Cerebral Perfusion Features in Takayasu Arteritis: Insights From pCASL MRI

Area of Science:

• Neuroimaging
• Vascular Medicine
• Radiology

Background:

• Takayasu arteritis (TA) is a large vessel vasculitis that can affect cerebral arteries, leading to potential neurological complications.
• Assessing cerebral perfusion is crucial for understanding the impact of TA on brain function.
• Pseudo-continuous arterial spin labeling (pCASL) MRI offers a non-invasive method to evaluate cerebral hemodynamics.

Purpose of the Study:

• To investigate cerebral perfusion characteristics in patients with Takayasu arteritis (TA) affecting brain blood supply arteries using pCASL MRI.
• To compare cerebral blood flow (CBF) and arterial transit time (ATT) between TA patients and healthy controls.
• To explore the relationship between perfusion deficits and clinical factors in TA patients.

Main Methods:

• pCASL-MRI was employed to measure whole-brain and regional CBF and ATT in 75 healthy women and 18 female TA patients.
• Statistical analyses, including independent sample t-tests or Mann-Whitney U tests, were used to compare groups.
• TA patients were analyzed based on history of cerebral infarction, disease duration, activity, and lesion extent.

Main Results:

• TA patients exhibited significantly lower whole-brain and regional CBF and longer ATT compared to healthy controls (p < 0.05).
• No significant differences in CBF or ATT were observed between TA patients with and without a history of cerebral infarction.
• TA patients with vertebral artery lesions of grade 3 or higher showed significantly lower CBF and longer ATT than those with less severe lesions.

Conclusions:

• Patients with TA and moderate to severe supra-aortic/intracranial artery lesions experience significant cerebral perfusion deficits.
• The degree of vertebral artery involvement is a key factor associated with reduced cerebral perfusion in TA.
• pCASL-MRI is a promising tool for the non-invasive, convenient, and dynamic assessment of cerebral perfusion in TA.