title: Impact of vessel wall lesions and vascular stenoses on cerebrovascular reactivity in patients with intracranial stenotic disease.
abstract: To compare cerebrovascular reactivity (CVR) and CVR lagtimes in flow territories perfused by vessels with vs. without proximal arterial wall disease and/or stenosis, separately in patients with atherosclerotic and nonatherosclerotic (moyamoya) intracranial stenosis.
  
  
  
  Atherosclerotic and moyamoya patients with >50% intracranial stenosis and <70% cervical stenosis underwent angiography, vessel wall imaging (VWI), and CVR-weighted imaging (n = 36; vessel segments evaluated = 396). Angiography and VWI were evaluated for stenosis locations and vessel wall lesions. Maximum CVR and CVR lagtime were contrasted between vascular territories with and without proximal intracranial vessel wall lesions and stenosis, and a Wilcoxon rank-sum was test used to determine differences (criteria: corrected two-sided P < 0.05).
  
  
  
  CVR lagtime was prolonged in territories with vs. without a proximal vessel wall lesion or stenosis for both patient groups: moyamoya (CVR lagtime = 45.5 sec ± 14.2 sec vs. 35.7 sec ± 9.7 sec, P < 0.001) and atherosclerosis (CVR lagtime = 38.2 sec ± 9.1 sec vs. 35.0 sec ± 7.2 sec, P = 0.001). For reactivity, a significant decrease in maximum CVR in the moyamoya group only (maximum CVR = 9.8 ± 2.2 vs. 12.0 ± 2.4, P < 0.001) was observed.
  
  
  
  Arterial vessel wall lesions detected on noninvasive, noncontrast intracranial VWI in patients with intracranial stenosis correlate on average with tissue-level impairment on CVR-weighted imaging.
  
  
  
  4 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1167-1176.
authors.affiliation: Department of Radiology, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Petrice M
authors.identifier: 0000-0002-8128-4476
authors.initials: PM
authors.lastname: Cogswell
authors.affiliation: Department of Radiology, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Taylor L
authors.initials: TL
authors.lastname: Davis
authors.affiliation: DXP-Imaging, Louisville, Kentucky, USA.
authors.forename: Megan K
authors.initials: MK
authors.lastname: Strother
authors.affiliation: Department of Radiology, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Carlos C
authors.initials: CC
authors.lastname: Faraco
authors.affiliation: Department of Radiology, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Allison O
authors.initials: AO
authors.lastname: Scott
authors.affiliation: Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA.|Department of Neurology, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Lori C
authors.initials: LC
authors.lastname: Jordan
authors.affiliation: Department of Neurosurgery, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Fusco
authors.affiliation: Department of Psychiatry, McLean Hospital, Boston, Massachusetts, USA.
authors.forename: Blaise deB
authors.initials: BD
authors.lastname: Frederick
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Jeroen
authors.initials: J
authors.lastname: Hendrikse
authors.affiliation: Department of Radiology, Vanderbilt University, Nashville, Tennessee, USA.|Department of Neurology, Vanderbilt University, Nashville, Tennessee, USA.|Department of Psychiatry, Vanderbilt University, Nashville, Tennessee, USA.
authors.forename: Manus J
authors.initials: MJ
authors.lastname: Donahue
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002539:Cerebral Arterial Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009072:Moyamoya Disease / Q000000981:diagnostic imaging; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: cerebrovascular reactivity; intracranial stenosis; moyamoya; vessel wall imaging