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Updated: Nov 18, 2025

MRI Mapping of Cerebrovascular Reactivity via Gas Inhalation Challenges
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Cerebrovascular Reactivity Mapping Without Gas Challenges: A Methodological Guide.

Joana Pinto1,2, Molly G Bright3,4, Daniel P Bulte1

  • 1Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom.

Frontiers in Physiology
|February 4, 2021
PubMed
Summary
This summary is machine-generated.

Cerebrovascular reactivity (CVR) mapping using MRI can be performed without gas challenges by analyzing spontaneous breathing fluctuations. This review provides guidelines for these methods, promoting wider clinical and academic use.

Keywords:
MRIbreath-holdcerebrovascular reactivitypaced deep breathingresting-state

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Area of Science:

  • Neuroimaging and neuroscience
  • Cardiovascular and cerebrovascular research

Background:

  • Cerebrovascular reactivity (CVR) measures the ability of cerebral blood vessels to change caliber, impacting regional cerebral blood flow (CBF).
  • CVR is a potential biomarker for cerebrovascular pathologies and is crucial for functional MRI studies relying on neurovascular coupling.
  • Traditional CVR assessment often involves external vasoactive stimuli like hypercapnia (elevated CO2), requiring complex equipment and potentially limiting accessibility.

Purpose of the Study:

  • To review Magnetic Resonance Imaging (MRI) techniques for Cerebrovascular Reactivity (CVR) mapping that utilize spontaneous breathing fluctuations instead of external gas challenges.
  • To focus on the methodological aspects of breathing protocols and data analysis for non-gas-challenge CVR mapping.
  • To provide practical guidelines for the application of these CVR mapping techniques in clinical and academic settings.

Main Methods:

  • Extensive literature review of MRI-based CVR mapping techniques.
  • Focus on methods employing spontaneous breathing variations (e.g., breath holding, paced deep breathing, resting-state fluctuations) as alternatives to CO2 challenges.
  • Analysis of methodological aspects including breathing protocols and data processing strategies.

Main Results:

  • Existing literature lacks definitive consensus on optimal protocols for non-gas-challenge CVR assessment.
  • Spontaneous breathing fluctuations offer a viable alternative to traditional gas challenges for CVR mapping.
  • Methodological variations in breathing tasks and data analysis impact CVR measurement reliability.

Conclusions:

  • CVR mapping without gas challenges is feasible and offers advantages in terms of accessibility and patient tolerance.
  • Standardized guidelines are needed to ensure consistent and reliable application of these techniques.
  • This review provides practical recommendations to facilitate wider adoption of CVR mapping in research and clinical practice.