Multifunctional magnetic resonance imaging of cerebrovascular disease

Abstract

Over the last few years magnetic resonance imaging (MRI) has developed into a multipurpose imaging technique. In addition to anatomical information, data can be obtained on perfusion, metabolism and imaging of the vascular anatomy. Especially in the field of neuroradiology the possibilities for obtaining multifunctional information from combined MR examinations are promising. In particular, stroke or stroke-related research benefits from these developments. This article reviews the current status and the potential of newly developed MR techniques with regard to the intracranial hemodynamic changes in patients with severe stenosis or occlusion of the internal carotid artery. The combination of MR angiography, perfusion-weighted MRI and MR spectroscopic imaging seems especially useful in the management of the individual patient.

Magnetic Resonance Techniques for the Identification of Patients With Symptomatic Carotid Artery Occlusion at High Risk of Cerebral Ischemic Events

“…12,13 In addition to assessment of the presence and extent of infarcts with MRI, MR angiography (MRA) can be applied to quantify flow in the middle cerebral arteries (MCAs), 14 and 1 H MR spectroscopy (MRS) has proven to be a valuable tool to study metabolic changes in the brain in both infarcted 15,16 and noninfarcted areas. 17, 18 The purpose of this study was to assess whether MR can provide prognostic information about the recurrence of cerebral ischemic events in patients with symptomatic CAO.…”

“…17, 18 The purpose of this study was to assess whether MR can provide prognostic information about the recurrence of cerebral ischemic events in patients with symptomatic CAO. We investigated the prognostic value of 3 factors that on theoretical grounds 12,19 may be related to the blood flow state of the brain: (1) presence of a relevant infarct of the border-zone type; (2) quantitative flow in the MCA ipsilateral to the symptomatic CAO; and (3) metabolic ratios measured by 1 H MRS, ipsilateral to the symptomatic CAO.…”

Evaluation of Cerebral Hemodynamics with Perfusion MRI in Childhood Moyamoya Disease

“…These serial MRI scans can be processed to generate a variety of hemodynamic parameters, depending upon the mathematical algorithm used [6, 13]. In the present study, rCBV and TTP were calculated as hemodynamic indicators and expressed in relative red-green-blue color coding.…”

“…Based on the analysis of the first pass of contrast material, perfusion MRI yields hemodynamic parameters such as relative perfusion maps of rCBV, mean transit time, arrival time and peak time [5, 6]. If perfusion MRI can provide comparable information at the same time as standard MRI and MR angiography are taken, it would be of clinical benefit [3, 6, 7].…”

“…Based on the analysis of the first pass of contrast material, perfusion MRI yields hemodynamic parameters such as relative perfusion maps of rCBV, mean transit time, arrival time and peak time [5, 6]. If perfusion MRI can provide comparable information at the same time as standard MRI and MR angiography are taken, it would be of clinical benefit [3, 6, 7]. Moreover, perfusion MRI is superior to SPECT in terms of the evaluation of blood flow in the white matter and has no associated radiation risk, allowing the repeated examination of children with MMD over a protracted follow-up period [3, 5].…”