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Cerebral perfusion measured by dynamic susceptibility contrast MRI is reduced in patients with idiopathic normal

Doerthe Ziegelitz1, Göran Starck, David Kristiansen

  • 1Department of Neuroradiology, Institute of Clinical Sciences, Gothenburg, Sweden.

Journal of Magnetic Resonance Imaging : JMRI
|September 6, 2013
PubMed
Abstract

Insights

Dynamic susceptibility contrast MRI reveals reduced cerebral blood flow (CBF) in idiopathic normal pressure hydrocephalus (iNPH) patients. This reduced CBF correlates with symptom severity and predicts shunt surgery outcomes.

Area of Science:

  • Neuroimaging
  • Neurology
  • Medical Physics

Background:

  • Idiopathic normal pressure hydrocephalus (iNPH) is a neurological condition characterized by gait disturbance, urinary incontinence, and cognitive impairment.
  • Accurate diagnosis and prediction of treatment response are crucial for managing iNPH patients.

Purpose of the Study:

  • To investigate cerebral blood flow (CBF) using dynamic susceptibility contrast (DSC) MRI in iNPH patients.
  • To correlate preoperative CBF with clinical symptom severity.
  • To determine if CBF can predict the outcome of shunt surgery.

Main Methods:

  • Multi-slice DSC MRI was performed on 21 iNPH patients and 16 healthy individuals (HI).
  • Regional relative CBF (rCBF) was calculated using the occipital cortex as a reference.
  • rCBF values were analyzed for differences between groups and correlations with clinical symptoms and shunt outcomes.

Main Results:

  • iNPH patients exhibited significantly lower rCBF in multiple brain regions, including the basal medial frontal cortex, hippocampus, and periventricular white matter (PVWM), compared to HI.
  • Higher preoperative rCBF in the PVWM was associated with better performance in clinical tests.
  • Shunt responders demonstrated higher rCBF in the basal medial frontal cortex compared to non-responders.

Conclusions:

  • DSC MRI-derived perfusion measurements are a valuable diagnostic tool for iNPH.
  • Perfusion parameters obtained via DSC MRI may serve as predictors of shunt response in iNPH patients.
Keywords:
cerebral blood flowdynamic susceptibility contrast MRIidiopathic normal pressure hydrocephalusshunt response

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