BHI showed a strong relation of the two variables, showing a decrease of the latter when the former increased.

CONCLUSION: DSC-MRI is a valuable tool for measuring hemodynamic changes in the presence of carotid disease with hemodynamic impairment. In our opinion, hemodynamic changes and efficiency of collateral pathways can be evaluated in occlusive carotid disease by using paired measurement of BHI and DSC-MRI. In the patient group, MR-determined rCBV and TCD-determined BHI showed a significant inverse correlation, suggesting similar significance of the two indices.

This article has been cited by other articles:

				R.P.H. Bokkers, P.J. van Laar, K.C.C. van de Ven, L.J. Kapelle, C.J.M. Klijn, and J. Hendrikse Arterial Spin-Labeling MR Imaging Measurements of Timing Parameters in Patients with a Carotid Artery Occlusion AJNR Am. J. Neuroradiol., October 1, 2008; 29(9): 1698 - 1703. [Abstract] [Full Text] [PDF]

				D. C. Steffens, K. M. Stechuchak, E. Z. Oddone, W. Mlekusch, I. Mlekusch, and M. Schillinger How Asymptomatic Is Asymptomatic Carotid Stenosis? Radiology, July 1, 2007; 244(1): 317 - 319. [Full Text] [PDF]

				T. Fukuda, K. Ogasawara, M. Kobayashi, N. Komoribayashi, H. Endo, T. Inoue, Y. Kuzu, H. Nishimoto, K. Terasaki, and A. Ogawa Prediction of Cerebral Hyperperfusion after Carotid Endarterectomy Using Cerebral Blood Volume Measured by Perfusion-Weighted MR Imaging Compared with Single-Photon Emission CT AJNR Am. J. Neuroradiol., April 1, 2007; 28(4): 737 - 742. [Abstract] [Full Text] [PDF]

				H. Endo, T. Inoue, K. Ogasawara, T. Fukuda, Y. Kanbara, and A. Ogawa Quantitative Assessment of Cerebral Hemodynamics Using Perfusion-Weighted MRI in Patients With Major Cerebral Artery Occlusive Disease: Comparison With Positron Emission Tomography Stroke, February 1, 2006; 37(2): 388 - 392. [Abstract] [Full Text] [PDF]

				J. Hendrikse, M. J. P. van Osch, D. R. Rutgers, C. J. G. Bakker, L. J. Kappelle, X. Golay, and J. van der Grond Internal Carotid Artery Occlusion Assessed at Pulsed Arterial Spin-labeling Perfusion MR Imaging at Multiple Delay Times Radiology, December 1, 2004; 233(3): 899 - 904. [Abstract] [Full Text] [PDF]

				E. Neri, G. Sani, M. Massetti, G. Frati, D. Buklas, R. Tassi, M. Giubbolini, A. Benvenuti, and C. Sassi Residual dissection of the brachiocephalic arteries: Significance, management, and long-term outcome J. Thorac. Cardiovasc. Surg., August 1, 2004; 128(2): 303 - 312. [Abstract] [Full Text] [PDF]

				A. W.J. Hoksbergen, C. B.L. Majoie, F.-J. H. Hulsmans, and D. A. Legemate Assessment of the Collateral Function of the Circle of Willis: Three-Dimensional Time-of-Flight MR Angiography Compared with Transcranial Color-Coded Duplex Sonography AJNR Am. J. Neuroradiol., March 1, 2003; 24(3): 456 - 462. [Abstract] [Full Text] [PDF]