We suggest prospective validation of a score ("STAMPE2") based on clinical findings, EEG, and brain-imaging measures to estimate postoperative seizure risk and guide anticonvulsant treatment in meningioma patients.
BOLD CVR corresponded well to CBF perfusion reserve measurements obtained with (O-)HO-PET, especially for detecting hemodynamic failure in the affected hemisphere and middle cerebral artery territory and for identifying hemodynamic failure stage II. BOLD CVR may, therefore, be considered for prospective studies assessing stroke risk in patients with chronic cerebrovascular steno-occlusive disease, in particular because it can potentially be implemented in routine clinical imaging.
ObjectiveTo improve quantitative cerebrovascular reactivity (CVR) measurements and CO
2 arrival times, we present an iterative analysis capable of decomposing different temporal components of the dynamic carbon dioxide‐ Blood Oxygen‐Level Dependent (CO
2‐BOLD) relationship.Experimental DesignDecomposition of the dynamic parameters included a redefinition of the voxel‐wise CO
2 arrival time, and a separation from the vascular response to a stepwise increase in CO
2 (Delay to signal Plateau – DTP) and a decrease in CO
2 (Delay to signal Baseline –DTB). Twenty‐five (normal) datasets, obtained from BOLD MRI combined with a standardized pseudo‐square wave CO
2 change, were co‐registered to generate reference atlases for the aforementioned dynamic processes to score the voxel‐by‐voxel deviation probability from normal range. This analysis is further illustrated in two subjects with unilateral carotid artery occlusion using these reference atlases.Principal ObservationsWe have found that our redefined CO
2 arrival time resulted in the best data fit. Additionally, excluding both dynamic BOLD phases (DTP and DTB) resulted in a static CVR, that is maximal response, defined as CVR calculated only over a normocapnic and hypercapnic calibrated plateau.ConclusionDecomposition and novel iterative modeling of different temporal components of the dynamic CO
2‐BOLD relationship improves quantitative CVR measurements.
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