title: Normalised time-to-peak-distribution curves correlate with cerebral white matter hyperintensities - Could this improve early diagnosis?
abstract: Parameter-free assessment of the time-to-peak (TTP) histogram, termed 'TTP-distribution curve' (TDC), of dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSC-MRI) was introduced as a robust method to evaluate cerebral perfusion. TDC-assessment works fully automatically without the need of an arterial input function, thereby providing full comparability between different measurements. In the investigated sample of 106 patients, a strong dependency of TDC on the hemodynamic state of cerebral microvessels and the arterio-venous bolus-transit time [Formula: see text] was demonstrated. Accordingly, TDC-derived [Formula: see text] was 3.3-3.7 s for control patients and 4.4 s for cerebral small vessel disease patients. Measurements of associated bolus spread velocities ν and accelerations [Formula: see text] additionally revealed a direct effect from spin-spin relaxation time T2-weighted white matter hyperintensity volume, considered to indicate microangiopathy in cerebral small vessel disease, on the TDC-measurements. This strongly supports the prevailing hypothesis that cerebral small vessel disease directly influences DSC-measurements, where the degree could be estimated from an analysis of TDC. While this may be used to correct DSC-parameters for undesirable effects from cerebral small vessel disease, it could also serve to potentially identify patients at risk for cerebral small vessel disease at an early stage, since a subset of patients without yet significant WHM-volume, but clearly altered hemodynamics in TDC-measurements, was identified in this study.
authors.affiliation: 1 Department of Radiology, University Hospital Tulln, Karl Landsteiner University of Health Sciences, Tulln, Austria.|2 Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.|3 MR Center of Excellence, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Nasel
authors.affiliation: 2 Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.|3 MR Center of Excellence, Medical University of Vienna, Vienna, Austria.
authors.forename: Roland
authors.initials: R
authors.lastname: Boubela
authors.affiliation: 2 Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.|3 MR Center of Excellence, Medical University of Vienna, Vienna, Austria.
authors.forename: Klaudius
authors.initials: K
authors.lastname: Kalcher
authors.affiliation: 2 Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria.|3 MR Center of Excellence, Medical University of Vienna, Vienna, Austria.
authors.forename: Ewald
authors.initials: E
authors.lastname: Moser
mesh_terms: D059345:Cerebral Small Vessel Diseases / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D042241:Early Diagnosis; D006439:Hemodynamics; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods; D066127:White Matter / Q000000981:diagnostic imaging*
keywords: Brain perfusion; cerebral small vessel disease; leukoaraiosis; perfusion imaging; perfusion magnetic resonance imaging
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