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Interrogating the Functional Correlates of Collateralization in Patients with Intracranial Stenosis Using Multimodal
B A Roach1, M J Donahue2, L T Davis1
1From the Departments of Radiology and Radiological Sciences (B.A.R., M.J.D., L.T.D., C.C.F., D.A., T.R.L., A.O.S., M.K.S.).
AJNR. American Journal of Neuroradiology
|April 9, 2016
Summary
Assessing collateral vessels in cerebral perfusion is key. This study found collateral presence on digital subtraction angiography strongly correlates with reduced cerebrovascular reactivity, especially in nonatherosclerotic conditions.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Cerebral perfusion maintenance via collateralization is crucial but difficult to measure noninvasively.
- Assessing collateral flow is vital for understanding stroke and related conditions.
Purpose of the Study:
- To correlate baseline perfusion, arterial transit time, cerebrovascular reactivity, and collateral vessels on digital subtraction angiography (DSA).
- To investigate the relationship between collateral vessels seen on arterial spin-labeling MRI and DSA with cerebrovascular reactivity.
Main Methods:
- Compared collateral vessels on DSA with blood oxygen level-dependent (BOLD) MRI measures of hypercapnic cerebrovascular reactivity in 18 patients with symptomatic intracranial stenosis.
- DSA and arterial spin-labeling (ASL) MRI maps were scored to quantify collateralization and perfusion.
Main Results:
- Collateral vessel presence on DSA strongly correlated with decreased cerebrovascular reactivity (P < .001) in ASL regions with normal-to-high signal.
- This correlation was most prominent in nonatherosclerotic disease.
- A trend suggested increasing cerebrovascular reactivity with greater collateralization (P = .082).
Conclusions:
- Collateral vessels may exhibit distinct vasoreactivity compared to healthy vessels.
- This difference is most pronounced in nonatherosclerotic cerebrovascular disease.
- Findings highlight the importance of collateral assessment in cerebrovascular conditions.
