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09.06.2020 | Diagnostic Neuroradiology

Multiparametric flow analysis using four-dimensional flow magnetic resonance imaging can detect cerebral hemodynamic impairment in patients with internal carotid artery stenosis

verfasst von: Takahiro Ando, Tetsuro Sekine, Yasuo Murai, Erika Orita, Ryo Takagi, Yasuo Amano, Kotomi Iwata, Masatoki Nakaza, Masashi Ogawa, Makoto Obara, Shin-ichiro Kumita

Erschienen in: Neuroradiology | Ausgabe 11/2020

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Abstract

Purpose

MRI-based risk stratification should be established to identify patients with internal carotid artery stenosis (ICS) who require further PET or SPECT evaluation. This study assessed whether multiparametric flow analysis using time-resolved 3D phase-contrast (4D flow) MRI can detect cerebral hemodynamic impairment in patients with ICS.

Methods

This retrospective study analyzed 26 consecutive patients with unilateral ICS (21 men; mean age, 71 years) who underwent 4D flow MRI and acetazolamide-stress brain perfusion SPECT. Collateral flow via the Willis ring was visually evaluated. Temporal mean flow volume rate (Net), pulsatile flow volume (ΔV), and pulsatility index (PI) at the middle cerebral artery were measured. Cerebral vascular reserve (CVR) was calculated from the SPECT dataset. Patients were assigned to the misery perfusion group if the CVR was < 10% and to the nonmisery perfusion group if the CVR was ≥ 10%. Parameters showing a significant difference in both groups were statistically evaluated.

Results

Affected side ΔV, ratio of affected to contralateral side Net (rNet), and ratio of affected to contralateral side ΔV were significantly correlated to CVR (p = 0.030, p = 0.010, p = 0.015, respectively). Absence of retrograde flow at the posterior communicating artery was observed in the misery perfusion group (p = 0.020). Combined cut-off values of the affected side ΔV (0.18 ml) and rNet (0.64) showed a sensitivity and specificity of 100% and 77.8%, respectively.

Conclusion

Multiparametric flow analysis using 4D flow MRI can detect misery perfusion by comprehensively assessing blood flow data, including blood flow volume, pulsation, and collateral flow.

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Titel: Multiparametric flow analysis using four-dimensional flow magnetic resonance imaging can detect cerebral hemodynamic impairment in patients with internal carotid artery stenosis
verfasst von: Takahiro Ando
Tetsuro Sekine
Yasuo Murai
Erika Orita
Ryo Takagi
Yasuo Amano
Kotomi Iwata
Masatoki Nakaza
Masashi Ogawa
Makoto Obara
Shin-ichiro Kumita
Publikationsdatum: 09.06.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Neuroradiology / Ausgabe 11/2020
Print ISSN: 0028-3940
Elektronische ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-020-02464-2

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Multiparametric flow analysis using four-dimensional flow magnetic resonance imaging can detect cerebral hemodynamic impairment in patients with internal carotid artery stenosis

Abstract

Purpose

Methods

Results

Conclusion

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Purpose

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