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Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleBrain
Open Access

Hemodynamic Alterations in Vertebrobasilar Large Artery Disease Assessed by Arterial Spin-Labeling MR Imaging

B.J. MacIntosh, L. Marquardt, U.G. Schulz, P. Jezzard and P.M. Rothwell
American Journal of Neuroradiology May 2012, DOI: https://doi.org/10.3174/ajnr.A3090
B.J. MacIntosh
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L. Marquardt
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U.G. Schulz
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P. Jezzard
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P.M. Rothwell
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Abstract

BACKGROUND AND PURPOSE: VB artery stenosis is associated with a high risk of recurrent ischemic events, and knowledge about the hemodynamic relevance of VB stenosis is important for clinical decision making. In this study, multiple inflow pulsed ASL MR imaging was assessed for its ability to measure CBF and ATT in patients with VB disease.

MATERIALS AND METHODS: ASL was performed on a 3T MR imaging scanner in 41 participants. Twenty-one patients had a history of ischemic events in the VB circulation (14 men, 7 women, age 66 ± 11 years). Clinical data and CE-MRA were used to classify VB disease severity. Twenty age-matched adults were controls. Group and within-VB analyses were performed. Mean CBF and ATT values in the ROIs were adjusted by excluding voxels that did not produce a reliable ASL estimate.

RESULTS: CBF was reduced (P < .003) in patients compared with controls, which was significant after excluding voxels with a poor fit. Differences in ATT between patients and controls were not significant after voxel correction. There was a strong correlation between CBF and ATT among patients. Finally, ATT was significantly correlated with VB disease severity (P = .026).

CONCLUSIONS: Multiple inflow ASL distinguished patients with VB disease from age matched-controls. VB disease rating was associated with prolonged ATT downstream. ASL may have diagnostic potential among patients in whom risk of intervention is high.

Abbreviations

ASL
arterial spin-labeling
ATT
arterial transit time
CE-MRA
contrast-enhanced MRA
GRASE
gradient and spin echo
MNI
Montreal Neurological Institute
Q2TIPS
quantitative imaging of perfusion with a single subtraction with thin-section TI1 periodic saturation
sig
significant
VB
vertebrobasilar
  • © 2012 American Society of Neuroradiology

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B.J. MacIntosh, L. Marquardt, U.G. Schulz, P. Jezzard, P.M. Rothwell
Hemodynamic Alterations in Vertebrobasilar Large Artery Disease Assessed by Arterial Spin-Labeling MR Imaging
American Journal of Neuroradiology May 2012, DOI: 10.3174/ajnr.A3090

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Hemodynamic Alterations in Vertebrobasilar Large Artery Disease Assessed by Arterial Spin-Labeling MR Imaging
B.J. MacIntosh, L. Marquardt, U.G. Schulz, P. Jezzard, P.M. Rothwell
American Journal of Neuroradiology May 2012, DOI: 10.3174/ajnr.A3090
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