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<meta name="HW.identifier" content="/ajnr/31/10/1791.atom" />
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<meta name="DC.Language" content="en" />
<meta name="DC.Title" content="Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization" />
<meta name="DC.Identifier" content="10.3174/ajnr.A2219" />
<meta name="DC.Date" content="2010-11-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Significant extracranial stenosis of the ICA is a known risk factor for future stroke and it has been shown that revascularization reduces the risk of future stroke. We applied BOLD fMRI in patients with carotid artery stenosis before and after CEA. Our purpose was to determine whether fMRI is able to demonstrate impaired CVR and to identify patient parameters that are associated with postoperative changes of cerebral hemodynamics.

MATERIALS AND METHODS: Nineteen consecutive patients with symptomatic ( n = 13) and asymptomatic ( n = 6) stenosis of the ICA were prospectively recruited (male/female ratio = 16:3; age, 69 ± 8,1 years). fMRI using a simple bilateral motor task was performed immediately before and after CEA.

RESULTS: Mean BOLD MSC was significantly increased postoperatively (MSC, 0.13 ± 0.66; P = 0.0002). Patients with a stenosis of &lt;80% demonstrated an increase in MSC (MSC, 0.32 ± 0.59; P ≤ .0001). Patients with previous ischemic stroke showed a larger MSC than patients with TIAs (stroke: MSC, 0.55 ± 0.65; P ≤ .0001; TIA: MSC, 0.05 ± 0.26; P = 0.054). Patients older than 70 years had a significantly larger MSC following surgery (≤70 years: MSC, −0.01 ± 0.39; P = .429; &gt;70 years: MSC, 0.29 ± 0.48; P ≤ .0001).

CONCLUSIONS: BOLD fMRI can demonstrate changes in cerebral hemodynamics before and after CEA, indicative of an ameliorated CVR. This response is dependent on the age of the patient, the degree of preoperative stenosis, and the patient's symptoms.

AF
:   amaurosis fugax
asymp
:   asymptomatic
BOLD
:   blood oxygen level–dependent
CBF
:   cerebral blood flow
CBV
:   cerebral blood volume
CEA
:   carotid endarterectomy
CO2
:   carbon dioxide
CPP
:   cerebral perfusion pressure
CVR
:   cerebrovascular reactivity
DWI
:   diffusion-weighed imaging
FLAIR
:   fluid-attenuated inversion recovery
fMRI
:   functional MR imaging
ICA
:   internal carotid artery
MRI
:   MR imaging
MSC
:   mean SC
N/A
:   not applicable
Pre
:   before
Post
:   after
SC
:   signal-intensity change
symp
:   symptomatic
T2WI
:   T2-weighted imaging
TIA
:   transient ischemic attack" />
<meta name="DC.Contributor" content="M. Schaaf" />
<meta name="DC.Contributor" content="G. Mommertz" />
<meta name="DC.Contributor" content="A. Ludolph" />
<meta name="DC.Contributor" content="S. Geibprasert" />
<meta name="DC.Contributor" content="G. Mühlenbruch" />
<meta name="DC.Contributor" content="M. Das" />
<meta name="DC.Contributor" content="T. Krings" />
<meta name="article:published_time" content="2010-11-01" />
<meta name="article:section" content="Functional" />
<meta name="citation_title" content="Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Significant extracranial stenosis of the ICA is a known risk factor for future stroke and it has been shown that revascularization reduces the risk of future stroke. We applied BOLD fMRI in patients with carotid artery stenosis before and after CEA. Our purpose was to determine whether fMRI is able to demonstrate impaired CVR and to identify patient parameters that are associated with postoperative changes of cerebral hemodynamics.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Nineteen consecutive patients with symptomatic (&lt;i&gt;n&lt;/i&gt; = 13) and asymptomatic (&lt;i&gt;n&lt;/i&gt; = 6) stenosis of the ICA were prospectively recruited (male/female ratio = 16:3; age, 69 ± 8,1 years). fMRI using a simple bilateral motor task was performed immediately before and after CEA.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;Mean BOLD MSC was significantly increased postoperatively (MSC, 0.13 ± 0.66; &lt;i&gt;P&lt;/i&gt; = 0.0002). Patients with a stenosis of &amp;lt;80% demonstrated an increase in MSC (MSC, 0.32 ± 0.59; &lt;i&gt;P&lt;/i&gt; ≤ .0001). Patients with previous ischemic stroke showed a larger MSC than patients with TIAs (stroke: MSC, 0.55 ± 0.65; &lt;i&gt;P&lt;/i&gt; ≤ .0001; TIA: MSC, 0.05 ± 0.26; &lt;i&gt;P&lt;/i&gt; = 0.054). Patients older than 70 years had a significantly larger MSC following surgery (≤70 years: MSC, −0.01 ± 0.39; &lt;i&gt;P&lt;/i&gt; = .429; &amp;gt;70 years: MSC, 0.29 ± 0.48; &lt;i&gt;P&lt;/i&gt; ≤ .0001).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;BOLD fMRI can demonstrate changes in cerebral hemodynamics before and after CEA, indicative of an ameliorated CVR. This response is dependent on the age of the patient, the degree of preoperative stenosis, and the patient9s symptoms.&lt;/p&gt;" />
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<meta name="twitter:title" content="Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Significant extracranial stenosis of the ICA is a known risk factor for future stroke and it has been shown that revascularization reduces the risk of future stroke. We applied BOLD fMRI in patients with carotid artery stenosis before and after CEA. Our purpose was to determine whether fMRI is able to demonstrate impaired CVR and to identify patient parameters that are associated with postoperative changes of cerebral hemodynamics.

MATERIALS AND METHODS: Nineteen consecutive patients with symptomatic ( n = 13) and asymptomatic ( n = 6) stenosis of the ICA were prospectively recruited (male/female ratio = 16:3; age, 69 ± 8,1 years). fMRI using a simple bilateral motor task was performed immediately before and after CEA.

RESULTS: Mean BOLD MSC was significantly increased postoperatively (MSC, 0.13 ± 0.66; P = 0.0002). Patients with a stenosis of &lt;80% demonstrated an increase in MSC (MSC, 0.32 ± 0.59; P ≤ .0001). Patients with previous ischemic stroke showed a larger MSC than patients with TIAs (stroke: MSC, 0.55 ± 0.65; P ≤ .0001; TIA: MSC, 0.05 ± 0.26; P = 0.054). Patients older than 70 years had a significantly larger MSC following surgery (≤70 years: MSC, −0.01 ± 0.39; P = .429; &gt;70 years: MSC, 0.29 ± 0.48; P ≤ .0001).

CONCLUSIONS: BOLD fMRI can demonstrate changes in cerebral hemodynamics before and after CEA, indicative of an ameliorated CVR. This response is dependent on the age of the patient, the degree of preoperative stenosis, and the patient's symptoms.

AF
:   amaurosis fugax
asymp
:   asymptomatic
BOLD
:   blood oxygen level–dependent
CBF
:   cerebral blood flow
CBV
:   cerebral blood volume
CEA
:   carotid endarterectomy
CO2
:   carbon dioxide
CPP
:   cerebral perfusion pressure
CVR
:   cerebrovascular reactivity
DWI
:   diffusion-weighed imaging
FLAIR
:   fluid-attenuated inversion recovery
fMRI
:   functional MR imaging
ICA
:   internal carotid artery
MRI
:   MR imaging
MSC
:   mean SC
N/A
:   not applicable
Pre
:   before
Post
:   after
SC
:   signal-intensity change
symp
:   symptomatic
T2WI
:   T2-weighted imaging
TIA
:   transient ischemic attack" />
<meta name="og-title" property="og:title" content="Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/31/10/1791" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Significant extracranial stenosis of the ICA is a known risk factor for future stroke and it has been shown that revascularization reduces the risk of future stroke. We applied BOLD fMRI in patients with carotid artery stenosis before and after CEA. Our purpose was to determine whether fMRI is able to demonstrate impaired CVR and to identify patient parameters that are associated with postoperative changes of cerebral hemodynamics.

MATERIALS AND METHODS: Nineteen consecutive patients with symptomatic ( n = 13) and asymptomatic ( n = 6) stenosis of the ICA were prospectively recruited (male/female ratio = 16:3; age, 69 ± 8,1 years). fMRI using a simple bilateral motor task was performed immediately before and after CEA.

RESULTS: Mean BOLD MSC was significantly increased postoperatively (MSC, 0.13 ± 0.66; P = 0.0002). Patients with a stenosis of &lt;80% demonstrated an increase in MSC (MSC, 0.32 ± 0.59; P ≤ .0001). Patients with previous ischemic stroke showed a larger MSC than patients with TIAs (stroke: MSC, 0.55 ± 0.65; P ≤ .0001; TIA: MSC, 0.05 ± 0.26; P = 0.054). Patients older than 70 years had a significantly larger MSC following surgery (≤70 years: MSC, −0.01 ± 0.39; P = .429; &gt;70 years: MSC, 0.29 ± 0.48; P ≤ .0001).

CONCLUSIONS: BOLD fMRI can demonstrate changes in cerebral hemodynamics before and after CEA, indicative of an ameliorated CVR. This response is dependent on the age of the patient, the degree of preoperative stenosis, and the patient's symptoms.

AF
:   amaurosis fugax
asymp
:   asymptomatic
BOLD
:   blood oxygen level–dependent
CBF
:   cerebral blood flow
CBV
:   cerebral blood volume
CEA
:   carotid endarterectomy
CO2
:   carbon dioxide
CPP
:   cerebral perfusion pressure
CVR
:   cerebrovascular reactivity
DWI
:   diffusion-weighed imaging
FLAIR
:   fluid-attenuated inversion recovery
fMRI
:   functional MR imaging
ICA
:   internal carotid artery
MRI
:   MR imaging
MSC
:   mean SC
N/A
:   not applicable
Pre
:   before
Post
:   after
SC
:   signal-intensity change
symp
:   symptomatic
T2WI
:   T2-weighted imaging
TIA
:   transient ischemic attack" />
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      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Functional</span></span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-series highwire-cite-metadata">E</span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">M. Schaaf</span>, <span class="highwire-citation-author" data-delta="1">G. Mommertz</span>, <span class="highwire-citation-author" data-delta="2">A. Ludolph</span>, <span class="highwire-citation-author" data-delta="3">S. Geibprasert</span>, <span class="highwire-citation-author" data-delta="4">G. Mühlenbruch</span>, <span class="highwire-citation-author" data-delta="5">M. Das</span> and <span class="highwire-citation-author" data-delta="6">T. Krings</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 2010,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1791-1798; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A2219 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-9691--6851824000" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">M. Schaaf </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BSchaaf%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Schaaf%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.%2BSchaaf%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">G. 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<p id="p-3"><strong>BACKGROUND AND PURPOSE:</strong> Significant extracranial stenosis of the ICA is a known risk factor for future stroke and it has been shown that revascularization reduces the risk of future stroke. We applied BOLD fMRI in patients with carotid artery stenosis before and after CEA. Our purpose was to determine whether fMRI is able to demonstrate impaired CVR and to identify patient parameters that are associated with postoperative changes of cerebral hemodynamics.</p>
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<p id="p-4"><strong>MATERIALS AND METHODS:</strong> Nineteen consecutive patients with symptomatic (<em>n</em> = 13) and asymptomatic (<em>n</em> = 6) stenosis of the ICA were prospectively recruited (male/female ratio = 16:3; age, 69 ± 8,1 years). fMRI using a simple bilateral motor task was performed immediately before and after CEA.</p>
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<p id="p-5"><strong>RESULTS:</strong> Mean BOLD MSC was significantly increased postoperatively (MSC, 0.13 ± 0.66; <em>P</em> = 0.0002). Patients with a stenosis of &lt;80% demonstrated an increase in MSC (MSC, 0.32 ± 0.59; <em>P</em> ≤ .0001). Patients with previous ischemic stroke showed a larger MSC than patients with TIAs (stroke: MSC, 0.55 ± 0.65; <em>P</em> ≤ .0001; TIA: MSC, 0.05 ± 0.26; <em>P</em> = 0.054). Patients older than 70 years had a significantly larger MSC following surgery (≤70 years: MSC, −0.01 ± 0.39; <em>P</em> = .429; &gt;70 years: MSC, 0.29 ± 0.48; <em>P</em> ≤ .0001).</p>
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<p id="p-6"><strong>CONCLUSIONS:</strong> BOLD fMRI can demonstrate changes in cerebral hemodynamics before and after CEA, indicative of an ameliorated CVR. This response is dependent on the age of the patient, the degree of preoperative stenosis, and the patient's symptoms.</p>
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</div><div class="section glossary" id="glossary-1"><h2>Abbreviations</h2><dl id="def-list-1"><dt id="def-item-1">AF<span class="def-item-dt-sep"></span></dt><dd>amaurosis fugax<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">asymp<span class="def-item-dt-sep"></span></dt><dd>asymptomatic<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">BOLD<span class="def-item-dt-sep"></span></dt><dd>blood oxygen level–dependent<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">CBF<span class="def-item-dt-sep"></span></dt><dd>cerebral blood flow<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">CBV<span class="def-item-dt-sep"></span></dt><dd>cerebral blood volume<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">CEA<span class="def-item-dt-sep"></span></dt><dd>carotid endarterectomy<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">CO<sub>2</sub><span class="def-item-dt-sep"></span></dt><dd>carbon dioxide<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">CPP<span class="def-item-dt-sep"></span></dt><dd>cerebral perfusion pressure<span class="def-item-dd-sep"></span></dd><dt id="def-item-9">CVR<span class="def-item-dt-sep"></span></dt><dd>cerebrovascular reactivity<span class="def-item-dd-sep"></span></dd><dt id="def-item-10">DWI<span class="def-item-dt-sep"></span></dt><dd>diffusion-weighed imaging<span class="def-item-dd-sep"></span></dd><dt id="def-item-11">FLAIR<span class="def-item-dt-sep"></span></dt><dd>fluid-attenuated inversion recovery<span class="def-item-dd-sep"></span></dd><dt id="def-item-12">fMRI<span class="def-item-dt-sep"></span></dt><dd>functional MR imaging<span class="def-item-dd-sep"></span></dd><dt id="def-item-13">ICA<span class="def-item-dt-sep"></span></dt><dd>internal carotid artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-14">MRI<span class="def-item-dt-sep"></span></dt><dd>MR imaging<span class="def-item-dd-sep"></span></dd><dt id="def-item-15">MSC<span class="def-item-dt-sep"></span></dt><dd>mean SC<span class="def-item-dd-sep"></span></dd><dt id="def-item-16">N/A<span class="def-item-dt-sep"></span></dt><dd>not applicable<span class="def-item-dd-sep"></span></dd><dt id="def-item-17">Pre<span class="def-item-dt-sep"></span></dt><dd>before<span class="def-item-dd-sep"></span></dd><dt id="def-item-18">Post<span class="def-item-dt-sep"></span></dt><dd>after<span class="def-item-dd-sep"></span></dd><dt id="def-item-19">SC<span class="def-item-dt-sep"></span></dt><dd>signal-intensity change<span class="def-item-dd-sep"></span></dd><dt id="def-item-20">symp<span class="def-item-dt-sep"></span></dt><dd>symptomatic<span class="def-item-dd-sep"></span></dd><dt id="def-item-21">T2WI<span class="def-item-dt-sep"></span></dt><dd>T2-weighted imaging<span class="def-item-dd-sep"></span></dd><dt id="def-item-22">TIA<span class="def-item-dt-sep"></span></dt><dd>transient ischemic attack</dd></dl></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">Copyright © American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/31/10/1791.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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      <div class="highwire-cite-title">Functional MR Imaging in Patients with Carotid Artery Stenosis before and after Revascularization</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Schaaf</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Mommertz</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Ludolph</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Geibprasert</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Mühlenbruch</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Das</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Krings</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1791-1798; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2219 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Schaaf</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Mommertz</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">A.</span> <span class="nlm-surname">Ludolph</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Geibprasert</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">G.</span> <span class="nlm-surname">Mühlenbruch</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Das</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">T.</span> <span class="nlm-surname">Krings</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 2010, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">31 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1791-1798; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A2219 </span></div>
  
  
  
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