Cerebrovascular reactivity mapping: an evolving standard for clinical functional imaging.

Area of Science:

• Neuroimaging
• Vascular Neurology
• Functional MRI

Background:

• Clinical functional MRI (fMRI) is vital for presurgical planning.
• Neurovascular uncoupling, a limitation in fMRI, can occur with brain lesions affecting hemodynamics.
• Assessing cerebrovascular reactivity is key to understanding brain function and disease.

Purpose of the Study:

• To detail the methodology of breath-hold cerebrovascular reactivity mapping.
• To review its applications in presurgical mapping and quality control for fMRI.
• To discuss exogenous carbon dioxide challenges for evaluating cerebrovascular reserve and disease.

Main Methods:

• Explains acquisition and analysis techniques for breath-hold cerebrovascular reactivity mapping.
• Reviews blood oxygen level-dependent (BOLD) fMRI applications.
• Details the use of exogenous carbon dioxide challenges.

Main Results:

• Breath-hold cerebrovascular reactivity mapping is essential for quality control in clinical fMRI.
• It helps assess the potential for neurovascular uncoupling, a significant limitation.
• The method is particularly important for presurgical mapping of eloquent cortex.

Conclusions:

• Breath-hold cerebrovascular reactivity mapping is an indispensable tool for presurgical fMRI.
• It aids in identifying and mitigating the risks of neurovascular uncoupling.
• This technique improves the reliability of fMRI for patients with brain tumors or vascular malformations.