Cerebrovascular reactivity mapping without hypercapnic challenge in patients with carotid artery stenosis
DOI:
https://doi.org/10.29384/rbfm.2019.v13.n2.p62-65Palavras-chave:
Cerebrovascular disease, resting state, magnetic resonance imaging, cerebral vasoreactivityResumo
Vascular reactivity represents the ability of the vascular smooth muscle to dilate or contract in response to changes in metabolic demand or vasoactive stimulus. More specifically, the cerebrovascular reactivity (CVR) has raised interest in several studies that point to its potential to predict stroke risk in patients with cerebrovascular disease. CVR mapping is typically performed using carbon dioxide (CO2) inhalation, breath-holding, or acetazolamide injection as vasoactive challenges, while magnetic resonance imaging (MRI) based on the blood oxygenation level-dependent (BOLD) contrast is acquired. However, such challenges of hypercapnia depend on additional equipment and cooperation of the subjects, limiting their applications, especially in elderly patients. Therefore, the objective of the present study was to map the CVR using resting-state MRI-BOLD, with no hypercapnic challenge, considering the variations in BOLD signal associated with variations in the arterial partial pressure of CO2. The CVR maps obtained with resting data showed a high correlation with those obtained by the conventional experiment with CO2 inhalation (r > 0.70). In addition, the CVR changes observed for the patients were consistent with their clinical reports. These results show that the mapping of CVR obtained with resting-state data may become a useful alternative in the detection of perfusion changes in clinical applications when the hypercapnic challenge is not feasible.
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Referências
Leoni RF. Avaliação da perfusão sangüínea cerebral em modelos animais de hipertensão utilizando Arterial Spin Labeling. 2011;
Liu P, Vis JB De, Lu H. NeuroImage Cerebrovascular reactivity ( CVR ) MRI with CO2 challenge : A technical review. Neuroimage [Internet]. 2018;(March):1–12. Available from: https://doi.org/10.1016/j.neuroimage.2018.03.047
Yoon SH, Zuccarello M, Rapoport RM. Reversal of hypercapnia induces endothelin-dependent constriction of basilar artery in rabbits with acute metabolic alkalosis. Gen Pharmacol Vasc Syst. 2000;
Magon S, Basso G, Farace P, Ricciardi GK, Beltramello A, Sbarbati A. Reproducibility of BOLD signal change induced by breath holding. Neuroimage. 2009;
Settakis G, Molnár C, Kerényi L, Kollár J, Legemate D, Csiba L, et al. Acetazolamide as a vasodilatory stimulus in cerebrovascular diseases and in conditions affecting the cerebral vasculature. European Journal of Neurology. 2003.
Lu H, Liu P, Yezhuvath U, Cheng Y, Marshall O, Ge Y. MRI mapping of cerebrovascular reactivity via gas inhalation challenges. J Vis Exp. 2014;
Leoni RF, Mazzetto-Betti KC, Silva AC, dos Santos AC, de Araujo DB, Leite JP, et al. Assessing Cerebrovascular Reactivity in Carotid Steno-Occlusive Disease Using MRI BOLD and ASL Techniques. Radiol Res Pract. 2012;2012:1–10.
Greenberg SM. Small vessels, big problems. New England Journal of Medicine. 2006.
Fierstra J, van Niftrik B, Piccirelli M, Burkhardt JK, Pangalu A, Kocian R, et al. Altered intraoperative cerebrovascular reactivity in brain areas of high-grade glioma recurrence. Magn Reson Imaging. 2016;
Alwatban M, Murman DL, Bashford G. Cerebrovascular Reactivity Impairment in Preclinical Alzheimer’s Disease. J Neuroimaging. 2019;
Pastorello BF. Em busca da região epileptogênica em pacientes com epilepsia do lobo temporal : métodos alternativos baseados em fMRI e EEG-fMRI Ribeirão Preto – SP Em busca da região epileptogênica em pacientes com epilepsia do lobo temporal : métodos alternativos basea. 2011;
Liu P, Li Y, Pinho M, Park DC, Welch BG, Lu H. Cerebrovascular reactivity mapping without gas challenges. Neuroimage. 2017;
Leoni RF, Oliveira IAF, Pontes-Neto OM, Santos AC, Leite JP. Cerebral blood flow and vasoreactivity in aging: An arterial spin labeling study. Brazilian J Med Biol Res. 2017;
Taneja K, Lu H, Welch BG, Thomas BP, Pinho M, Lin D, et al. Evaluation of cerebrovascular reserve in patients with cerebrovascular diseases using resting-state MRI: A feasibility study. Magn Reson Imaging. 2019;
Tong Y, Frederick B de B. Tracking cerebral blood flow in BOLD fMRI using recursively generated regressors. Hum Brain Mapp. 2014;
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