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26.04.2023 | Magnetic Resonance

Diffusion prepared pseudo-continuous arterial spin labeling reveals blood–brain barrier dysfunction in patients with CADASIL

verfasst von: Chen Ling, Jinyuan Zhang, Xingfeng Shao, Li Bai, Zhixin Li, Yunchuang Sun, Fan Li, Zhaoxia Wang, Rong Xue, Yan Zhuo, Qi Yang, Zihao Zhang, Danny J. J. Wang, Yun Yuan

Erschienen in: European Radiology | Ausgabe 10/2023

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Abstract

Objectives

Diffusion prepared pseudo-continuous arterial spin labeling (DP-pCASL) is a newly proposed MRI method to noninvasively measure the function of the blood–brain barrier (BBB). We aim to investigate whether the water exchange rate across the BBB, estimated with DP-pCASL, is changed in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), and to analyze the association between the BBB water exchange rate and MRI/clinical features of these patients.

Methods

Forty-one patients with CADASIL and thirty-six age- and sex-matched controls were scanned with DP-pCASL MRI to estimate the BBB water exchange rate (kw). The MRI lesion burden, the modified Rankin scale (mRS), and the neuropsychological scales were also examined. The association between kw and MRI/clinical features was analyzed.

Results

Compared with that in the controls, kw in patients with CADASIL was decreased at normal-appearing white matter (NAWM) (t =  − 4.742, p < 0.001), cortical gray matter (t =  − 5.137, p < 0.001), and deep gray matter (t =  − 3.552, p = 0.001). After adjustment for age, gender, and arterial transit time, kw at NAWM was negatively associated with the volume of white matter hyperintensities (β =  − 0.754, p = 0.001), whereas decreased kw at NAWM was independently associated with an increased risk of abnormal mRS scale (OR = 1.058, 95% CI: 1.013–1.106, p = 0.011) in these patients.

Conclusions

This study found that the BBB water exchange rate was decreased in patients with CADASIL. The decreased BBB water exchange rate was associated with an increased MRI lesion burden and functional dependence of the patients, suggesting the involvement of BBB dysfunction in the pathogenesis of CADASIL.

Clinical relevance statement

DP-pCASL reveals BBB dysfunction in patients with CADASIL. The decreased BBB water exchange rate is associated with MRI lesion burden and functional dependence, indicating the potential of DP-pCASL as an evaluation method for disease severity.

Key Points

DP-pCASL reveals bloodbrain barrier dysfunction in patients with CADASIL.
Decreased BBB water exchange rate, an indicator of BBB dysfunction detected by DP-pCASL, was associated with MRI/clinical features of patients with CADASIL.
DP-pCASL can be used as an evaluation method to assess the severity of disease in patients with CADASIL.
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Metadaten
Titel
Diffusion prepared pseudo-continuous arterial spin labeling reveals blood–brain barrier dysfunction in patients with CADASIL
verfasst von
Chen Ling
Jinyuan Zhang
Xingfeng Shao
Li Bai
Zhixin Li
Yunchuang Sun
Fan Li
Zhaoxia Wang
Rong Xue
Yan Zhuo
Qi Yang
Zihao Zhang
Danny J. J. Wang
Yun Yuan
Publikationsdatum
26.04.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 10/2023
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-023-09652-7

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