Comparison of Blood Oxygenation Level–Dependent fMRI and Provocative DSC Perfusion MR Imaging for Monitoring Cerebrovascular Reserve in Intracranial Chronic Cerebrovascular Disease

Thulborn, Keith R.; Atkinson, Ian C.; Alexander, A.; Singal, Mukul; Amin‐Hanjani, Sepideh; Du, Xinjian; Alaraj, Ali; Charbel, Fady T.

doi:10.3174/ajnr.a5515

Cited by 5 publications

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“…Comparison of rCBV and MTT to a nonaffected territory is a standard strategy used to evaluate cerebral perfusion 5 . These parameters measured using DSC MR perfusion have been reported as a tool to assess tissue‐level hemodynamic compromise and stroke risk in the anterior circulation, although with variable results 4,6 . The utility of these DSC MRP parameters has not been studied in the VB circulation.…”

Section: Discussionmentioning

confidence: 99%

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Perfusion‐MRI is a Poor Indicator of Hemodynamic Compromise in Vertebrobasilar Disease in the VERiTAS Study

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Stapleton

et al. 2020

Journal of Neuroimaging

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BACKGROUND AND PURPOSE Dynamic susceptibility perfusion MR imaging (DSC MRP) has been used to assess changes in cerebral perfusion attributable to vascular stenosis or occlusion that may predict stroke risk. However, DSC MRP is not validated for identifying hemodynamic compromise in the posterior circulation. We investigated the clinical utility of DSC MRP in vertebrobasilar (VB) atherosclerotic disease in the observational VERiTAS study. METHODS VERiTAS enrolled patients with symptomatic ≥50% VB stenosis/occlusion. Posterior circulation hemodynamic status was designated as low or normal based on large vessel flow measured using quantitative magnetic resonance angiography (QMRA) and was predictive of future stroke risk. In this study, DSC MRP conducted concurrently with QMRA was used to evaluate posterior circulation perfusion. The primary outcome was the mean transit time (MTT) and relative cerebral blood volume (rCBV) in the posterior circulation normalized to the anterior circulation, compared between patients with low and normal blood flow as determined on QMRA. RESULTS Twenty‐six subjects had 47 DSC MRP studies for review. There was no statistically or clinically significant difference in the rCBV ratio (1.02 vs. .96 P = .89), or MTT ratio (1.04 vs. 1.04 P = .96) relative to normal or low VB territory flow. CONCLUSIONS In this study, we did not find that DSC MRP adequately distinguished between patients with low or normal flow status based on large‐vessel flow measurements.

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Section: Discussionmentioning

confidence: 99%

“…DSC MRP was performed using the voxel‐wise fitting of gamma variate functions to the gadolinium contrast agent concentration time course, derived from the signal intensity time course data 4 . All DSC images were performed using 3T systems (GE 3.0 Discovery MR750, GE 3.0 Signa HDxt, Siemens 3.0 TrioTim, and Philips 3.0 Achieva).…”

Section: Methodsmentioning

confidence: 99%