Correlation between P2-PCA Volume Flow Rate and BOLD Cerebrovascular Reactivity in Patients with Symptomatic Carotid Artery Occlusion.

Amely Walser, Jorn Fierstra, Lara Maria Höbner, Jacopo Bellomo, Tilman Schubert, Menno Germans, Vittorio Stumpo, Christiaan Hendrik Bas van Niftrik, Susanne Wegener, Andreas R Luft, Zsolt Kulcsár, Luca Regli, Giuseppe Esposito, Martina Sebök
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Abstract

Background and purpose: Identifying and assessing hemodynamic and flow status in patients with symptomatic ICA occlusion is crucial for evaluating recurrent stroke risk. The aim of this study was to analyze the correlation between 2 quantitative imaging modalities: 1) blood oxygenation level-dependent (BOLD) cerebrovascular reactivity (CVR) and 2) quantitative MR angiography (qMRA) with noninvasive optimal vessel analysis (NOVA), measuring volume flow rate (VFR). Comparing these modalities is relevant for assessing collateral circulation and hemodynamic impairment.

Materials and methods: In this retrospective analysis of prospectively collected data, 37 symptomatic patients with unilateral ICA occlusion, who underwent both NOVA-qMRA and BOLD-CVR investigation, were included. The correlation analysis between NOVA-qMRA-derived second segment of the posterior cerebral artery (PCA-P2) VFR and BOLD-CVR (hemispheric and MCA territory CVR) was done by using a linear mixed-effects model.

Results: A moderate correlation was found between P2-VFR and BOLD-CVR values for the ipsilateral MCA territory (r = 0.44, R2 = 0.2, P < .001) and the ipsilateral hemisphere (r = 0.39, R2 = 0.15, P < .001), indicating that 20% of the variance in P2-VFR can be explained by the BOLD-CVR of the MCA territory and 15% by the BOLD-CVR of the affected hemisphere.

Conclusions: This correlation suggests that impaired BOLD-CVR is partly linked to an increased PCA-P2 volume flow rate, potentially indicating the activation of leptomeningeal collaterals in severe hemodynamic conditions. Both imaging techniques could aid clinicians in creating personalized treatment strategies for patients with symptomatic ICA occlusion.

症状性颈动脉闭塞患者P2-PCA容积流量与BOLD脑血管反应性的相关性
背景和目的:识别和评估症状性颈内动脉(ICA)闭塞患者的血流动力学和血流状态对于评估卒中复发风险至关重要。本研究的目的是分析两种定量成像方式之间的相关性:(1)血氧水平依赖性(BOLD)脑血管反应性(CVR)和(2)定量磁共振血管造影(qMRA)与无创最佳血管分析(NOVA),测量体积血流速率(VFR)。比较这些模式与评估侧枝循环和血流动力学损伤有关。材料和方法:回顾性分析前瞻性收集的资料,纳入37例有症状的单侧ICA闭塞患者,同时进行NOVA-qMRA和BOLD-CVR调查。采用线性混合效应模型分析novaqmra衍生的大脑后动脉第二段(PCA-P2) VFR与BOLD-CVR(半球和MCA区域CVR)的相关性。结果:发现同侧MCA区域的p2 - vfr和BOLD-CVR值之间存在中度相关性(|r|=0.44, R2=0.2, p2=0.15)。结论:这种相关性表明,受损的BOLD-CVR部分与PCA-P2体积流速增加有关,可能表明在严重的血流动力学条件下,小脑膜侧支被激活。这两种成像技术都可以帮助临床医生为症状性ICA闭塞患者制定个性化的治疗策略。缩写:ACA =大脑前动脉;BOLD =血氧水平依赖性;脑血管反应性;M1 =大脑中动脉第一段;MCA =大脑中动脉;NOVA =无创最佳血管分析;P2 =大脑后动脉第二段;PCA =大脑后动脉;后交通动脉;VFR =体积流量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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