title: Functional MR imaging in patients with carotid artery stenosis before and after revascularization.
abstract: OBJECTIVE
  Significant extracranial stenosis of the ICA is a known risk factor for future stroke and it has been shown that revascularization reduces the risk of future stroke. We applied BOLD fMRI in patients with carotid artery stenosis before and after CEA. Our purpose was to determine whether fMRI is able to demonstrate impaired CVR and to identify patient parameters that are associated with postoperative changes of cerebral hemodynamics.
  
  
  METHODS
  Nineteen consecutive patients with symptomatic (n = 13) and asymptomatic (n = 6) stenosis of the ICA were prospectively recruited (male/female ratio = 16:3; age, 69 ± 8,1 years). fMRI using a simple bilateral motor task was performed immediately before and after CEA.
  
  
  RESULTS
  Mean BOLD MSC was significantly increased postoperatively (MSC, 0.13 ± 0.66; P = 0.0002). Patients with a stenosis of <80% demonstrated an increase in MSC (MSC, 0.32 ± 0.59; P ≤ .0001). Patients with previous ischemic stroke showed a larger MSC than patients with TIAs (stroke: MSC, 0.55 ± 0.65; P ≤ .0001; TIA: MSC, 0.05 ± 0.26; P = 0.054). Patients older than 70 years had a significantly larger MSC following surgery (≤70 years: MSC, -0.01 ± 0.39; P = .429; >70 years: MSC, 0.29 ± 0.48; P ≤ .0001).
  
  
  CONCLUSIONS
  BOLD fMRI can demonstrate changes in cerebral hemodynamics before and after CEA, indicative of an ameliorated CVR. This response is dependent on the age of the patient, the degree of preoperative stenosis, and the patient's symptoms.
authors.affiliation: Departments of Neuroradiology, University Hospital Aachen, Aachen University, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Schaaf
authors.forename: G
authors.initials: G
authors.lastname: Mommertz
authors.forename: A
authors.initials: A
authors.lastname: Ludolph
authors.forename: S
authors.initials: S
authors.lastname: Geibprasert
authors.forename: G
authors.initials: G
authors.lastname: Mühlenbruch
authors.forename: M
authors.initials: M
authors.lastname: Das
authors.forename: T
authors.initials: T
authors.lastname: Krings
mesh_terms: D017677:Age Distribution; D000368:Aged; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000098:blood supply; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D012307:Risk Factors
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