TY - JOUR T1 - Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 1791 LP - 1798 DO - 10.3174/ajnr.A2219 VL - 31 IS - 10 AU - M. Schaaf AU - G. Mommertz AU - A. Ludolph AU - S. Geibprasert AU - G. Mühlenbruch AU - M. Das AU - T. Krings Y1 - 2010/11/01 UR - http://www.ajnr.org/content/31/10/1791.abstract N2 - BACKGROUND AND PURPOSE: Significant extracranial stenosis of the ICA is a known risk factor for future stroke and it has been shown that revascularization reduces the risk of future stroke. We applied BOLD fMRI in patients with carotid artery stenosis before and after CEA. Our purpose was to determine whether fMRI is able to demonstrate impaired CVR and to identify patient parameters that are associated with postoperative changes of cerebral hemodynamics. MATERIALS AND METHODS: Nineteen consecutive patients with symptomatic (n = 13) and asymptomatic (n = 6) stenosis of the ICA were prospectively recruited (male/female ratio = 16:3; age, 69 ± 8,1 years). fMRI using a simple bilateral motor task was performed immediately before and after CEA. RESULTS: Mean BOLD MSC was significantly increased postoperatively (MSC, 0.13 ± 0.66; P = 0.0002). Patients with a stenosis of <80% demonstrated an increase in MSC (MSC, 0.32 ± 0.59; P ≤ .0001). Patients with previous ischemic stroke showed a larger MSC than patients with TIAs (stroke: MSC, 0.55 ± 0.65; P ≤ .0001; TIA: MSC, 0.05 ± 0.26; P = 0.054). Patients older than 70 years had a significantly larger MSC following surgery (≤70 years: MSC, −0.01 ± 0.39; P = .429; >70 years: MSC, 0.29 ± 0.48; P ≤ .0001). CONCLUSIONS: BOLD fMRI can demonstrate changes in cerebral hemodynamics before and after CEA, indicative of an ameliorated CVR. This response is dependent on the age of the patient, the degree of preoperative stenosis, and the patient's symptoms. AFamaurosis fugaxasympasymptomaticBOLDblood oxygen level–dependentCBFcerebral blood flowCBVcerebral blood volumeCEAcarotid endarterectomyCO2carbon dioxideCPPcerebral perfusion pressureCVRcerebrovascular reactivityDWIdiffusion-weighed imagingFLAIRfluid-attenuated inversion recoveryfMRIfunctional MR imagingICAinternal carotid arteryMRIMR imagingMSCmean SCN/Anot applicablePrebeforePostafterSCsignal-intensity changesympsymptomaticT2WIT2-weighted imagingTIAtransient ischemic attack ER -