title: Cerebral blood flow by using pulsed arterial spin-labeling in elderly subjects with white matter hyperintensities.
abstract: OBJECTIVE
  On MR imaging, white matter hyperintensities (WMH) on T2-weighted images are generally considered as a surrogate marker of ischemic small vessel disease in elderly subjects. Pulsed arterial spin-labeling (PASL) is a noninvasive MR perfusion-weighted technique. We hypothesized that elderly subjects with diffuse confluent WMH should have lower cerebral blood flow (CBF) measurements than subjects with punctiform or beginning confluent WMH.
  
  
  METHODS
  MR images of 21 subjects (13 women; mean age, 76 years; SD, 5), stratified for the degree of WMH, from a single center within the multinational Leukoaraiosis and Disability (LADIS) study, were investigated. CBF images were obtained by means of quantitative imaging of perfusion by using a single-subtraction second version, with thin-section TI periodic saturation PASL. Values of cortical gray matter, subcortical (including white matter and deep gray matter), and global CBF were calculated. CBF measurements of subjects with diffuse confluent WMH (n = 7) were compared with those of subjects with punctiform or beginning confluent WMH (n = 14).
  
  
  RESULTS
  Subjects with diffuse confluent WMH were found to have approximately 20% lower mean global CBF (43.5 mL/100 mL/min; SD, 6.3) than subjects with punctiform or beginning confluent WMH (57.9 mL/100 mL/min; SD, 8.6; P < .01), as well as approximately 20% lower mean subcortical (P < .01) and cortical gray matter CBF (P < .05).
  
  
  CONCLUSIONS
  PASL revealed a significant reduction of CBF measurements in elderly subjects with diffuse confluent WMH.
authors.affiliation: Image Analysis Center, VU University Medical Center, Amsterdam, the Netherlands. abastosleite@med.up.pt
authors.forename: A J
authors.initials: AJ
authors.lastname: Bastos-Leite
authors.forename: J P A
authors.initials: JP
authors.lastname: Kuijer
authors.forename: S A R B
authors.initials: SA
authors.lastname: Rombouts
authors.forename: E
authors.initials: E
authors.lastname: Sanz-Arigita
authors.forename: E C
authors.initials: EC
authors.lastname: van Straaten
authors.forename: A A
authors.initials: AA
authors.lastname: Gouw
authors.forename: W M
authors.initials: WM
authors.lastname: van der Flier
authors.forename: P
authors.initials: P
authors.lastname: Scheltens
authors.forename: F
authors.initials: F
authors.lastname: Barkhof
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity / Q000502:physiology; D001921:Brain / Q000098:blood supply; D002545:Brain Ischemia / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D049292:Leukoaraiosis / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008833:Microcirculation / Q000473:pathology; D012039:Regional Blood Flow / Q000502:physiology; D012680:Sensitivity and Specificity