Continuous arterial spin labeled perfusion magnetic resonance imaging in patients before and after carotid endarterectomy.
Continuous arterial spin labeling perfusion magnetic resonance imaging (CASL-pMRI) uses magnetically labeled arterial blood water as a tracer to obtain quantifiable measurements of cerebral blood flow (CBF) (mL/100 g-1/min-1). CASL-pMRI was used to assess CBF changes in major vascular distributions in patients (n = 10) prior to and 3 months after carotid endarterectomy (CEA). No significant change in the global baseline CBF before and after CEA was observed in the group as a whole (P = .81). In patients with reduced CBF prior to CEA (< 50 ml/100 g/min), a significant increase in global CBF following CEA was observed. An inverse relationship existed between percent change in CBF after CEA versus baseline CBF within the anterior circulation (r = -.78, P < .05) but not in the posterior distribution (r = .25, P = .63). CASL-pMRI may provide a convenient, inexpensive, noninvasive method for identifying CEA patients at risk for hyperperfusion following carotid revascularization.
Ances
Beau M
BM
Department of Neurology, Department of Neurosurgery, Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
McGarvey
Michael L
ML
Abrahams
John M
JM
Maldjian
Joseph A
JA
Alsop
David C
DC
Zager
Eric L
EL
Detre
John A
JA
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology; D001921:Brain / Q000098:blood supply*; D002545:Brain Ischemia / Q000175:diagnosis* / Q000601:surgery; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D002544:Cerebral Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D016894:Endarterectomy, Carotid; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D002546:Ischemic Attack, Transient / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000175:diagnosis* / Q000503:physiopathology; D012039:Regional Blood Flow / Q000502:physiology; D015427:Reperfusion Injury / Q000175:diagnosis* / Q000503:physiopathology; D012680:Sensitivity and Specificity; D016896:Treatment Outcome