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

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.

Regional Cerebral Arterial Transit Time Hemodynamics Correlate with Vascular Risk Factors and Cognitive Function in Men with Coronary Artery Disease

“…Ischemic diseases, such as stroke and steno-occlusive large-artery disease, are known to produce prolonged ATT due to the necessity for collateral delivery of blood to tissue or narrowing of the large supplying arteries. 15,16 In the current study, prolonged LATT and reduced ATT were associated with vascular risk factors. The reduced ATT may be attributed to altered pulsatile pressures, as reflected in the literature, 35,36 and may be an indication of vessel wall hardening and thickening, which are arteriosclerosis processes consistent with higher BMI and body fat.…”

“…[10][11][12][13] Mapping the ASL arterial transit time, for instance, is of interest because it reflects the time for labeled blood to travel from the labeling plane to the microvascular perfusion site. Previously, ATT has been used as an adjunct perfusion measure to study minor stroke and transient ischemic attack, 14 large artery steno-occlusive disease, 15,16 multiple sclerosis, 17 and Alzheimer disease, 18,19 but to date, it has not been used to examine the potential effects of vascular risk factors on cognition, to our knowledge. We have recently reported gray matter perfusion findings in coronary artery disease (CAD) in the context of cerebrovascular health.…”

Temporal and Spatial Variances in Arterial Spin-Labeling Are Inversely Related to Large-Artery Blood Velocity

“…23 Arterial transit time increases with cerebrovascular disease. 24,25 Thus, labeled blood is more likely to remain in the macrovascular compartment and be captured as hyperintense signal, contributing to greater heterogeneity within the perfusion-weighted image. 26 Indeed, a recent ASL study in hypertensive older adults demonstrated a direct relationship between single postlabel delay spatial CoV and arterial transit time.…”

White Matter Hyperintensity Volume and Cerebral Perfusion in Older Individuals with Hypertension Using Arterial Spin-Labeling

“…[17][18][19] This velocity reduction could be caused by increased resistance due to large-vessel atherosclerosis or small-vessel arteriolosclerosis, which are both associated with WMHs. 6,37,38 The association between antihypertensive medication use and a higher WMH volume may be due to antihypertensive use being associated with more chronic and severe hypertension. Hypothetically antihypertensive drugs may lead to hypoperfusion, aggravating WMHs, but recent study findings make that possibility unlikely.…”