Hypertension Correlates With Lenticulostriate Arteries Visualized by 7T Magnetic Resonance Angiography

Kang, Chang-Ki; Park, Chan-A; Lee, Hyon; Kim, Sang-Hoon; Park, Cheol-Wan; Kim, Young-Bo; Cho, Zang-Hee

doi:10.1161/hypertensionaha.109.140350

Cited by 83 publications

(69 citation statements)

References 32 publications

(31 reference statements)

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“…7,8 Lacunar infarcts account for Ͼ20% of all strokes, and the basal ganglia are involved in 35%-44% of intracerebral hemorrhages. 9,10 Thus, in vivo imaging of LSAs could provide important insights for understanding the pathophysiology and mechanism of microvascular diseases associated with hypertension.…”

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confidence: 99%

Analysis of Correlation between the Number of Lenticulostriate Arteries and Hypertension Based on High-Resolution MR Angiography Findings

Chen¹,

Li²,

Li³

et al. 2011

AJNR Am J Neuroradiol

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confidence: 99%

Analysis of Correlation between the Number of Lenticulostriate Arteries and Hypertension Based on High-Resolution MR Angiography Findings

Chen¹,

Li²,

Li³

et al. 2011

AJNR Am J Neuroradiol

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“…In an imaging study of the LSA by TOF-MRA using a 7 T MR image, there was a significant difference in LSA visualisation between subjects with and without hypertension at age 45 years or under [10]. The others found no such difference in subjects more than 45 years old.…”

Section: Discussionmentioning

confidence: 94%

“…LSA branches have been successfully visualised with a 7-T MRI scanner by using TOF [8,9], and the relationship between decreased LSA visualisation and hypertension has also been demonstrated [10]. However, availability of a 7-T MRI system is very limited, and it is currently used for research purposes only.…”

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confidence: 99%

Evaluation of CT angiography for visualisation of the lenticulostriate artery: difference between normotensive and hypertensive patients

Gotoh¹,

Okada²,

Satogami³

et al. 2012

The British Journal of Radiology

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Objective: High-resolution CT angiography (CTA) is currently available using multidetector row CT (MDCT); however, its use for small artery visualisation has been limited. To evaluate its capability, we investigated CTA visualisation for difference in number of the lenticulostriate artery (LSA) branches between normotensive and hypertensive patients, because hypertension is a major cause of LSA damage. Methods: This was a retrospective study evaluating cerebrovascular CTA at our hospital conducted from February 2008 to June 2009 under approval of the institutional review board. 117 patients (39 males and 78 females, 19-88 years old) were included. CTA was conducted using a 64 channel MDCT. Total numbers of LSA branches were examined for differences by age with regression analysis and the presence or absence of hypertension and/or aneurysm using two-sample t-tests. A p-value ,0.016 was considered statistically significant after correction for multiple comparisons. A multiple variable analysis of three factors was also conducted. Results: The average number of LSA branches was 3.6 [95% confidence interval (CI) 3.0-4.1] and 4.4 (95% CI 4.1-4.7), respectively, for a patient with and without history of hypertension, and the difference was statistically significant (p50.013). The difference was approximately one branch in the multiple variable analysis. No significant correlation was observed for age and no significant difference was observed for the presence or absence of aneurysms. Conclusions: Contrast-enhanced CTA can visualise significant differences in the number of LSA branches among patients with and without hypertension. Advances in knowledge: Current high-resolution CTA can visualise LSA well, which enables finding a difference in the LSA between normotensive subjects and hypertensive patients. . Despite its importance, however, the LSA has not been much investigated with imaging modalities, because visualisation of small LSA branches is difficult. It has resulted in only a few image investigations of LSA branches for changes caused by such factors as ageing and hypertension. Small aneurysms were observed in LSA branches by using digital subtraction angiography (DSA) [6,7] in cases of deep brain haemorrhage. DSA allows detailed analysis, but it is invasive and occasional adverse events are inevitable.There are widely available methods to visualise the cerebral artery in general; contrast-enhanced CT angiography (CTA) and non-contrast-enhanced MR angiography (MRA) with the time-of-flight (TOF) method are frequently used. LSA branches have been successfully visualised with a 7-T MRI scanner by using TOF [8,9], and the relationship between decreased LSA visualisation and hypertension has also been demonstrated [10]. However, availability of a 7-T MRI system is very limited, and it is currently used for research purposes only. There is a study of LSA visualisation in healthy subjects by using a 1.5-T MRI system with a new acquisition method called ''flow-sensitive black blood'' imaging [11], but its capability i...

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“…To capture the total cSVD-related brain damage, a total SVD score was proposed, which integrates all individual MRI markers into one measure. 50 Cross-sectional studies have shown that this total SVD score is associated with higher blood pressure levels, 51 hypertension, age, other risk factors for SVD 50 and lower cognitive performance. 52,53 This SVD score has never been applied in longitudinal cognition research.…”

Section: Csvd and Cognitive Functionmentioning

confidence: 99%

“…48 In addition, with 7T MR angiography it might be possible to visualize small vessels without using contrast agents. [49][50][51] Besides a more detailed visualization of structural changes, 7T MRI might also enable the opportunity to show functional changes, such as blood flow velocity and pulsatility in the small vessels. 52 Although 7T MRI is unlikely to replace 3T MRI in clinical practice, the use of 7T MRI in research offers more information on hypertensive brain damage, both at a structural and a functional level.…”

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confidence: 99%

Cognitive function and cerebral small vessel disease in hypertension

Uiterwijk¹

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General introductionGeneral introduction | 9 general introduction HypertensionHypertension is a highly prevalent condition. In 2000, it was estimated that hypertension affects 972 million adults worldwide and this is predicted to increase by about 60% to a total of 1.56 billion in 2025. 1 Hypertension is a leading cause of morbidity and mortality, 2 because it causes damage in several end organs, such as the kidneys, heart and eyes. 3-7Hypertension does not similarly affect all organs. Organ damage can co-occur in several organs, but can also be limited to one. 8 Little is known about the implications of combined hypertensive organ damages. Guidelines recommend to routinely assess hypertensive organ damage in the heart and kidneys. 9 Brain damage is less recognized as hypertensive end-organ damage and is an under-researched area, even though the brain is one of the main target organs affected by hypertension.2 Cerebral small vessel diseaseHypertension is, besides age, the most important risk factor for haemorrhagic and ischemic stroke. 10 About 54% of strokes worldwide are attributable to hypertension. 11 In addition, hypertension is strongly associated with cerebral small vessel disease (cSVD).The term cSVD is used to describe all pathological processes that affect the small vessels of the brain, including small arteries, arterioles, capillaries and small veins. 12 The most prevalent hypertension-related small vessel pathology is arteriolosclerosis, which is also called age-and vascular risk-factor-related cSVD. 12The precise pathophysiology of cSVD is unknown, but the occurrence of inflammation and endothelial activation in small perforating vessels, 13 which also has been suggested in the development of hypertension, 14 probably plays an important role. Endothelial activation and inflammation lead to an increase in the permeability of the blood-brain barrier and induce microvascular dysfunction. Both leakage of the blood-brain barrier and microvascular dysfunction are thought to play a pivotal role in subsequent cSVD-related brain damage. 15,16 Unlike large vessels, the small perforating brain vessels are difficult to visualize in vivo.Therefore, the lesions that occur in the brain parenchyma and are thought to be caused by pathological processes in the small vessels have been accepted as markers of cSVD. 12These lesions can be seen on neuroimaging, preferably Magnetic Resonance Imaging (MRI), and include white matter hyperintensities (WMH), lacunes, cerebral microbleeds and perivascular spaces (figure 1). 44 In the 3-year follow-up of the LADIS study, which included subjects between 65 and 84 years with at least mild WMH, baseline WMH volume predicted cognitive decline, while baseline number of lacunes did not have an independent association with cognitive decline. 45 A study in first-ever lacunar stroke patients showed that severity of WMH and total number of lacunes were independent predictors of development of VCI 3 to 5 years after stroke. 46 Only one longitudinal study could be found investiga...

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Hypertension Correlates With Lenticulostriate Arteries Visualized by 7T Magnetic Resonance Angiography

Cited by 83 publications

References 32 publications

Analysis of Correlation between the Number of Lenticulostriate Arteries and Hypertension Based on High-Resolution MR Angiography Findings

Analysis of Correlation between the Number of Lenticulostriate Arteries and Hypertension Based on High-Resolution MR Angiography Findings

Evaluation of CT angiography for visualisation of the lenticulostriate artery: difference between normotensive and hypertensive patients

Cognitive function and cerebral small vessel disease in hypertension

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