title: Cerebrovascular reactivity in the caudate nucleus, lentiform nucleus and thalamus in patients with carotid artery disease.
abstract: OBJECTIVE
  To assess the effect of unilateral large vessel disease upon the cerebral hemodynamic autoregulatory status in the basal ganglia of patients with steno-occlusive internal carotid artery (ICA) disease.
  
  
  METHODS
  Twenty-five healthy volunteers and 38 patients with a unilateral symptomatic steno-occlusive ICA lesion and were investigated; 20 with a stenosis >50% and 18 with an occlusion. Cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) were assessed with pseudo-continuous arterial spin labeling (ASL) magnetic resonance (MR) imaging before and after administration of acetazolamide.
  
  
  RESULTS
  When compared to controls, the CVR in patients with ICA stenosis was significantly lower in the middle cerebral artery (MCA) territory (P<0.05), and in the caudate (P<0.05) and lentiform nucleus (P<0.05) of the hemisphere ipsilateral to the stenosis. The CVR in the caudate nucleus contralateral to the stenosis was significantly lower (P<0.05) as well. In patients with ICA occlusion, the CVR in the hemisphere ipsilateral to the occlusion as well as in the contralateral hemisphere was significantly lower in the MCA territory (P<0.05), the caudate (P<0.05) and lentiform nucleus (P<0.05), and in the thalamus (P<0.05).
  
  
  CONCLUSIONS
  Perfusion ASL MR imaging shows impaired cerebral hemodynamic autoregulation of the basal ganglia in patients with steno-occlusive ICA disease both in the hemisphere ipsilateral as well as in the hemisphere contralateral to the stenosis or occlusion.
authors.affiliation: Room E01.132, Department of Radiology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Nolan S
authors.initials: NS
authors.lastname: Hartkamp
authors.affiliation: Room E01.132, Department of Radiology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Reinoud P H
authors.initials: RP
authors.lastname: Bokkers
authors.affiliation: Department of Radiology, C.J. Gorter Institute of High-Field MRI, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: M J P
authors.initials: MJ
authors.lastname: van Osch
authors.affiliation: Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Gert J
authors.initials: GJ
authors.lastname: de Borst
authors.affiliation: Room E01.132, Department of Radiology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. Electronic address: j.hendrikse@umcutrecht.nl.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Hendrikse
mesh_terms: D000086:Acetazolamide / Q000008:administration & dosage; D000368:Aged; D002340:Carotid Artery Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D002421:Caudate Nucleus / Q000098:blood supply* / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D003287:Contrast Media / Q000008:administration & dosage; D003342:Corpus Striatum / Q000098:blood supply* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging; D013113:Spin Labels; D013788:Thalamus / Q000098:blood supply* / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D013113:Spin Labels; D000086:Acetazolamide
keywords: Carotid artery disease; Cerebrovascular reactivity; Magnetic resonance imaging; Perfusion