title: Quantitative T2, T2*, and T2' MR imaging in patients with ischemic leukoaraiosis might detect microstructural changes and cortical hypoxia.
abstract: BACKGROUND
  Quantitative MRI with T2, T2*, and T2' mapping has been shown to non-invasively depict microstructural changes (T2) and oxygenation status (T2* and T2') that are invisible on conventional MRI. Therefore, we aimed to assess whether T2 and T2' quantification detects cerebral (micro-)structural damage and chronic hypoxia in lesions and in normal appearing white matter (WM) and gray matter (GM) of patients with ischemic leukoaraiosis (IL). Measurements were complemented by the assessment of the cerebral blood flow (CBF) and the degree of GM and WM atrophy.
  
  
  METHODS
  Eighteen patients with IL and 18 age-matched healthy controls were included. High-resolution, motion-corrected T2, T2*, and T2' mapping, CBF mapping (pulsed arterial spin labeling, PASL), and segmentation of GM and WM were used to depict specific changes in both groups. All parameters were compared between patients and healthy controls, using t testing. Values of p < 0.05 were accepted as statistically significant.
  
  
  RESULTS
  Patients showed significantly increased T2 in lesions (p < 0.01) and in unaffected WM (p = 0.045) as well as significantly increased T2* in lesions (p = 0.003). A significant decrease of T2' was detected in patients in unaffected WM (p = 0.027), while no T2' changes were observed in GM (p = 0.13). Both unaffected WM and GM were significantly decreased in volume in the patient-group (p < 0.01). No differences of PASL-based CBF could be shown.
  
  
  CONCLUSIONS
  Non-invasive quantitative MRI with T2, T2*, and T2' mapping might be used to detect subtle structural and metabolic changes in IL. Assessing the grade of microstructural damage and hypoxia might be helpful to monitor disease progression and to perform risk assessment.
authors.affiliation: Institute of Neuroradiology, University Hospital, Goethe-University, Schleusenweg 2-16, D-60528, Frankfurt am Main, Frankfurt, Germany. marlies.wagner@kgu.de.
authors.forename: Marlies
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Institute of Neuroradiology, University Hospital, Goethe-University, Schleusenweg 2-16, D-60528, Frankfurt am Main, Frankfurt, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Helfrich
authors.affiliation: Brain Imaging Center, University Hospital, Goethe-University, Frankfurt, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Volz
authors.affiliation: Institute of Neuroradiology, University Hospital, Goethe-University, Schleusenweg 2-16, D-60528, Frankfurt am Main, Frankfurt, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Magerkurth
authors.affiliation: Institute of Neuroradiology, University Hospital, Goethe-University, Schleusenweg 2-16, D-60528, Frankfurt am Main, Frankfurt, Germany.
authors.forename: Stella
authors.initials: S
authors.lastname: Blasel
authors.affiliation: Institute of Neuroradiology, University Hospital, Goethe-University, Schleusenweg 2-16, D-60528, Frankfurt am Main, Frankfurt, Germany.
authors.forename: Luciana
authors.initials: L
authors.lastname: Porto
authors.affiliation: Department of Neurology, University Hospital, Goethe-University, Frankfurt, Germany.
authors.forename: Oliver C
authors.initials: OC
authors.lastname: Singer
authors.affiliation: Brain Imaging Center, University Hospital, Goethe-University, Frankfurt, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Deichmann
authors.affiliation: Institute of Neuroradiology, University Hospital, Goethe-University, Schleusenweg 2-16, D-60528, Frankfurt am Main, Frankfurt, Germany.
authors.forename: Alina
authors.initials: A
authors.lastname: Jurcoane
authors.affiliation: Institute of Neuroradiology, University Hospital, Goethe-University, Schleusenweg 2-16, D-60528, Frankfurt am Main, Frankfurt, Germany.
authors.forename: Elke
authors.initials: E
authors.lastname: Hattingen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002545:Brain Ischemia / Q000473:pathology* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D066128:Gray Matter / Q000473:pathology; D006801:Humans; D049292:Leukoaraiosis / Q000473:pathology* / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000378:metabolism; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D066127:White Matter / Q000473:pathology
chemical_list: D010100:Oxygen
keywords: Chronic hypoxia; Ischemic leukoaraiosis; Quantitative MRI; T2′ mapping