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Magnetic Resonance Imaging Methods for Assessment of Hemodynamic Reserve in Chronic Steno-occlusive Cerebrovascular Disease

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Cerebrovascular Reactivity

Part of the book series: Neuromethods ((NM,volume 175))

Abstract

Assessment of cerebrovascular hemodynamic reserve is an important component of evaluating patients with steno-occlusive cerebrovascular disease, as loss of reserve can be indicative of elevated future stroke risk. Here we describe multimodal magnetic resonance imaging (MRI) techniques for assessment of cerebrovascular reserve, including (1) local blood oxygenation level-dependent (BOLD) signal arising from increased regional blood flow with task performance during functional MRI, using a task paradigm that interrogates cortical areas in all vascular territories simultaneously, (2) global BOLD signal response occurring as a result of increased widespread cerebral blood flow from hypercapnia as a vasodilatory challenge, and (3) direct large cerebral vessel volumetric flow measurements using phase-contrast quantitative MR angiography to assess flow before and after global vasodilation with intravenous acetazolamide. Absence of the expected responses allows detection of compromised or absent hemodynamic reserve. The techniques for performing the different MRI modalities are discussed including relative advantages and limitations.

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Acknowledgments

KRT acknowledges financial support from NIH RO1 NS059745 stroke.

Disclosures: KRT is the owner of the commercially available MRIx Technologies software used for the analysis of fMRI studies in this chapter.

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Authors and Affiliations

  1. Center for Magnetic Resonance Research, University of Illinois at Chicago, Chicago, IL, USA

    Keith R. Thulborn

  2. Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA

    Laura Stone McGuire, Fady T. Charbel & Sepideh Amin-Hanjani

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  1. Keith R. Thulborn
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  2. Laura Stone McGuire
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  3. Fady T. Charbel
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  4. Sepideh Amin-Hanjani
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Corresponding author

Correspondence to Sepideh Amin-Hanjani .

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Editors and Affiliations

  1. Baycrest Centre for Geriatric Care, University of Toronto, Toronto, ON, Canada

    Jean Chen

  2. Department of Neurosurgery, University Hospital Zurich, Zürich, Zürich, Switzerland

    Jorn Fierstra

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Thulborn, K.R., McGuire, L.S., Charbel, F.T., Amin-Hanjani, S. (2022). Magnetic Resonance Imaging Methods for Assessment of Hemodynamic Reserve in Chronic Steno-occlusive Cerebrovascular Disease. In: Chen, J., Fierstra, J. (eds) Cerebrovascular Reactivity. Neuromethods, vol 175. Humana, New York, NY. https://doi.org/10.1007/978-1-0716-1763-2_8

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  • DOI: https://doi.org/10.1007/978-1-0716-1763-2_8

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  • Publisher Name: Humana, New York, NY

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