Patients with carotid occlusive disease express altered hemodynamics in the post-occlusive vasculature and lesions commonly attributed to cerebral small vessel disease (SVD). We addressed the... Show morePatients with carotid occlusive disease express altered hemodynamics in the post-occlusive vasculature and lesions commonly attributed to cerebral small vessel disease (SVD). We addressed the question if cerebral perforating artery flow measures, using a novel 7T MRI technique, are altered and related to SVD lesion burden in patients with carotid occlusive disease. 21 patients were included with a uni- (18) or bilateral (3) carotid occlusion (64±7 years) and 19 controls (65 ±10 years). Mean flow velocity and pulsatility in the perforating arteries in the semi-oval center (CSO) and basal ganglia (BG), measured with a 2D phase contrast 7T MRI sequence, were compared between patients and controls, and between hemispheres in patients with unilateral carotid occlusive disease. In patients, relations were assessed between perforating artery flow measures and SVD burden score and white matter hyperintensity (WMH) volume. CSO perforating artery flow velocity was lower in patients than controls, albeit non-significant (mean difference [95% confidence interval] 0.08 cm/s [0.00–0.16]; p = 0.053), but pulsatility was similar (0.07 [-0.04–0.18]; p = 0.23). BG flow velocity and pulsatility did not differ between patients and controls (velocity = 0.28 cm/s [-0.32–0.88]; p = 0.34; pulsatility = 0.00 [-0.10–0.11]; p = 0.97). Patients with unilateral carotid occlusive disease showed no significant interhemispheric flow differences. Though non-significant, within patients lower CSO (p = 0.06) and BG (p = 0.11) flow velocity related to larger WMH volume. Our findings suggest that carotid occlusive disease may be associated with abnormal cerebral perforating artery flow and that this relates to SVD lesion burden in these patients, although our observations need corroboration in larger study populations. Show less
Arts, T.; Onkenhout, L.P.; Amier, R.P.; Geest, R. van der; Harten, T. van; Kappelle, J.; ... ; Heart-Brain Connection Consortium 2021
Background Damping of heartbeat-induced pressure pulsations occurs in large arteries such as the aorta and extends to the small arteries and microcirculation. Since recently, 7 T MRI enables... Show moreBackground Damping of heartbeat-induced pressure pulsations occurs in large arteries such as the aorta and extends to the small arteries and microcirculation. Since recently, 7 T MRI enables investigation of damping in the small cerebral arteries. Purpose To investigate flow pulsatility damping between the first segment of the middle cerebral artery (M1) and the small perforating arteries using magnetic resonance imaging. Study Type Retrospective. Subjects Thirty-eight participants (45% female) aged above 50 without history of heart failure, carotid occlusive disease, or cognitive impairment. Field Strength/Sequence 3 T gradient echo (GE) T1-weighted images, spin-echo fluid-attenuated inversion recovery images, GE two-dimensional (2D) phase-contrast, and GE cine steady-state free precession images were acquired. At 7 T, T1-weighted images, GE quantitative-flow, and GE 2D phase-contrast images were acquired. Assessment Velocity pulsatilities of the M1 and perforating arteries in the basal ganglia (BG) and semi-oval center (CSO) were measured. We used the damping index between the M1 and perforating arteries as a damping indicator (velocity pulsatility(M1)/velocity pulsatility(CSO/BG)). Left ventricular stroke volume (LVSV), mean arterial pressure (MAP), pulse pressure (PP), and aortic pulse wave velocity (PWV) were correlated with velocity pulsatility in the M1 and in perforating arteries, and with the damping index of the CSO and BG. Statistical Tests Correlations of LVSV, MAP, PP, and PWV with velocity pulsatility in the M1 and small perforating arteries, and correlations with the damping indices were evaluated with linear regression analyses. Results PP and PWV were significantly positively correlated to M1 velocity pulsatility. PWV was significantly negatively correlated to CSO velocity pulsatility, and PP was unrelated to CSO velocity pulsatility (P = 0.28). PP and PWV were uncorrelated to BG velocity pulsatility (P = 0.25; P = 0.68). PWV and PP were significantly positively correlated with the CSO damping index. Data Conclusion Our study demonstrated a dynamic damping of velocity pulsatility between the M1 and small cerebral perforating arteries in relation to proximal stress. Level of Evidence 4 Technical Efficacy Stage 1 Show less
Magnetic susceptibility based (T-2* weighted) contrast in MRI at high magnetic field strength is of great value in research on brain structure and cortical architecture, but its use is hampered by... Show moreMagnetic susceptibility based (T-2* weighted) contrast in MRI at high magnetic field strength is of great value in research on brain structure and cortical architecture, but its use is hampered by the low signal-to-noise ratio (SNR) efficiency of the conventional spoiled gradient echo sequence (GRE) leading to long scan times even for a limited number of slices. In this work, we show that high resolution (0.5 mm isotropic) T-2* weighted images of the whole brain can be obtained in 6 min by utilizing the high SNR efficiency of echo-planar imaging (EPI). A volumetric (3D) EPI protocol is presented and compared to conventional 3D GRE images acquired with the same resolution, amount of T-2* weighting, and imaging duration. Spatial coverage in 3D EPI was increased by a factor of 4.5 compared to 3D GRE, while also the SNR was increased by a factor of 2. Image contrast for both magnitude and phase between gray and white matter was similar for both sequences, with enhanced conspicuity of anatomic details in the 3D EPI images due to the increased SNR. Even at 7 T, image blurring and distortion is limited if the EPI train length remains short (not longer than the T-2* of the imaged tissue). 3D EPI provides steps (speed, whole brain coverage, and high isotropic resolution) that are necessary to utilize the benefits of high field MRI in research that employs T-2* weighted imaging. (C) 2011 Elsevier Inc. All rights reserved. Show less
